Role of Echocardiography in Assessment of Cardioembolic Sources: a Strong Diagnostic Resource in Patients with Ischemic Stroke
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Purpose of Review
This review will discuss the most frequent sources of cardiac embolism and the role of echocardiography in these different clinical settings, and, in addition, provide suggestions about the choice between transthoracic (TTE) and transesophageal echocardiography (TEE).
Stroke is the third leading cause of death in industrial countries, and 15–40% of all ischemic strokes are due to cardioembolism. TTE and TEE are cornerstones in the detection of cardioembolic sources and provide fundamental information about the embolic risk and most suitable treatment of these patients, improving long-term outcomes.
Echocardiography is a widely available, inexpensive, and safe diagnostic tool that is almost free from contraindication, and these elements allow the common use of this technique in almost all the patients with ischemic stroke. The most common cardioembolic sources include left atrial appendage thrombosis during atrial fibrillation; vegetations in infective endocarditis; cardiac masses including left ventricular thrombosis, cardiac tumors, etc.; atherosclerotic plaques; and passageways within the heart serving as conduits for paradoxical embolization, e.g., patent foramen ovale.
KeywordsStroke Cardioembolic sources Endocarditis Atrial fibrillation Thrombus Echocardiography
The authors are grateful to Jennifer Pfaff and Susan Nord of Aurora Cardiovascular Services for editorial preparation of the manuscript.
Compliance with Ethical Standards
Conflict of Interest
Luca Longobardo, Concetta Zito, Scipione Carerj, Giuseppe Caracciolo, Matt Umland, and Bijoy K. Khandheria declare that they have no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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