Yield of Transesophageal Echocardiography for Nonbacterial Thrombotic Endocarditis and Other Cardiac Sources of Embolism in Cancer Patients With Cerebral Ischemia

Cerebrovascular events occur frequently in patients who succumb to cancer, and nonbacterial thrombotic endocarditis (NBTE) is a frequent postmortem finding in these patients. Despite the excellent diagnostic accuracy of transesophageal echocardiography (TEE) for cardiac sources of cerebral embolism,...

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Bibliographic Details
Published in:The American journal of cardiology 2006-03, Vol.97 (6), p.894-898
Main Authors: Dutta, Tanya, Karas, Maria G., Segal, Alan Z., Kizer, Jorge R.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Blood clots
Brain Ischemia - complications
Brain Ischemia - diagnostic imaging
Cancer
Cardiology
Cardiology. Vascular system
Cohort Studies
Echocardiography, Transesophageal
Endocardial and cardiac valvular diseases
Endocarditis - complications
Endocarditis - diagnostic imaging
Endocarditis - epidemiology
Female
Heart
Heart Ventricles - diagnostic imaging
Humans
Intracranial Embolism - diagnostic imaging
Intracranial Embolism - epidemiology
Intracranial Embolism - etiology
Male
Medical sciences
Middle Aged
Neoplasms - complications
Neoplasms - diagnostic imaging
Neurology
Prevalence
Retrospective Studies
Thrombosis - complications
Thrombosis - diagnostic imaging
Tumors of the heart
Ultrasonic imaging
Vascular diseases and vascular malformations of the nervous system
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Description
Summary:Cerebrovascular events occur frequently in patients who succumb to cancer, and nonbacterial thrombotic endocarditis (NBTE) is a frequent postmortem finding in these patients. Despite the excellent diagnostic accuracy of transesophageal echocardiography (TEE) for cardiac sources of cerebral embolism, however, the prevalence of NBTE and other cardioembolic sources in patients with cancer and cerebral ischemia has not been investigated using this modality. This study examined the frequency of cardioembolic findings in consecutive patients with cancer referred to our institution for TEE evaluation of cerebrovascular events. The study cohort comprised 51 patients, of whom 18% had marantic vegetations, and 47% and 55% of whom had definite and definite or probable cardiac sources of embolism, respectively. The present study documents, for the first time, a high frequency of marantic endocarditis and other cardioembolic sources in patients with cancer and cerebrovascular events selected for TEE. This finding has important implications for evaluation and management in this patient population.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2005.09.140