Key result
Echocardiography remains the cornerstone of cardiac imaging after ischemic stroke, with transesophageal echocardiography considered the initial diagnostic tool for suspected cardioembolic sources.
Why the study?
About 20-25% of all ischemic strokes are cardioembolic, making noninvasive cardiac imaging essential for guiding therapeutic changes such as secondary prevention.
This review highlights that while TTE and TEE remain the gold standard for identifying cardioembolic sources after ischemic stroke, cardiac CT and MRI can provide valuable complementary information in specific clinical scenarios.
Reinforces echocardiography as initial post-stroke imaging; leaves open the incremental value of CT/MRI in routine care.
About 20-25% of all ischemic strokes are of cardioembolic etiology, with atrial fibrillation and heart failure as the most common underlying pathologies. Diagnostic work-up by noninvasive cardiac imaging is essential since it may lead to changes in therapy, e.g., in-but not exclusively-secondary stroke prevention. Echocardiography remains the cornerstone of cardiac imaging after ischemic stroke, with the combination of transthoracic and transesophageal echocardiography as gold standard thanks to their high sensitivity for many common pathologies. Transesophageal echocardiography should be considered as the initial diagnostic tool when a cardioembolic source of stroke is suspected. However, to date, there is no proven benefit of transesophageal echocardiography-related therapy changes on the main outcomes after ischemic stroke. Based on the currently available data, cardiac computed tomography and magnetic resonance imaging should be regarded as complementary methods to echocardiography, providing additional information in specific situations; however, they cannot be recommended as first-line modalities.
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Camen et al. (2019) conducted a review in Ischemic stroke. Cardiac imaging (Echocardiography, CT, MRI) was evaluated. Echocardiography remains the cornerstone of cardiac imaging after ischemic stroke, with transesophageal echocardiography considered the initial diagnostic tool for suspected cardioembolic sources.
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