1. [Systematic implementation of transthoracic echocardiography, transesophageal echocardiography and 24-hour Holter ECG for the detection of cardiac sources of embolism in patients with stroke or transient ischemic attack. A retrospective study of 220 patients.]
- Author
-
Vinsonneau, Ulric, Leblanc, Amélie, Buchet, J.-F., Pangnarind-Heintz, V., Le Gal, Grégoire, Rohel, G., Paleiron, Nicolas, Piquemal, Marie, Blanchard, Christian, Zagnoli, Fabien, Paule, Philippe, Service de Cardiologie (HIA BREST - Cardio), HIA - BREST, Service de Neurologie [Brest], Hôpital d'Instruction des Armées 'Clermont-Tonnerre' (HIA), Centre d'Investigation Clinique (CIC - Brest), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Adult ,Aged, 80 and over ,Male ,Adolescent ,Heart Diseases ,[SDV]Life Sciences [q-bio] ,Embolism ,Middle Aged ,Stroke ,body regions ,Young Adult ,Echocardiography ,Ischemic Attack, Transient ,Electrocardiography, Ambulatory ,cardiovascular system ,Humans ,Female ,cardiovascular diseases ,human activities ,Echocardiography, Transesophageal ,Aged ,Retrospective Studies - Abstract
International audience; INTRODUCTION: Embolism of cardiac origin accounts for around 20% of ischemic strokes. ECG and transthoracic echocardiography (TTE) are commonly obtained during the evaluation of patient of ischemic stroke but specific indications for the transesophageal (TEE) echocardiography and 24-hour Holter ECG (Holter) remain uncertain. OBJECTIVES: The aim of this study is to report the contribution of TTE, TEE and Holter performed as a routine during the evaluation of patients with ischemic stroke (IS) or transient ischemic attack (TIA). METHODS: This is a retrospective single-center study of 220 patients hospitalized between 1st January 2007 and 31st December 2010 for a first IS or TIA. RESULTS: One hundred and forty-three IS and 77 TIA are identified. The average age of patients was 66 years (18-88 years). TTE/TEE/24-hour Holter allowed the diagnosis of cardiac sources of embolism in 135 patents (61.3%). TTE/TEE identified potential source of cardiogenic embolism in 126 patients (52.2%). Twenty four-hour Holter ECG tracked supraventricular arrhythmia in 15 patients (6.7%), 9 (4%) which had non-contributory ultrasound assessment. CONCLUSION: The systematic implementation of TTE/TEE/Holter is useful for identifying potential sources of cardiogenic embolism. The performance of TEE remains above the TTE. Holter should be recommended because it is a cost effective and non-invasive tool.
- Published
- 2014
- Full Text
- View/download PDF