Search

Background: To evaluate the incidence, frequency, and contributing factors of microembolic signals (MESs) in patients with cryptogenic stroke with or without patent foramen ovale (PFO). Methods: Transcranial Doppler monitoring for MESs detection was performed for 62 patients with acute cryptogenic stroke with PFO (PFO+) and 34 patients with acute cryptogenic stroke without PFO (PFO−). Results: The incidence of MESs was not significantly higher in PFO+ patients (17/62, 27.4%) in comparison to PFO− patients (6/34, 17.6%; odds ratio 1.76, 95% confidence interval 0.62-5.00; P = .327). The frequency of MESs in PFO+ patients was statistically higher than that of PFO− patients (0.70 ± 1.47 v 0.23 ± 0.55; P = .026). MESs was presented with higher incidence in a subgroup of patients suffering from both patent foramen ovale and atrial septal aneurysm (P = .044). Conclusions: The likelihood of PFO as a source of MESs is higher when associated with atrial septal aneurysm. [Copyright &y& Elsevier]

Abstract: This study compared the diagnostic efficacy of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) for patients with stroke. Examination with TTE was followed by TEE. Stroke causes were classified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) and Causative Classification of Stroke (CCS) criteria before and after TEE to determined, cryptogenic or unclassified groups. We identified that 55.1% of patients had a determined etiology for stroke with TTE; adding TEE to the examinations increased the proportion of patients with determined stroke etiology to 69.4% (κ =0.79). TTE alone showed fair agreement with the combined results of TTE and TEE in determining the cause of stroke in young adults (κ =0.38). TEE improved the detection of cardio-aortic sources, but had no impact on patients who had a determined cause for stroke with other examinations. TEE examination was most useful in young adults with stroke and in patients with an undetermined cause for stroke despite TTE examination and other standard investigations. [Copyright &y& Elsevier]

The patient is a 17-year-old boy who was referred to our center with complaints of easy fatigability and exertional dyspnea. In echocardiography, the left ventricle was identified to be composed of a small functional cavity, and 2 sequestrated apical cavities that communicated with the functional cavity only through few stenotic orifices. The mitral valve apparatus was also abnormal: there was no definite papillary muscle, and chordae tendineae arose from the aberrant fibromuscular ridge that partitioned the left ventricular cavity. Imaging findings and management of this patient with a triple-cavity left ventricle are discussed. [Copyright &y& Elsevier]

Abstract: A 23-year-old male, a professional body builder, developed squeezing retrosternal chest pain following weight lifting. On examination, heart rate was 42 bpm and he had blood pressure of 70/50 mm Hg. An electrocardiogram was taken and showed inferior and right ventricular ST elevation myocardial infarction. Therefore, emergency coronary angiography was done and showed normal left coronaries. Right coronary artery angiogram revealed a dissection in the mid-part of the right coronary artery which was extended to the right ventricular branch. [Copyright &y& Elsevier]