Stroke is a leading cause of morbidity and mortality. According to pathophysiologic mechanisms, stroke can be divided into two major groups: ischemic (85%) and hemorrhagic (15%). 20% of ischemic strokes are caused by cardiac embolisms. Brain imaging (CT, MR) confirms the diagnosis, some specific characteristics seen during the imaging of the brain may suggest a distinct cardiac cause. Clinical history, examination and electrocardiogram can shed light on a potential cardiac cause of ischemic stroke. Echocardiography is a key method in the evaluation, diagnosis and management of embolic stroke (transthoracic echo, transesophageal echo, 3D echo, contrast echo).
The etiological factors of cerebrovascular events are: blood clots, tumor fragments, infected and noninfected vegetations, calcified particles, atherosclerotic debris. Cardiac sources of emboli can be divided according to embolic potential into a)
The indications for echocardiography in patients with neurological events are: abrupt occlusion of a major peripheral or visceral artery in patients of any age; younger patients with CV events (<45 years), older patients (>45 years) with neurologic events without evidence of cerebrovascular disease or other obvious cause, patients for whom a clinical therapeutic decision will depend on the results of echocardiography.