Transesophageal Echocardiography in Cardiogenic Embolic Cerebral Infarction

Abstract

Objective:To evaluate the diagnostic values of transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) in cardiogenic embolic cerebral infarction.Methods:Fifty patients with occult cerebral infarction who were admitted to the hospital between June 2015 and June 2016 were selected as research subjects. The patients were diagnosed by transesophageal echocardiography and transthoracic echocardiography. Diagnostic data were compared to analyze the values of the two diagnostic methods.Results:Sixteen out of fifty patients were diagnosed as cardiogenic embolic cerebral infarction by TEE (32%), including two cases of aortic plaques, six cases of atrial septal defect, two cases of atrial septal aneurysm, two cases of patent foramen ovale, one case of left atrial spontaneous echo contrast, one case of mitral prolapse and two case of mitral stenosis. Four cases were diagnosed as cardiogenic embolic cerebral infarction by TTE (8.0%), including one case of patent foramen ovale, one case of left atrial spontaneous echo contrast, one case of mitral prolapse and one case of mitral stenosis. The difference was statistically significant (P<0.05). The main difference of TEE and TTE was detection of aorta atheromatous plaques and atrial septal lesions. Aortic atheromatous plaques of two cases and atrial septal lesions of eight cases were missed in the diagnosis by TTE.Conclusion:Detection and diagnosis of cardiac embolic cerebral infarction with TEE is highly accurate and advantageous. Therefore, TEE is worth promotion and application.

Dramatic Aneurysmal Atrial Septum Identified with Intracardiac Echo Complicating Transseptal Puncture

“…As transesophageal echocardiography is superior to TTE in elucidating cardiac anatomy, as borne out in a 5-to 13-fold increase in detection rates of atrial structural abnormalities, the true prevalence of ASA may actually be much higher than the approximately 2% prevalence currently reported in the literature. 12,13 ICE, which offers ad-vantages by providing a larger field of view and superior soft-tissue contrast, is comparable to transesophageal echocardiography in cost and effectiveness, and avoids the added complications of esophageal intubation. 14 As a result, there are growing applications for ICE beyond enhancing the safety of transseptal puncture, including for improved clarity in imaging of atrial, ventricular, and valvular structures.…”

Cerebrovascular disease in pregnancy and puerperium: perspectives from neuroradiologists

“…Owing to the hypercoagulable state, birth injuries and infections may lead to thrombosis. When a left-to-right intracardial shunt is present, a thrombus from the systemic circulation or left heart thrombus may embolize to the central nervous system (35). In pregnant patients with cerebral infarction, revascularization in the ischemic area may also lead to secondary bleeding in the infarcted area (Figure 3).…”