Echocardiography and Stroke; A Narrative Review

Abstract

Evaluation of embolic stroke mechanism is an important diagnostic step in approaching patients with ischemic stroke (IS). Cardiogenic embolism has been estimated to be the causative factor in 15-30 percent of all IS; and near to 30 of patients with IS, are also embolic stroke undetermined source (ESUS). Various cardiac disorders including arrhythmias (atrial fibrillation), ventricular and arterial thrombus, valvular heart disease, cardiac tumors, endocarditis, structural atrial and ventricular defects, and atrial and ventricular cardiomyopathies can cause cardioembolic stroke. Although the aortic arch is not a cardiac structure, it is usually evaluated under source of cardiac. Transthoracic and transesophageal echocardiography are widely used diagnostic modalities for evaluation, diagnosis, and management of embolic stroke and ESUS, systemic and pulmonary embolism. This article reviews potential high- and low-risk cardiac sources of stroke, and discusses the role of both types of echocardiography in clinical practice. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.