[Role of two-dimensional echocardiography in the diagnosis of embolic cardiopathy in patients with transient cerebral ischemia attacks]. / Ruolo dell'ecocardiografia bidimensionale nella diagnosi di cardiopatia embolizzante nei pazienti con attacchi ischemici cerebrali transitori.

Cardiac sources of emboli have been frequently described in patients with Transitory Ischemic Attacks (TIAs). The aim of our study was to assess the value of two-dimensional echocardiography (2D-E) in the investigation for possible cardiac aetiology of TIAs. As an offshoot of a larger epidemiologic study which aimed at determining the period prevalence of TIAs in 6.504 subject(s) of the general population aged between 40-65, fifty subjects with TIA (group A) and 66 controls (group B) were studied. A heart disease was found in 20/50 s. (40%) in group A (coronary artery disease: 5; hypertensive heart disease: 4; mitral valve prolapse: 5; left ventricular aneurysms: 2; aortic valve disease: 2; aortic valve prosthesis: 1; atrial fibrillation: 1) and in 5/66 s. (7.5%) in group B (p less than 0.01) (coronary disease: 2; hypertensive heart disease: 1; mitral valve prolapse: 2). A potential source of emboli was present in 11 s. in group A (22%) and in 2 s. in group B (3%) (p less than 0.01). In 4/50 s. in group A and in 1/66 in group B the diagnosis was obtained by means of 2D-E only, because other clinical signs and ECG data were negative. 2D-E could only confirm the diagnosis in the remaining cases, with no additional information (i.e., no intracavitary masses were seen). In conclusion there is a high prevalence of heart disease in patients with TIA over 40 years of age. A cardiac source of emboli may be suspected in a substantial number of cases. Nevertheless the value of routine 2D-E in disclosing an otherwise undetected source of emboli is rather low.