Diagnostic Yield of Echocardiography in Transient Ischemic Attack

Background Echocardiography is often performed to identify a cardiac source of embolism (CSE) causing transient ischemic attack (TIA). However, the diagnostic yield of echocardiography in TIA remains uncertain, and its role in routine evaluation of TIA is controversial. Methods Patients with acute T...

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Bibliographic Details
Published in:Journal of stroke and cerebrovascular diseases 2016-05, Vol.25 (5), p.1135-1140
Main Authors: Wilson, Christina A., MD, PhD, Tai, Waimei, MD, Desai, Jamsheed A., MD, FRCPC, Mulvihill, Ian, MBBCh, Olivot, Jean-Marc, MD, Murphy, Sean, MD, Coutts, Shelagh B., MD, FRCPC, Albers, Gregory W., MD, Kelly, Peter, MD, Cucchiara, Brett L., MD
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
aortic atheroma
California
Canada
cardioembolism
cardiomyopathy
Cardiovascular
Echocardiography
Embolism, Paradoxical - diagnostic imaging
Embolism, Paradoxical - etiology
Embolism, Paradoxical - prevention & control
Female
Fibrinolytic Agents - therapeutic use
Heart Diseases - complications
Heart Diseases - diagnostic imaging
Heart Diseases - drug therapy
Humans
Intracranial Embolism - diagnostic imaging
Intracranial Embolism - etiology
Intracranial Embolism - prevention & control
Ireland
Ischemic Attack, Transient - diagnostic imaging
Ischemic Attack, Transient - etiology
Ischemic Attack, Transient - prevention & control
Male
Middle Aged
Neurology
patent foramen ovale (PFO)
Pennsylvania
Predictive Value of Tests
Prognosis
Prospective Studies
Risk Factors
transient ischemic attack (TIA)
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Summary:Background Echocardiography is often performed to identify a cardiac source of embolism (CSE) causing transient ischemic attack (TIA). However, the diagnostic yield of echocardiography in TIA remains uncertain, and its role in routine evaluation of TIA is controversial. Methods Patients with acute TIA were prospectively enrolled at 4 stroke centers. A CSE was defined using the Causative Classification of Stroke system; patent foramen ovale was considered a relevant CSE only if the patient underwent closure or was placed on anticoagulation. Patients with a known CSE at time of admission were excluded from analysis of the yield of echocardiography. Results A total of 869 patients were enrolled at stroke centers, and 129 had a known CSE at presentation. Of the 740 remaining patients, 603 (81%) underwent echocardiography. A potential CSE was identified in 60 (10%) of these patients. The most common CSEs noted on echocardiography were complex aortic arch atherosclerosis and patent foramen ovale. History of coronary artery disease ( P  
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2016.01.011