What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Unexplained stroke or transient ischemic attack (n=79). Intervention: Transesophageal echocardiography vs. Transthoracic echocardiography. Primary outcome: Identification of a potential cardiac source of embolism (p=<0.0005).

What question did this study set out to answer?

To compare the diagnostic yield of transesophageal echocardiography against transthoracic echocardiography for detecting potential cardiac sources of embolism in patients with unexplained stroke or transient ischemic attack.

August 26, 2026Journal of the American College of CardiologyOpen Access

Superiority of transesophageal echocardiography in detecting cardiac source of embolism in patients with cerebral ischemia of uncertain etiology

Q: What are the key findings of this study?

Transesophageal echocardiography identified a potential cardiac source of embolism in 57% of patients with unexplained stroke or TIA, compared to 15% with transthoracic echocardiography (p<0.0005).

Q: What question did this study set out to answer?

To compare the diagnostic yield of transesophageal echocardiography against transthoracic echocardiography for detecting potential cardiac sources of embolism in patients with unexplained stroke or transient ischemic attack.

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Key result

TEE identifies potential embolic sources in 57% of unexplained stroke or TIA vs. TTE.

P<0.0005
n=79

Why the study?

Does transesophageal echocardiography improve the detection of cardiac sources of embolism compared to transthoracic echocardiography in patients with unexplained stroke or transient ischemic attack?

Population

79 patients presenting with unexplained stroke or transient ischemic attack, mean age 59 years, 35 men and…

Comparison

Transesophageal echocardiography using Doppler… vs Transthoracic echocardiography using Doppler…

Design

Cross-sectional

Authors

APAnthony C. PearsonUniversity of Chicago ALArthur J. LabovitzCardiac Imaging STSatyararayan TatineniUniversity Medical Center

Discussion

Member takes

Implication

Transesophageal echocardiography provides a significantly higher diagnostic yield than transthoracic echocardiography for identifying potential cardiac sources of embolism in patients with unexplained stroke or TIA.

Key Points

To compare the diagnostic yield of transesophageal echocardiography against transthoracic echocardiography for detecting potential cardiac sources of embolism in patients with unexplained stroke or transient ischemic attack.
Evaluated 79 patients (35 men, 44 women; mean age 59 years, range 17 to 84) presenting with unexplained stroke or transient ischemic attack.
Conducted both transthoracic and transesophageal echocardiography in all patients using Doppler color flow and contrast imaging.
Transesophageal echocardiography identified a potential cardiac source of embolism in 57% of patients versus 15% by transthoracic echocardiography (p < 0.0005).
Transesophageal imaging significantly improved detection of atrial septal aneurysm with patent foramen ovale (9 vs 1 of 79, p < 0.005), left atrial thrombus or tumor (6 vs 0 of 79, p < 0.05), and left atrial spontaneous contrast (13 vs 0 of 79, p < 0.0005).
Among the 38 patients without clinical heart disease, transesophageal echocardiography detected abnormalities in 39% compared with 19% for transthoracic echocardiography (p < 0.005).

Study Design

Type

Cross-Sectional (n=79)

Structured PICO

Does transesophageal echocardiography improve the detection of cardiac sources of embolism compared to transthoracic echocardiography in patients with unexplained stroke or transient ischemic attack?

Population

79 patients (mean age 59 years, 55.7% female) presenting with unexplained stroke or transient ischemic attack.

Exposure

Transesophageal echocardiography (TEE) using Doppler color flow and contrast imaging

Comparator

Transthoracic echocardiography (TTE) using Doppler color flow and contrast imaging

Outcome

Identification of a potential cardiac source of embolismsurrogate

Main Result

Absolute Event Rate: 57% vs 15%

p-value: p=<0.0005

Cite This Study

Pearson et al. (1991) conducted a cross-sectional in Unexplained stroke or transient ischemic attack (n=79). Transesophageal echocardiography vs. Transthoracic echocardiography was evaluated on Identification of a potential cardiac source of embolism (p=<0.0005). Transesophageal echocardiography identified a potential cardiac source of embolism in 57% of patients with unexplained stroke or TIA, compared to 15% with transthoracic echocardiography (p<0.0005).

synapsesocial.com/papers/6a8eaf76c654ed1bd5587d0d https://doi.org/10.1016/0735-1097(91)90705-e

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Superiority of transesophageal echocardiography in detecting cardiac source of embolism in patients with cerebral ischemia of uncertain etiology

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Superiority of transesophageal echocardiography in detecting cardiac source of embolism in patients with cerebral ischemia of uncertain etiology

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider