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Echocardiography in Diagnostic Assessment of Stroke

PHILIP GREENLAND, M. D.; DAVID S. KNOPMAN, M.D.; FRANK L. MIKELL, M.D.; RICHARD W. ASINGER, M.D.; DAVID C. ANDERSON, M.D.; and DAVID C. GOOD, M.D.
[+] Article and Author Information

Presented in part at the Fifth International Joint Conference on Stroke and Cerebral Circulation, 22 February 1980, Lake Buena Vista, Florida, and at the American Heart Association Scientific Sessions, 17-20 November 1980, Miami Beach Florida.

▸Requests for reprints should be addressed to Philip Greenland, M.D.; P.O. BOX MED, University of Rochester Medical Center, 601 Elmwood Avenue; Rochester, NY 14642.


Minneapolis, Minnesota


© 1981 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1981;95(1):51-53. doi:10.7326/0003-4819-95-1-51
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We assessed the use of echocardiography in the evaluation of stroke by recording M-mode and two-dimensional (2D) echocardiograms in 100 consecutive hospitalized patients. Of the 95 persons satisfactorily imaged with 2D echocardiography, 47 lacked clinical and routine laboratory evidence of heart disease; no potential embolic source or other finding that altered therapy was diagnosed by echocardiography. In the remaining 48 patients with clinical or routine laboratory evidence of heart disease, two with left ventricular thrombus as a potential embolic source were identified by 2D echocardiography. M-mode echocardiograms failed to detect the thrombus in either patient. No patients with left atrial thrombi, mitral stenosis, cardiac tumor, or vegetations suggesting endocarditis were identified. One patient had possible mitral valve prolapse. Echocardiograms in patients lacking other available evidence of heart disease are unlikely to yield findings that alter the clinical approach to patients with stroke; echocardiography in stroke patients with clinically evident heart disease may have greater clinical utility; additional study of the role of echocardiography in selected subgroups of stroke patients is indicated.

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