Transthoracic Echocardiography in Thai Patients with Acute Ischemic Stroke
Tapawas Piriyapong MD*, Pornpatr A. Dharmasaroja MD*, Sombat Muengtaweepongsa MD*, Dilok Piyayotai MD*, Pisit Hutayanon MD*
Affiliation : * Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Objective : Transthoracic echocardiography (TTE) is routinely performed to look for the cardiac sources of emboli in many
Western stroke centers. Due to a limitation of resources in Thailand, echocardiography is done in only some patients with
acute ischemic stroke. The purpose of this study is to evaluate the need for cardiac investigations, especially TTE, in Thai
patients with acute ischemic stroke.
Material and Method: Two-hundred and seven patients with acute ischemic stroke or transient ischemic attack (TIA), who
had TTE results during August 2006 to November 2008, were studied. Patients were divided into 2 groups by the risk of
cardioembolism: low- versus high-risk groups. All echocardiography results were reviewed and classified by the need for
management change following the echocardiography.
Results : Abnormal TTE results indicating a need for change in management were found in 4% (4/102) and 18% (18/105) in
low- and high- risk patients, respectively. The results of ECG alone led to change in management in 17% (36 patients). Atrial
fibrillation was the most common cause of cardioembolism, which was found in 35 patients (17%).
Conclusion : Because of limited resources in Thailand, ECG should be routinely performed on all ischemic stroke patients
and TTE in patients with high risk for cardioembolism. However, larger studies are still needed to clarify the benefits of
echocardiography in low-risk patients.
Keywords : Echocardiography, Stroke, Thai, Asia
