Transesophageal ECHO Affects Stroke Care

HealthDay News — Patients suspected of cardioembolic stroke that undergo transesophageal echocardiography (TEE) may experience a significant change in medical management, according to a study published in The American Journal of Cardiology.

Yevgeniy Khariton, MD, from Saint Luke’s Mid America Heart Institute in Kansas City, Mo., and colleagues examined the clinical impact of TEE on management in a retrospective single-center study. Participants included 1,458 consecutive patients hospitalized with acute ischemic stroke or transient ischemic attack who underwent TEE evaluation.

The researchers found that there was a significant change in management (including initiation of anticoagulation, placement of a patent foramen ovale [PFO] closure device, initiation of antibiotic therapy for endocarditis, surgical PFO closure, other cardiac surgery, and coil embolization of a pulmonary arteriovenous malformation) in 16.7% of patients. Of these, 71% underwent treatment for PFO with a percutaneous PFO closure device, initiation of chronic systemic anticoagulation, or surgical PFO closure. There was a change in management with additional findings, including endocarditis, aortic arch atheroma, intracardiac thrombus, pulmonary arteriovenous malformation, aortic valve fibroelastoma, other valve masses, and miscellaneous causes.

“In conclusion, in patients with suspected cardioembolic stroke, TEE findings led to a change in management in 16.7% of patients,” the authors write.


  1. Khariton Y et al. Am J Cardiol. 2014; doi:10.1016/j.amjcard.2014.09.035.