TY - JOUR
T1 - Low yield of transthoracic echocardiography for cardiac source of embolism
AU - Sansoy, Vedat
AU - Abbott, Robert D.
AU - Jayaweera, Ananda R.
AU - Kaul, Sanjiv
N1 - Funding Information:
From the Cardiovascular Division and Division of Biostatistics, University of Virginia School of Medicine, Charlottesville, Virginia. This study was supported in part by a Grant-in-Aid from the Virginia Affiliate of the American Heart Association, Glen Allen, Virginia, and Grant ROl-Ht48890 from the National Institutes of Health, Bethesda, Mayland. Dr. Kaul is an Established Investigator of the American Heart Association, Dallas, Texas, Manuscript received July 1 1, 1994; revised manuscript received and accepted September 1, 1994.
PY - 1995/1/15
Y1 - 1995/1/15
N2 - To test the hypothesis that the yield for a cardiac source of embolism is very low using transthoracic echocardiography, we reviewed the echocardiographic reports of 1,010 consecutive patients with cerebrovascular accidents who had undergone echocardiography to rule out a cardiac source of embolism; risk factor information was also available in 493 patients. We also used 325 controls who had undergone echocardiography for other reasons during the same period. Each report was examined for the presence of predefined findings depending on their propensity for causing cerebrovascular accidents via an embolic process. The prevalence of a highly probable source of embolism was low in cases (<3%) and no different from controls after adjusting for age and other risk factors. The prevalence of a possible cardiac source of embolism was also low (<5%) and similar in cases and controls. The presence of definite or possible thrombus on echocardiography resulted in alteration in therapy in only 2% of cases, of whom 77% had either heart failure, atrial fibrillation, or Q waves on the electrocardiogram. We conclude that the yield of highly probable or possible cardiac source of embolism in patients with cerebrovascular accidents is very low with transthoracic echocardiography, and is no higher than that noted in similar patients without cerebrovascular accidents.
AB - To test the hypothesis that the yield for a cardiac source of embolism is very low using transthoracic echocardiography, we reviewed the echocardiographic reports of 1,010 consecutive patients with cerebrovascular accidents who had undergone echocardiography to rule out a cardiac source of embolism; risk factor information was also available in 493 patients. We also used 325 controls who had undergone echocardiography for other reasons during the same period. Each report was examined for the presence of predefined findings depending on their propensity for causing cerebrovascular accidents via an embolic process. The prevalence of a highly probable source of embolism was low in cases (<3%) and no different from controls after adjusting for age and other risk factors. The prevalence of a possible cardiac source of embolism was also low (<5%) and similar in cases and controls. The presence of definite or possible thrombus on echocardiography resulted in alteration in therapy in only 2% of cases, of whom 77% had either heart failure, atrial fibrillation, or Q waves on the electrocardiogram. We conclude that the yield of highly probable or possible cardiac source of embolism in patients with cerebrovascular accidents is very low with transthoracic echocardiography, and is no higher than that noted in similar patients without cerebrovascular accidents.
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U2 - 10.1016/S0002-9149(00)80068-5
DO - 10.1016/S0002-9149(00)80068-5
M3 - Article
C2 - 7810494
AN - SCOPUS:0028854315
SN - 0002-9149
VL - 75
SP - 166
EP - 169
JO - The American journal of cardiology
JF - The American journal of cardiology
IS - 2
ER -