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The increasing role of transesophageal echocardiography in unexplained cerebral ischemia
1Department of Internal Medicine, Division of Cardiology, Saint Louis University Medical Center, Missouri 63110.
Insights
Transesophageal echocardiography (TEE) helps identify cardiac causes of stroke, such as clots and atrial septum issues. This advanced imaging may guide treatment for patients with unexplained cerebral ischemia.
Area of Science:
- Cardiology
- Neurology
- Medical Imaging
Context:
- Cerebrovascular disease is a major cause of death and disability.
- Cardiac embolism is a significant cause of cerebral infarction.
- Transesophageal echocardiography (TEE) is increasingly utilized for stroke evaluation.
Purpose:
- To highlight the role of TEE in diagnosing cardiac sources of cerebral ischemia.
- To detail the diagnostic capabilities of TEE for various cardiac abnormalities.
- To present preliminary findings on TEE's impact on clinical management.
Summary:
- TEE offers high sensitivity for detecting left atrial and appendage thrombi.
- TEE effectively visualizes atrial septum abnormalities like PFO and aneurysms.
- TEE clearly identifies aortic and valvular abnormalities, both native and prosthetic.
Impact:
- TEE may significantly influence clinical decision-making for stroke patients.
- Improved detection of cardiac sources can lead to more targeted stroke prevention strategies.
- Enhanced visualization aids in understanding complex cerebrovascular events.
Abstract:
Cerebrovascular disease is a leading cause of morbidity and mortality in the United States. A significant number of cerebral infarctions are due to a cardiac source of embolus. Transesophageal echocardiography (TEE) is being used with increasing frequency to study patients with potential cardiac causes of cerebral ischemia. TEE has a higher sensitivity for detecting left atrial and left atrial appendage thrombi and for visualizing abnormalities of the atrial septum such as patent foramen ovale and aneurysm. Abnormalities of the aorta and native and prosthetic valves can now be clearly identified by TEE. Preliminary data suggest that TEE may influence clinical management in patients with unexplained stroke.