Cardiovascular Causes of Ischemic Cerebrovascular Stroke by Using Transesophageal Echocardiography

Abstract

The present study has been designed aiming to evaluate the incidence of cardiac causes of ischemic stroke using transesophageal echocardiography. A total of 100 patients with cerebrovascular stroke were enrolled into the study. The studied patients included 59 males and 41 females aged 19 – 75 years old with mean age 54.5 years old. Regarding assessment of risk factors among the studied patients we have found that the mean systolic blood pressure is 135.1 mm.Hg while the mean diastolic blood pressure is 83.9 mm.Hg. It was found that 19% of the patients have family history of ischemic stroke. Regarding prevalence of hypertension and DM, the present study has shown that 64% of the patients have hypertension and 57% of the patients have DM. Other evaluated risk factors included smoking and dyslipidemia. It was found that 52% of the patients are smokers and that 41% of the patients have dyslipidemia. Obesity was reported among 13% of patients. In the present study, using trans-thoracic echocardiography (TTE), more than half of the studied patients showed normal findings. Most common findings are ischemic heart diseases (IHD) (9%), left atrial dilatation (7%), ischemic cardiomyopathy (5%) In addition to other findings e.g., rheumatic AO/mitral stenosis, PFO, dilated cardiomyopathy with left ventricular ejection fraction less than 35%, LA / LV thrombus. When transesophageal echocardiography (TEE) was applied for all patients, also 59% of patients showed normal findings. The most common finding using TEE are aortic atheromatous plaques (11%). Other common findings including LA heavy sec (7%), PFO (6%) and LA thrombus (5%). Also TEE has shown another finding including mitral/aortic valvular vegetations, ASD, LAA thrombus, LV thrombus and LV aneurysm. Current study have shown that regarding ischemic stroke risk factors there was no statistically significant difference between patients with hypertension, DM, and family history of stroke and patients without, regarding TEE findings. It was estimated that 81.82% of the patients diagnosed with AO atheromatous plaques, all of patients with LA thrombus, and all of patients with aortic valvular vegetations are males, and there was no statistically significant difference. Also, 90.91% of the patients diagnosed with AO atheromatous plaques, all of patients with LAA thrombus, and all of patients with LV thrombus are hypertensives. Similarly FH of ischemic stroke didn't affect TEE findings as 36.36% of the patients diagnosed with AO atheromatous plaque, 50% of patients with LAA thrombus, 50% of patients with LV aneurysm and 20% of patients with LA thrombus have FH of ischemic stroke with no statistically significant difference.