![]() In recent years, reports on the use of cardiac magnetic resonance imaging (MRI) and computed tomography (CT) after stroke have been increasingly published, particularly in patients with unknown stroke etiology. Transthoracic (TTE) and/or transesophageal echocardiography (TEE) are the standard methods for cardiac imaging after ischemic stroke. ![]() ![]() Ao aorta, IVC inferior vena cava, LA left atrium, LAA left atrial appendage, LV left ventricle, LVOT left ventricular outflow tract, (M/R) PA (main/right) pulmonary artery, RA right atrium, RV right ventricle g Aortic atheroma ≥ 4 mm have been associated with ischemic stroke and can be detected during retraction of the TEE probe at the end of the examination (here mid-esophageal short (left) and long (right) axis view of the ascending aorta). f Vegetations, a main criterion for endocarditis (here mitral valve endocarditis diagnosed in a mid-esophageal longitudinal axis view of the left ventricle at about 120° in the TEE examination left), and prosthetic valves (here double-wing prosthesis of the mitral valve shown in a parasternal longitudinal axis view of the TTE right) are further potential sources of cardioembolism. e Bubble transition from the right to the left atrium (positive “bubble test”) in case of a patent foramen ovale documented using a TEE mid-esophageal bicaval view at about 110°. d The usually valve associated papillary fibroelastoma (PFE) and myxoma, typically located in the atria, are the most common primary cardiac tumors in adults, which are both associated with a high risk of embolism (TTE parasternal long-axis view). c Transthoracic apical 4-chamber-view demonstrating the pronounced dilation of the left ventricle in case of a dilated cardiomyopathy (left) and the multiple prominent ventricular trabeculations with intertrabecular spaces seen in non-compaction cardiomyopathy (right). b Typical presentation of a LAA thrombus on a TEE mid-esophageal 2-chamber view at about 90°. a The most common localization of LV thrombi, usually the result of regional akinesia due to a previous myocardial infarction, is the LV apex, which is ideally visualized on the apical 4-chamber view of the TTE. Schematic presentation of the most frequent sources for cardiovascular embolism.
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