The full content of Annals is available to subscribers

Subscribe/Learn More  >
Reviews |

Transesophageal Echocardiography in the Evaluation of Stroke

Frances A. DeRook, MD; Keith A. Comess, MD; Gregory W. Albers, MD; and Richard L. Popp, MD
[+] Article, Author, and Disclosure Information

Requests for Reprints: Frances A. DeRook, MD, Echocardiography Laboratory, University of Washington Hospital, 4-North, 1959 NE Pacific, Seattle, WA 98195.

Current Author Addresses: Dr. Albers: Palo Alto Veterans Affairs Hospital, 3801 Miranda Street, Palo Alto, CA 94304.

Dr. DeRook: Echocardiography Laboratory, University of Washington Hospital, 4-North, 1959 NE Pacific, Seattle, WA 98195.

Dr. Comess: Virgnia Mason Clinic, 1100 9th Avenue, Seattle, WA 98111.

Dr. Popp: Cardiology Division, Stanford University Medical Center, Stanford, CA 94305.

Ann Intern Med. 1992;117(11):922-932. doi:10.7326/0003-4819-117-11-922
Text Size: A A A

Objective: To review the current role of transesophageal echocardiography in the evaluation of stroke.

Data Identification: Articles examining the role of transesophageal echocardiography for evaluation of patients with stroke were identified using computer and bibliography searches.

Study Selection: All English-language articles that provided full details on patient selection criteria, methods, and study design were reviewed.

Results of Data Analysis: Cardiogenic embolism is frequently an uncertain diagnosis merely inferred by finding a potential cardiac source. Transthoracic echocardiography has had a low yield in screening unselected patients with stroke. Several series of patients with stroke have been reported comparing transthoracic and transesophageal echocardiography. Potential cardiac sources of embolism were consistently identified in many more patients by transesophageal echocardiography. Many findings are, however, of uncertain significance; these include spontaneous echo contrast, patent foramen ovale, filamentous strands on the mitral valve, and atrial septal aneurysm.

Conclusions: Transesophageal echocardiography is most helpful in patients with stroke who are less than 45 years of age and in those without clinical evidence of heart disease. The indications for its use in the evaluation of stroke remain controversial. Further studies are needed using transesophageal echocardiography in patients with stroke and in control groups, not only to determine the natural history of transesophageal, echocardiographically detected abnormalities but also to evaluate treatment options.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $42.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.