Echocardiography

Current guidelines recommend extensive cardiovascular imaging in patients who experience ischaemic stroke or a transient ischaemic attack to prevent recurrent stroke. High-quality echocardiography is crucial for detection of the wide range of cardiac and proximal aortic conditions that can predispose to cerebral embolism. These conditions may be classified as major, minor, or uncertain risk sources of embolism. Although both transthoracic (TTE) and transoesophageal echocardiography (TOE) have substantial clinical utility in patients with cryptogenic stroke, these methods offer complementary information. TOE is typically used for assessment of defects in the atrial septum or detection of thrombus in the left atrial appendage. In contrast, TTE is the recommended method for assessment of cardiac chamber structure and function, and valvular disease. Furthermore, assessment of aortic stiffness and electrocardiography may offer additional insight to cardiac function. This chapter gives an overview of the use of echocardiography in ischaemic stroke patients.