This was a retrospective comparison of the results of a standard TTE performed as part of a routine stroke workup with POCUS performed by a cardiologist.  A total of 99 stroke patients were included.   Patients selected for study had a cardiologist perform a quick (roughly 10 min) POCUS, using four basic views (parasternal long-axis, parasternal short-axis, subcostal, and apical).  The cardiologist qualitatively assessed basic parameters relevant to the workup of acute ischemic stroke/TIA that included an estimate of LV function, left atrial size, mitral valve and aortic valve pathology, and the presence of LA or LV thrombi, masses, or aneurysms.  The cardiologist was blinded to the results of the TTE.

All 16 cases with LV dysfunction, LV thrombi, or AV/MV vegetations on TTE were seen on POCUS.  Of the 13 patients with severely abnormal LV function on TTE, 12 were identified as severe on POCUS, with one being identified as mild-moderate LV dysfunction.  Findings of TTE in 9 patients changed management. All findings were seen on POCUS.

POCUS was non-inferior to the “gold standard” TTE as a screening echocardiography in the workup of acute ischemic stroke & TIA.  Significant findings on the TTE relevant to the workup of a stroke patient were detected by bedside POCUS with high accuracy.  When compared to a standard TTE, POCUS may lead to crucial earlier treatment decisions.