INDICATIONS FOR TRANSESOPHAGEAL ECHOCARDI OGRAPHY AFTER CEREBRAL-ISCHEMIA

Possible intracardiac sources of emboli were looked for by transoesoph ageal echocardiography (TOE) in 271 patients (149 men, 122 women; mean age 60 +/- 11 years) a mean of 12 +/- 8 days after suffering an episo de of cerebral ischaemia. Left atrial thrombi were revealed in 9 patie nts: they were more frequent in those with atrial fibrillation (odds r atio [OD] 25.2; P<0.0001) or known cardiac disease COD 3.5; P = 0.06). Using the two factors together, the 9 left atrial thrombi could be pr edicted in 96 patients, while in the remaining 175 patients without ca rdiac abnormalities no left atrial thrombi were;found. Overall, TOE is not an essential investigation additional to transthoracic echocardio graphy to exclude left atrial thrombi in patients without heart diseas e who are in sinus rhythm. But in those with atrial fibrillation and/o r organic heart disease, TOE can in many instances facilitate the indi cation for anticoagulation.