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Echocardiography in patients with acute cerebral events
Insights
Echocardiography screening for heart conditions in acute stroke patients has limited value. The study found a low yield for detecting conditions like mitral valve prolapse, suggesting it should be reserved for select cases.
Area of Science:
- Cardiology
- Neurology
- Diagnostic Imaging
Background:
- Acute cerebral events, such as transient ischemic attacks and cerebral infarctions, can be linked to underlying cardiac conditions.
- Echocardiography is a common diagnostic tool for evaluating cardiac health.
Purpose of the Study:
- To assess the clinical and economic feasibility of using echocardiography for screening cardiac disease in patients experiencing acute cerebral events.
- To determine the diagnostic yield of M-mode and two-dimensional echocardiography in this patient population.
Main Methods:
- M-mode and two-dimensional echocardiograms were recorded in 170 patients presenting with symptoms of acute cerebral events.
- Patients included those with transient ischemic attacks or cerebral infarctions.
Main Results:
- Of 170 patients, 96 (56%) had normal echocardiographic findings.
- 74 patients (43%) exhibited cardiac disorders potentially related to their cerebral event.
- Only a small number of patients were diagnosed with specific conditions like mitral valve prolapse (4) or cardiac thrombosis/vegetation (7).
Conclusions:
- M-mode and two-dimensional echocardiography demonstrated limited value as a screening tool for excluding specific cardiac conditions like mitral valve prolapse or thrombosis in patients with acute cerebral events.
- While associated cardiac disorders were identified, the overall low diagnostic yield does not support routine screening.
- Echocardiographic screening should be reserved for carefully selected patients with specific indications.
Abstract:
The question of the clinical and economic feasibility of echocardiographic screening for cardiac disease in patients with symptoms of acute cerebral events was assessed by recording M-mode and two-dimensional (2D) echocardiograms in 170 patients. Patients with transient ischemic attacks or cerebral infarctions were included. Of the patients with satisfactory echocardiograms, 96 (56%) had normal diagnostic findings; 74 (43%) had cardiac disorders possibly related to the acute cerebral event. There were 4 patients who fulfilled the standard criteria for mitral valve prolapse and 7 patients who were identified as having probable cardiac thrombosis or vegetation, or both. Thus, M-mode and two-dimensional echocardiography was of limited value in patients referred for these studies for screening to exclude mitral valve prolapse and cardiac thrombosis or vegetation. Although a diverse range of cardiac disorders was demonstrated that may be associated with cerebral ischemia, the overall low yield does not support such screening and should be reserved for selected patients.