Background: Cardioembolic stroke accounts for approximately 17-30% of all strokes. For recurrence, treatment and prognosis are different from other strokes, embolism of cardiac origin need to be diagnosed by imaging tools with evidence of cardiac sources of embolism. Transthoracic and transesophageal echocardiography have allowed clinicians to better characterize cardioembolic sources and to detect other potential etiologies of embolism of cardiac origin. Cardiogenic strokes may have symptoms and signs (atrial fibrillation, rheumatic heart disease, infective endocarditis...), but may not have any symptoms and signs even normal transthoracic echocardiography in some embolism of cardiac origin (patent foramen oval, atrial septal aneurysm...).
Objective: By transthoracic and/or transesophageal echocardiography detection of cardioembolic sources in suspected cardiogenic stroke.
Method: 61 patients (57 strokes and 4 transient ischemic attacks) were suspected cardiogenic embolism with exclusion of carotid stenosis and atheroma. Transthoracic echocardiography was performed first and transesophageal echocardiography followed latter in patients who had negative finding or did not explain on transthoracic echocardiography.
Conclusion: Besides major risk cardiogenic sources, echocardiography can detect occult cardiac lesions of cardioembolic stroke. Transthoracic echocardiography has been showed to be effective in dectecting potential cardiac sources at ventricles. Combination of transthoracic and transesophageal echocardiography when necessary obtains more effective in detection of embolism of cardiac origin.