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On-line version ISSN 1678-4227
Arq. Neuro-Psiquiatr. vol.64 no.4 São Paulo Dec. 2006
Transesophageal echocardiography in patients with ischemic stroke (Abstract)*. Thesis. São Paulo, 2005.
Marcia Maiumi Fukujima**
The clinical protocol "Transesophageal echocardiography and treatment with aspirin in patients with ischemic stroke" is going on, and, as an inicial part of it, we present the article "Transesophageal echocardiography discloses unexpected cardiac sources of embolus in stroke patients aged more than 45 years". Cerebral embolism from cardiac source is an important cause of stroke, specially in patients younger than 45 years old.
OBJECTIVE: To describe the TEE findings in young and no-young stroke patients without any prior evidence of cardiac source for cerebral embolism.
METHOD: Transversal study. 523 patients (267 men and 256 women) with ischemic stroke, without any evidence of cardiac abnormality, underwent to transesophageal echocardiography (TEE).
RESULTS: Ten percent were aged 45 years or less. Left ventricle hypertrophy, left atrial enlargement, spontaneous contrast in aorta, interatrial septum aneurysm, mitral and aortic valve calcification, aortic valve regurgitation, and atherosclerotic plaques in aorta were significantly more frequent in patients aged more than 45 years. 2.8% of no-young patients had thrombus in left heart.
CONCLUSION: TEE is widely used to diagnose cardiac source of cerebral embolism in young patients, but it seems to be as useful for older ones, in whom cerebral embolism risk is underestimated; atherogenic and cardioembolic causes may actually coexist, and both should be treated.
Key words: stroke, cardiac embolism, transesophageal echocardiogram, elderly.
* Ecocardiograma transesofágico em pacientes com acidente vascular cerebral isquêmico (Resumo). Tese de Doutorado. Universidade Federal de São Paulo - Escola Paulista de Medicina, (Área: Ciências / Neurologia). Orientador: Alberto Alain Gabbai; Co-Orientador: Gilmar Fernandes do Prado.
** Addess: Rua Dr. Diogo de Faria 1298/32, 04037-005 São Paulo SP, Brasil. E-mail: firstname.lastname@example.org