Gabriel Kamenský
A review of cardinal sources of embolization (CSE), possibilities of their detection, contribution of transthoracal and transesophageal echocardiography. The incidence of CSE in non selective population is relatively low and the highest effectiveness of examination is expected in patients with positive clinical history of ventricular fibrillation, postrheumatic mitral stenosis, difuse atherosclerosis, left ventricle aneurysm and bacterial endocarditis. Despite cases of apical thrombus in left ventricle and findings of thick calcifications of mitral ring in the elderly, TEE is more significant in detection of CSE than TTE. However, therapeutic implications in patients with suspected CSE are ambiguous and controversial. Currently there are several ongoing prospective multicentric randomized studies evaluating TEE effectiveness in patients with cryptogenous stroke or TIA. TEE is indicated if history or physical examination confirm the presence of CSE and where change of therapeutic approach might affect the prognosis of the patient.