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  • Title: [Which cardiologic diagnosis in patients with cerebral ischemia?].
    Author: Fröhlig G.
    Journal: Z Arztl Fortbild Qualitatssich; 1999 May; 93(3):183-90. PubMed ID: 10412197.
    Abstract:
    There are few scenarios which need urgent clarification for the acute therapy of stroke. Normally, the patient's history, clinical findings, an electrocardiogram and a limited number of blood tests are suitable to govern precise management. Additional questions can be answered by transthoracic echocardiography (TTE) which gives information on left ventricular function, the development of thrombi after myocardial infarction, valvular lesions or vegetations. Transesophageal imaging (TEE) is required if TTE remains technically inadequate or if specific questions (e.g. the suspicion of a mitral valve prosthetic vegetation) shall be answered. The procedure is indicated only if therapeutic implications can be anticipated. Outside scientific protocols, the same criterion has to be applied when screening for potential sources of emboli (patent foramen ovale, atherosclerotic lesions of the ascending aorta) which can only be detected by TEE with adequate sensitivity and may be shown to require secondary prophylaxis in the near future.
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