TRANSESOPHAGEAL ECHOCARDIOGRAPHY FOR DETECTING INTRACARDIAC THROMBI IN EMBOLIC STROKE

The authors studied 56 patients with cardioembolic stroke to search fo r intracardiac thrombi by use of transesophageal and transthoracic ech ocardiography. Forty consecutive patients were examined within four we eks of stroke onset and the remaining 16 in the chronic stage. They al so performed ultrafast computed tomography in 9 of them. Underlying he art disease was present in all subjects. Anticoagulant therapy had alr eady been started in 29 at the time of examinations. Using their own c riteria for echocardiography, they diagnosed intracardiac thrombus in 7 cases and valvular vegetation in 1. Six thrombi were located in the left atrial appendage, 4 of which were smaller than 10 mm in diameter. These small thrombi were not found by either transthoracic echocardio graphy or computed tomography. Transesophageal echocardiography appear s to be superior to the other two methods, especially for detecting sm all intracardiac thrombi in the left atrial appendage.