Does echocardiography change the course of treatement after stroke or transient ischemic attack

Background Transthoracic and/or transesophageal echocardiography serves as a cornerstone in the evaluation, diagnosis, and management of these patients with stroke or TIA. Transthoracic echocardiography is routinely performed in patients with stroke or transient ischemic attack (TIA) to help plan secondary stroke management, but recent data evaluating its usefulness in this context are lacking. Purpose We sought to evaluate the value of echocardiography for identifying clinically actionable findings for secondary stroke prevention. Methods We conducted a monocentric study of 154 patients admitted to hospital with stroke or TIA between January 2019 and January 2020 at the military hospital of Tunis. Results One hundred fifty four Acute Stroke Unit inpatients were audited between January 2019 and January 2020 and all of them received an echocardiogram: Age average of 61 years old; Sex ratio of 3:1 (66,7% males); 79% had cardiovascular risk factors ; 13.2% had history of atrial fibrillation; 24.7% had transient ischemic attack (TIA) and 75.3% had an ischemic stroke. For Stroke inpatients receiving echocardiography, 47,1% had a significant echocardiographic finding : Left atrium (LA) enlargement was found in 28.2% and a potentiel cardioembolic sources were found in 10.42%. Echocardiographic findings have changed the course of treatement in 10% of the cases, whether it's anticoagulation therapy, valvular replacement or coronary angiography. Conclusion In our monocentric study, we found that echocardiograms were most often normal for patients with stroke or TIA. In this regard, both TTE and TEE play a central role for the detection of cardioembolic sources for stroke and but also to establish recommendations for the primary and secondary prevention of cardioembolic stroke.