Transesophageal Echocardiographic Findings in Stroke Subtypes

J Korean Neurol Assoc > Volume 13(4); 1995 > Article

Journal of the Korean Neurological Association 1995;13(4): 825-832.

뇌졸중의 유형에 따른 경식도 초음파도 소견

양대웅, 김종성, 이재홍

울산대학교 서울중앙병원 신경과

Transesophageal Echocardiographic Findings in Stroke Subtypes

Dae Woong Yang, M.D., Jong Sung Kim, M.D., Jae Hong Lee, M.D.

Department of Neurology, College of Medicine, University of Ulsan, Asan Medical Center

Abstract

Although transesophageal echocardiography (TEE) is known to be useful in detecting a possible embolic source in patients with ischemic stroke, its usefulness in various stroke subtypes remains still uncertain. We reviewed the clinical findings and TEE records of 191 patients with various stroke subtypes. We classified them into four stroke subtypes- cardiac embolism, lacunar infarct, large artery disease and stroke of unclear etiology. TEE parameters such as left atrial thrombus, spontaneous echo contrast, atrial septal aneurysm, interatrial shunts, ventricular thrombus or aneurysm, myxomatous mitral valve or mitral valve prolapse and atheromatous plaque on ascending aorta or aortic arch were compared among different stroke subtypes. The yield of TEE was subtantial in all stroke subtypes. Left atrial thrombi and spontaneous echo contrast were frequent in patients with high-risk cardiac embolism-21.4% and 42.9%, respectively, whereas only one patient had spontaneous echo contrast in other subtypes. Interatrial shunt was common in all stroke subtypes and was found more frequently in stroke of unclear etiology (42. 9%) compared to other subtypes (27. 2%) (P=O. 02, X2). Other parameters were detected in only a few patients. TEE seems to be a useful procedure in patients with high-risk cardiac embolism, and the clinical significance of interatrial shunt in patients with stroke of unclear etiology remains to be determined.