| The utility of transoesophageal echocardiography to determine management in suspected embolic stroke. | |
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MedLine Citation:
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PMID: 19849751 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Background: Assessment for source of stroke is a common indication for transoesophageal echocardiography (TOE). Although an abnormality is frequently found, it remains uncertain how frequently the findings alter patient management. Also, the role of transthoracic echocardiography (TTE) prior to or instead of TOE is not well defined. We sought to determine the use of TTE prior to TOE, the outcome of the TOE and its impact on management. Methods: We retrospectively reviewed the records and echocardiography results of 100 consecutive patients who underwent TOE for any reason at a tertiary hospital. In 35 subjects (35%), the indication was evaluation for source of stroke. Among these, we determined clinical risk factors for stroke, if a TTE was performed prior to their TOE, the results of the TOE and its effect on management. Results: The mean age of the stroke patients was 64.6 years (17-90) and 49% were women. Eighty per cent had at least one risk factor for stroke and 17% had atrial fibrillation. A TTE, performed in 40% prior to the TOE, found an abnormality in 14% (2/14). The TOE showed an abnormality in 71% of patients; 54% had aortic atheroma; 17% PFO; 14% spontaneous echo contrast; 6% left atrial appendage thrombus, 3% left ventricular thrombus and 3% vegetation. In only one patient (3%) the management was altered based on the abnormal TOE findings. Conclusion: An abnormality on TOE, although common (71%) and more sensitive than TTE, altered management in only 3% of subjects referred for stroke assessment. Its role requires further consideration. |
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Authors:
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K K Galougahi; T Stewart; C Y P Choong; C E Storey; M Yates; G H Tofler |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Internal medicine journal Volume: 40 ISSN: 1445-5994 ISO Abbreviation: Intern Med J Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2011-01-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101092952 Medline TA: Intern Med J Country: Australia |
Other Details:
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Languages: eng Pagination: 813-8 Citation Subset: IM |
Copyright Information:
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© 2010 The Authors. Internal Medicine Journal © 2010 Royal Australasian College of Physicians. |
Affiliation:
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Departments of Cardiology and Neurology, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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