Related Experiment Videos
Aortic plaque in patients with brain ischemia: diagnosis by transesophageal echocardiography
D R Horowitz1, S Tuhrim, J Budd
1Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029.
Insights
Mobile aortic plaque projections were identified in 4% of patients with brain ischemia. This finding suggests a previously underdiagnosed embolic source easily visualized by transesophageal echocardiography.
Area of Science:
- Cardiology
- Neurology
- Vascular Imaging
Background:
- Brain ischemia necessitates identifying embolic sources for effective treatment.
- Transesophageal echocardiography (TEE) is a key diagnostic tool for cardiac and vascular assessments.
Purpose of the Study:
- To investigate the prevalence and characteristics of mobile aortic plaque as a source of cerebral embolism.
- To assess the utility of TEE in visualizing these aortic plaque projections.
Main Methods:
- Evaluated 183 patients presenting with brain ischemia.
- Utilized transesophageal echocardiography with comprehensive thoracic aorta imaging.
- Identified and characterized mobile, frond-like aortic plaque projections.
Main Results:
- Mobile aortic plaque was found in 7 (4%) of patients.
- Plaque originated from the ascending aorta/transverse arch junction (6 patients) or aortic root (1 patient).
- Associated acute events included cerebral infarction (5 patients) and transient ischemic attack (2 patients).
Conclusions:
- Mobile aortic plaque is a potential, underdiagnosed source of cerebral embolism.
- Transesophageal echocardiography effectively visualizes these aortic abnormalities.
- Identifying this plaque can improve stroke risk stratification and management.
Abstract:
We evaluated 183 patients with brain ischemia for an embolic source, using transesophageal echocardiography with extensive imaging of the thoracic aorta. There were mobile, frond-like projections of aortic plaque in seven (4%) patients. The plaque originated on a wide base on the posterior aspect of the ascending aorta at its junction with the transverse arch in six patients, and on the aortic root in one. The acute event was a cerebral infarction in five patients, and a transient ischemic attack in two. This type of aortic plaque could be a previously underdiagnosed source of cerebral embolism that is now easily visualized by transesophageal echocardiography.