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Transoesophageal Echocardiography in Selecting Patients for Anticoagulation After Ischaemic Stroke or Transient Ischaemic Attack
JNNP 73:29-33, Strandberg,M.,et al, 2002
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Article Abstract
A major risk factor for a cardiac source of embolism excluding atrial fibrillation, acute myocardial infarction, and prosthetic valve was detected in 10% of patients and a minor risk factor for a cardiac source of embolism in 46%. When a maj or risk factor of a cardiac source of embolism was detected using TTE or TEE and no contraindications were present, the patient was given anticoagulation drugs. If a minor risk factor for a cardiac source of embolism was detected, anticoagulation treatme nt was started after clinical assessment, if no contraindications were present. In 62 (14%) cases, the patient was given oral anticoagulation drugs or the necessity of ongoing anticoagulation treatment was confirmed on the basis of TEE. When these antic oagulation treated patients were evaluated using logistic regression analysis, they were found have significantly more atrial fibrillation and histories of myocardial infarctions. Moreover, the patients were mainly men. When patients in sinus rhythm and without any history of cardiac disease were analysed, 8% of patients were found to have been given anticoagulation drugs on the basis of TEE data. This study suggests that TEE should be used in patients with stroke even without any clinical evidence of cardiac disease when the patients are candidates for anticoagulation.
 
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anticoagulant,treatment
anticoagulant,treatment in CVD
cerebral ischemia
cerebrovascular accident
cerebrovascular accident,prevention of
cerebrovascular accident,work up for
echocardiogram
echocardiogram,transesophageal
transient ischemic attack
treatment of neurologic disorder

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