Role of Echocardiography in Assessment of Cardioembolic Sources: a Strong Diagnostic Resource in Patients with Ischemic Stroke

Curr Cardiol Rep. 2018 Oct 11;20(12):136. doi: 10.1007/s11886-018-1085-5.


Purpose of review: This review will discuss the most frequent sources of cardiac embolism and the role of echocardiography in these different clinical settings, and, in addition, provide suggestions about the choice between transthoracic (TTE) and transesophageal echocardiography (TEE).

Recent findings: Stroke is the third leading cause of death in industrial countries, and 15-40% of all ischemic strokes are due to cardioembolism. TTE and TEE are cornerstones in the detection of cardioembolic sources and provide fundamental information about the embolic risk and most suitable treatment of these patients, improving long-term outcomes. Echocardiography is a widely available, inexpensive, and safe diagnostic tool that is almost free from contraindication, and these elements allow the common use of this technique in almost all the patients with ischemic stroke. The most common cardioembolic sources include left atrial appendage thrombosis during atrial fibrillation; vegetations in infective endocarditis; cardiac masses including left ventricular thrombosis, cardiac tumors, etc.; atherosclerotic plaques; and passageways within the heart serving as conduits for paradoxical embolization, e.g., patent foramen ovale.

Keywords: Atrial fibrillation; Cardioembolic sources; Echocardiography; Endocarditis; Stroke; Thrombus.

Publication types

  • Review

MeSH terms

  • Atrial Fibrillation / complications
  • Atrial Fibrillation / diagnostic imaging*
  • Brain Ischemia / etiology
  • Brain Ischemia / prevention & control
  • Echocardiography*
  • Endocarditis / complications
  • Endocarditis / diagnostic imaging
  • Foramen Ovale, Patent / complications
  • Foramen Ovale, Patent / diagnostic imaging*
  • Heart Neoplasms / complications
  • Heart Neoplasms / diagnostic imaging*
  • Humans
  • Stroke / etiology*
  • Stroke / prevention & control