TRANSESOPHAGEAL ECHOCARDIOGRAPHY DOES NOT IMPROVE CLINICAL RISK-ESTIMATION IN RECURRENT EMBOLIC STROKE

We used transesophageal echocardiography (TEE) in 95 consecutive patie nts after a first cerebral ischemic event in order to find out how muc h information TEE contributes to the estimation of the risk of subsequ ent stroke as compared to simple clinical criteria and conventional ec hocardiography. During a mean follow-up period of 20 months, 12 patien ts had a second ischemic event. Only 5 of them had initially been stra tified into the high-risk group according to either clinical or TEE cr iteria. The risk of sub sequent stroke of patients with pathological T EE exams was only half that of patients assumed to be at high risk acc ording to clinical criteria. Of 16 patients at high risk based upon TE E findings, only 1 had a subsequent event. We conclude that routine TE E does not improve risk estimation in stroke