Should echocardiography be performed in all acute ischemic stroke patients? Echocardiography in acute ischemic stroke

Aim: Echocardiography is one of the most commonly used diagnostic methods in the investigation of cardiac etiologies among patients with acute ischemic stroke (AIS). However, data regarding the diagnostic value of this method in patients with and without cardiac abnormalities are limited. The aim of this study is to determine the diagnostic yield of echocardiography in AIS patients with and without any cardiac disease. Material and Methods: We retrospectively analyzed the data of patients with an AIS regarding medical history, cardiac examination, transthoracic echocardiography and transesophageal echocardiography. The patients were divided into two groups. Patients with a history of cardiac disease, cardiovascular risk factors, and abnormal findings in cardiac examination or ECG were allocated into Group A, while Group B included patients without cardiac disease with ischemic stroke. Results: A total of 633 patients with acute ischemic stroke (327 females (51.7%); mean age: 68.9 +/- 13.4 years) were included in the study. There were 393 patients in Group A (62.1%), and 240 patients in Group B (39.9%). The diagnostic yield of echocardiography was significantly more frequent in Group A (41.2%) than in Group B (28.3%) (p=0.001). Antithrombotic treatment was changed among 24 (6.1%) patients in Group A and 19 (7.9%) patients in Group B as a result of the echocardiography findings (p=0.38). Discussion: The diagnostic yield of echocardiography is low if it is used routinely in patients with acute ischemic stroke. Consequently, echocardiography could be performed for acute ischemic stroke patients with negative diagnostic work-up for other etiologic stroke subtypes.