Systemic embolisation resulting in transient ischemic neurological attack, embolic stroke or peripheral gangrene is a common entity seen in practice. Left heart along with aorta and carotids have been implicated in these patients. Echocardiographic examination provides a useful and definitive information in majority of these cases.

Left atrial, appendicular and left ventricular thrombi, vegetations on native or prosthetic valves, mitral valve prolapse, atrial septal aneurysm, annular calcifications, patent foramen ovale, septal defects, cardiac tumors, can all be imaged rapidly with routine transthoracic and transesophageal examination.

Protruding atheromatous plaques in aorta and carotids can be visualized successfully during the same examination.

Intra-operative monitoring with transesophageal echo during device closure procedures for PFO or septal defects can ensure the total success of the procedure.

Echocardiography only demonstrates a potential cardiac source of embolus. Negative finding does not rule out cardiogenic embolism, positive finding does not prove that it is the cause as some of these conditions may be present is otherwise normal asymptomatic healthy population.