The Correlation of TEE Results with Cardiac Examination, ECG, and TTE in Ischemic Stroke Patients

Abstract

Scientific background and aim: Transesophageal echocardiography (TEE) is used for young patients with ischemic stroke and for those with ischemic stroke of undetermined etiology. It is not known clearly which of the clinical and laboratory findings mark an abnormality ascertained with TEE. The aim of this study was to assess the correlation of the abnormal findings by TEE with cardiac history, cardiac examination, electrocardiography (ECG) and transthoracic echocardiography (TTE) findings.Material and Methods: The files of the patients who were admitted with ischemic stroke and underwent diagnostic tests to determine stroke etiology in last three years were reviewed. Fifty patients aged from 27 to 87 years who completed the investıgations including cardiac history, cardiac examination, ECG, TTE, and TEE were included in the study. We evaluated the correlation of TEE findings with the abnormalities ascertained by cardiac history, cardiac examination, ECG and TTE.Results: Both cardiac history-examination and ECG were normal in 15 cases. Eight of these cases had TTE abnormalities and 9 cases had TEE abnormalities. TEE abnormalities were found in %95,5 of the cases who had atrial fibrillation and most of them had spontaneous echo contrast (SEC) in the left atrium. Thirthynine cases had TEE abnormalities and only 3 of them had normal TTE. The abnormal finding on TEE in these three patients was patent foramen ovale (PFO). Left atrial size was larger in the patients who had thrombus or SEK in the left atrium (p=0,001). Four cases (%8) were switched to anticogulant treatment after TEE and nane of them had abnormal findings in cardiac history, cardiac examination, ECG or TTE.Conclusion: Echocardiography may show abnormalities although the cardiac history-examination and ECG findings are normal. PFO is the most seen abnormality by TEE in the cases who have normal TTE. SEK and thrombus were found more frequently in the patients with a left atrium size of >4 cm. TEE may give valuable results that changes treatment strategy in the patients who had no cardiac illness or ECG abnormalities.