The Indian Academy of Echocardiography practice guideline for the performance of transesophageal echocardiographic evaluation of a patient with cerebrovascular stroke

Abstract

Ischemic stroke remains a major cause of morbidity and mortality. Cardiac sources of embolism account for almost up to 40% of all the ischemic strokes. Accordingly, echocardiography is an important investigation in the evaluation of clinically suspected cardioembolic stroke or cryptogenic stroke. Both transthoracic echocardiography and transesophageal echocardiography (TEE) are complementary to each other for this purpose. However, because of its superior resolution and the ability to image structures that are the most likely sources of cardioembolism (e.g., left atrial appendage), TEE is the preferred imaging modality in the cardiac evaluation of stroke. This document describes the systematic TEE evaluation of the patients referred with a clinical diagnosis of either cryptogenic stroke or cardioembolic stroke.

Keywords

• atrial septal aneurysm
• cardiac tumor
• infective endocarditis
• intracardiac thrombus
• lambl's excrescences
• left atrial appendage
• paradoxical embolism
• patent foramen ovale
• rope score
• spontaneous echo contrast
• valsalva maneuver