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허혈성 뇌졸증 환자에서 경식도 심초음파 소견

Other Titles
 The Findings of Transesophageal Echocardiography in the Evaluation of the Source of Ischemic Stroke 
 장윤수  ;  정남식  ;  임세중  ;  하종원  ;  이상학  ;  최선아  ;  이병인 
 Korean Circulation Journal (순환기), Vol.28(10) : 1746-1754, 1998 
Journal Title
Issue Date
Background and Objectives : Intracardiac pathology results in 15 - 20% of ischemic stroke, but transthoracic echocardiography (TTE) has a number of limitations because of suboptimal precordial windows or ultrasound interference with prosthetic materials. Transesophageal echocardiography (TEE) provides superior resolution of basal structures such as the left atrium, left atrial appendage, mitral valvular apparatus, atrial septum, and aorta. The purpose of this study was to describe the various TEE findings which were sources of cerebral emboli. Materials and Method : The study population was comprised of 122 patients (mean age : 54.5, male 83, female 39) who. were admitted to Severance Hospital because of ischemic stroke from 1991 to 1997. All patients underwent TEE with agitated saline contrast administration. Patients without a definitive cardiac source of embolism underwent Holtor monitoring, internal carotid and cerebral angiography, as well as transcranial Doppler. Results : 1) The number of patients diagnosed as cardioembolic stroke was 55 (45.1%). Atrial fibrillation was noted in 31 patients of cardioembolic stroke and it was the most frequent finding. Among these patients, 16 did not have any other cardiac problem. 2) We were able to find the possible source of embolism in 49 (40.2%) patients with TEE. Among these patients, 12 did not have dysrhythmia or any known previous heart problem. We found spontaneous echo contrast in the left atrium and left atrial appendage in 33 cases. There were 8 patients who had intracardiac thrombus. Among these patients, 6 patients had thrombi in the left atrial appendage, 1 in left atrium and 1 in left ventricular apex. We found patent foramen ovale in 3 cases and atrial aneurysm in 1 case. We found atheromatous plaque and/or thrombi of the aorta in 16 cases, while there were 4 cases where lesions located in the ascending aorta and aortic arch and which were considered as the source of embolism. Small thrombi in the left atrial appendage and left atrium were only detectable with TEE. Conclusions : We described TEE findings in ischemic stroke patients. And we assert TEE is a useful diagnostic tool in detecting the source of cardioembolic stroke and it may be used as a primary diagnostic tool in patients who are being evaluated for ischemic stroke.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Sang Hak(이상학) ORCID logo https://orcid.org/0000-0002-4535-3745
Rim, Se Joong(임세중) ORCID logo https://orcid.org/0000-0002-7631-5581
Chang, Yoon Soo(장윤수) ORCID logo https://orcid.org/0000-0003-3340-4223
Chung, Nam Sik(정남식)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
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