TRANSESOPHAGEAL ECHOCARDIOGRAPHIC FINDINGS IN PATIENTS WITH ANTERIOR AND POSTERIOR CIRCULATION INFARCTS

Objectives - The aim of this study was to assess the role of transesop hageal echocardiography in detecting the source of cerebral embolism i n ischemic stroke patients and to evaluate the difference in occurrenc e of heart abnormalities in anterior and posterior circulation infarct s. Material and Methods - The study group included 104 patients, 51 ma les and 53 females with ischemic stroke without significant atheroscle rosis in the carotid arteries. Age of the patients ranged from 14 to 8 2 years (mean 55). The clinical picture of stroke suggested the emboli c etiology, 34 of them had atrial fibrillation. Transthoracic and tran sesophageal echocardiography were performed in all patients. All patie nts were separated as anterior or posterior circulation infarcts. The control group consisted of 100 patients aged from 14 to 73 years (mean 53) without stroke history. Results - Transesophageal echocardiograph y (TEE) examination revealed left atrial thrombus in 12%, left atrial spontaneous contrast in 16%, interatrial communication in 31%, mitral valve prolapse in 20%, atrial septal aneurysm in 14%, ventricular thro mbus in 6% and aortic atheromas of 5 mm or more in size in 7% of strok e patients. In the control group left atrial spontaneous contrast was found in 10% interatrial communication in 17%, mitral valve prolapse i n 4%, atrial septal aneurysm in 8%,neither atrial nor ventricular thro mbi were found. At least one abnormal TEE finding was present in 70 (6 7%) of stroke patients. Abnormal TEE findings were more often seen in patients with anterior circulation infarct than in those with posterio r circulation infarcts. although the difference was not statistically significant. Left atrial thrombus and mitral valve prolapse occurred s tatistically significantly more often in stroke patients than in the c ontrol group. Conclusions - Echocardiographic examination is often abn ormal in patients with ischemic stroke. The study did not reveal the s tatistically significant difference in the prevalence of abnormal tran sesophageal echocardiography findings between patients with anterior a nd posterior circulation infarcts.