• A V Mattioli, E T Castellani, and E Casali.
• Cattedra di Cardiologia, Università degli Studi, Modena.
• Cardiologia. 1994 Feb 1; 39 (2): 101-5.

AbstractCardiac evaluation of stroke or transient ischemic attack (TIA) patients includes transthoracic and transesophageal echocardiography to identify potential cardiac source of embolism. In the present study transesophageal echocardiography was performed in 53 consecutive patients with non valvular atrial fibrillation and a previous embolic stroke. All patients were referred to our department because of an episode of atrial fibrillation. They all underwent computed tomography (CT) scan: 31 patients had a positive scan whereas 22 had a negative scan with a positive history of TIA diagnosed from a neurologist during hospitalization. In the group of 31 patients with a positive scan 9 patients with no history of a previous ischemic attack were found. The transesophageal echocardiography was performed in all the study subjects: 7 patients had a thrombus in the left atrial appendage, 2 patients had a thrombus in the right atrium. Spontaneous echo contrast was reported in 15 patients. Evaluating the interatrial septum we observed a patent foramen ovale in 4 patients, a defect in 2 patients and a fossa ovalis aneurysm in 3 patients. The mitral valve analysis showed a leaflet prolapse in 3 patients. The entire thoracic aorta was imaged in each patient: in 12 an abnormal atherosclerotic plaque was found. Transesophageal echocardiography is an important component of the comprehensive evaluation of potential sources of embolism in patients with ischemic cerebral attack and nonrheumatic atrial fibrillation.

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