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2012, Number 4

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Rev Cub Med Int Emerg 2012; 11 (4)

Transesophageal echocardiogram and cardioembolic stroke

Wong VL, Blanco VE, Chávez EJA, Chao CL, Gómez SA

Language: Spanish
References: 79
Page: 2551-2575
PDF size: 255.05 Kb.


ABSTRACT

Introduction: Transesophageal echocardiography (TEE) is more sensitive than transthoracic echocardiography for detecting emboli source mainly in patients without clinical evidence of heart disease.
Objectives: To describe the findings obtained by transesophageal echocardiography as a tool for the etiological diagnosis of cardioembolic stroke.
Methods: Between January 1st and December 31st of 2009 a descriptive, prospective and cross-sectional study was performed. The universe consisted of 42 patients admitted to the intermediate care unit of the University Hospital of Medicine "General Calixto Garcia". The variables studied were: true diagnosis of cardiac pathologies potentially embolic -and embolic conditions-, atrial fibrillation (AF) and its relationship with thrombus in the left atrium (LA), spontaneous echo contrast in the left atrial appendage (LAA), left atrial diameter and flow rate of the LAA.
Results: Of the 42 patients studied with cardioembolic stroke, 57,1 % had cardiac embolic sources, the true diagnoses were thrombus located in left atrium or left ventricle (50 % each), 30 % of the patients had spontaneous echo contrast in the LAA, 52 % of patients had AF and 72,7 % of them had no thrombus in LA neither spontaneous echo in the LAA. In addition, 54.5 % of patients with AF had a left atrial diameter less than or equal to 45 mm.
Conclusions: The finding that prevailed in the study was the presence of cardioembolic source diagnosed by TEE. Of all patients with a true diagnosis of cardioembolic heart pathologies found by TEE, half showed thrombus in the left atrium and the other half in the left ventricle.


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