Background- Stroke is one of the most common causes of death and an important ‎cause of disability. Detection and correct diagnosis of the source of emboli influences ‎our recommendations and therapeutic outcome. There have been concerns regarding ‎the routine use of transesophageal echocardiography (TEE) in these patients. This ‎study examined the preference of TEE over transthoracic echocardiography (TTE) in ‎the detection of cardiac embolic sources in patients suffering ischemic stroke.
‎ Methods- The study population comprised 50 consecutive patients referred to the ‎echocardiography laboratories for TEE with a diagnosis of stroke or transient ‎ischemic attack from Sep. 2001 through Nov. 2002. All the patients underwent both ‎TTE and TEE.
‎ Results- There were 26 men and 24 women with a mean age of 40 ± 11.8 years. ‎Forty-three patients (86%) were in sinus rhythm and 7 (14%) in atrial fibrillation. ‎With TTE data, we were able to detect embolic sources with cardiac origin in 9 (18%) ‎patients. When we added TEE examination, we found cardiac embolic sources in a ‎further 17 (34%) patients. Finally, with TEE added to TTE, the total number of these ‎patients rose from 9 to 26 (52%). This means TEE has significantly greater sensitivity ‎than TTE in the detection of cardiac embolic sources in patients with ischemic ‎stroke‏.‏‎
‎ Conclusions- The present study suggests that the type of embolic source detectable by ‎TEE may not reasonably be predicted on the basis of TTE findings; therefore, for the ‎detection of embolic sources, TEE is preferred to TTE (Iranian Heart Journal 2003; 4 ‎‎(2,3):4349).‎