[Cardiac and arterial causes of transient monocular blindness]

It has been accepted that transient monocular blindness (TMB) is highly suggestive of an ipsilateral carotid artery lesion in patients with arterial risk factors. We confirmed this in 55 patients, who had an internal carotid artery severe stenosis, occlusion or ulceration on angiography in more than 50 per cent of the cases. However, 12-lead-ECG, 2 D--echocardiography and Holter monitoring also showed a potential cardiac source of emboli in 22 per cent of the patients. Most of these patients (83 per cent) also had an appropriate arterial lesion, and the exact cause of the episodes of TMB remained undetermined. Our study shows that every fourth of fifth patient with TMB may have a potential cardiac source of emboli, the detection of which could alter the management. Systematic non-invasive cardiac investigations are warranted, especially in TMB patients with known heart disease.