J Korean Neurol Assoc.
1994 Mar;12(1):10-21.
Enhanced Detection of Inftracardiac Sources of Cerebral Emboli by Transesophageal Echocardiography
- Affiliations
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- 1Department of Neurology, Keimyung University School of medicine, Korea.
- 2Department of Internal Medicine, Keimyung University School of medicine, Korea.
Abstract
- We studied 73 patients with ischemic stroke (56 patients) and transient ischemic attacks (17 patients) to evaluate the clinical efficacy of the two techniques, tansthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). For detecting potential intracardiac sources of cerebral emboli. Group I (40 cases) patients had no clinical cardiac abnorrnality. And group II (33 cases) patients had cardiac abnormality upon clinical examination. In group I. Intracardiac abnormalities were detected in 5%(2 to 40) with TTE and 37.5%(15 to 40) with TEE, and 34.2%(13 to 38) with TEE among the patients with normal finding with TTE which was statistically significant difference. In group II. Intracardiac abnormalities were detected in 21.1%(7 to 33) with TTE and 75.8%(25 to 33) with TEE, and 69.2% (18 to 26) with TEE arnong the patients with normal finding with TTE In comparison of 40 patients uith intracardiac source of embolism by echocardiogram (group A) and 33 patients without cardiac source of embolism(group B), atrial fibrillation was observed in 12 patients in group A versus 2 in group B (p<0.01), mean atrial size was 41.5mm in group A versus 35.3mm in group B. and left ventricular hypertrophy was in lQ in group A versus 6 in group B. Territories of cerebral arteries in cerebral infarction or TlAs of 40 patients with intracardiac source of embolism showed middle cerebral artery in 32.5%, posterior cerebral artery in 25% and bilateral or multiple in l2.5%. We concluded that TEE is superior to TTE for detecting potential cardiac sources of embolism.
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