Comparison of the Utility of Transesophageal Echocardiography in Patients With Acute Ischemic Stroke and Transient Ischemic Attack Stratified by Age Group (<60, 60 to 80, ≥80 Years).

The objective was to study the utility of transesophageal echocardiography (TEE) in affecting acute ischemic stroke treatment of older adults (age ≥80 years). Patients hospitalized in January 2010 and February 2015 were included who had TEE ordered as part of their diagnostic workup at a tertiary medical center. We studied 515 hospitalized patients with acute stroke or transient ischemic attack who underwent TEE. The proportion of patients with important TEE findings was 35%. However, TEE changed management in only 2.5% of cases. When anticoagulation for proximal mobile aorta atheroma was excluded, no change in management resulted from TEE for patients older than 80 years. In conclusion, TEE has a low likelihood of a pathologic finding that resulted in a change in treatment strategy, especially in patients ≥80 years of age.