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Low yield of transthoracic echocardiography for cardiac source of embolism

To test the hypothesis that the yield for a cardiac source of embolism is very low using transthoracic echocardiography, we reviewed the echocardiographic reports of 1,010 consecutive patients with cerebrovascular accidents who had undergone echocardiography to rule out a cardiac source of embolism;...

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Published in:	The American journal of cardiology 1995-01, Vol.75 (2), p.166-169
Main Authors:	Sansoy, Vedat, Abbott, Robert D., Jayaweera, Ananda R., Kaul, Sanjiv
Format:	Article
Language:	English
Subjects:	Adult Aged Aged, 80 and over Biological and medical sciences Cardiovascular system Cerebrovascular Disorders - diagnostic imaging Cerebrovascular Disorders - etiology Echocardiography, Transesophageal Female Head injuries Heart Diseases - complications Heart Diseases - diagnostic imaging Humans Intracranial Embolism and Thrombosis - diagnostic imaging Intracranial Embolism and Thrombosis - etiology Investigative techniques, diagnostic techniques (general aspects) Male Medical research Medical sciences Middle Aged Risk Factors Stroke Thrombosis - complications Thrombosis - diagnostic imaging Ultrasonic imaging Ultrasonic investigative techniques
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creator	Sansoy, Vedat Abbott, Robert D. Jayaweera, Ananda R. Kaul, Sanjiv
description	To test the hypothesis that the yield for a cardiac source of embolism is very low using transthoracic echocardiography, we reviewed the echocardiographic reports of 1,010 consecutive patients with cerebrovascular accidents who had undergone echocardiography to rule out a cardiac source of embolism; risk factor information was also available in 493 patients. We also used 325 controls who had undergone echocardiography for other reasons during the same period. Each report was examined for the presence of predefined findings depending on their propensity for causing cerebrovascular accidents via an embolic process. The prevalence of a highly probable source of embolism was low in cases (
doi_str_mv	10.1016/S0002-9149(00)80068-5
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We also used 325 controls who had undergone echocardiography for other reasons during the same period. Each report was examined for the presence of predefined findings depending on their propensity for causing cerebrovascular accidents via an embolic process. The prevalence of a highly probable source of embolism was low in cases (<3%) and no different from controls after adjusting for age and other risk factors. The prevalence of a possible cardiac source of embolism was also low (<5%) and similar in cases and controls. The presence of definite or possible thrombus on echocardiography resulted in alteration in therapy in only 2% of cases, of whom 77% had either heart failure, atrial fibrillation, or Q waves on the electrocardiogram. 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We also used 325 controls who had undergone echocardiography for other reasons during the same period. Each report was examined for the presence of predefined findings depending on their propensity for causing cerebrovascular accidents via an embolic process. The prevalence of a highly probable source of embolism was low in cases (<3%) and no different from controls after adjusting for age and other risk factors. The prevalence of a possible cardiac source of embolism was also low (<5%) and similar in cases and controls. The presence of definite or possible thrombus on echocardiography resulted in alteration in therapy in only 2% of cases, of whom 77% had either heart failure, atrial fibrillation, or Q waves on the electrocardiogram. 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risk factor information was also available in 493 patients. 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subjects	Adult Aged Aged, 80 and over Biological and medical sciences Cardiovascular system Cerebrovascular Disorders - diagnostic imaging Cerebrovascular Disorders - etiology Echocardiography, Transesophageal Female Head injuries Heart Diseases - complications Heart Diseases - diagnostic imaging Humans Intracranial Embolism and Thrombosis - diagnostic imaging Intracranial Embolism and Thrombosis - etiology Investigative techniques, diagnostic techniques (general aspects) Male Medical research Medical sciences Middle Aged Risk Factors Stroke Thrombosis - complications Thrombosis - diagnostic imaging Ultrasonic imaging Ultrasonic investigative techniques
title	Low yield of transthoracic echocardiography for cardiac source of embolism
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