Abstract Details

Title Utility of Routine Transthoracic Echocardiogram in Stroke Evaluation in a Low-resource Settings.

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-020

Objective To assess the effectiveness of routine transthoracic echocardiography (TTE) in stroke management in a low-resource setting.

Background A TTE is a key investigation in stroke evaluation. Evidence on the utility of routine TTE in stroke workup is heavily skewed towards resource-rich settings. Whether or
not its routine use can lead to clinically actionable findings that can improve patient outcomes in ischemic stroke or transient ischemic attack in low-resource settings is unclear.

Design/Methods We conducted a cross-sectional study with stroke patients from two stroke units in Senegal.
Transthoracic echocardiograms were done on patients presenting with either ischemic stroke or transient ischemic attack (TIA) as standard first-line tests for stroke evaluation. We assessed the proportion of patients with TTE findings that altered management and assessed the impact on patient outcomes.

Results We enrolled a total of 479 stroke patients, with 83.7% (401/479) confirmed ischemic stroke and
16.3% (78/479) transient ischemic attack. Of all the TTEs assessed, 78.2% were normal or revealed no
clinically actionable findings. TTE findings altered management in 22.8% of patients by identifying
rheumatic valvular heart disease (54.1%), dilated cardiomyopathy (24.1%), intracardiac thrombus (8.4%), and ischemic heart disease (7.2%). There was no statistically significant improvement in Modified Rankin scores at discharge for patients with clinically actionable findings. A younger age (≤50 years) was significantly associated with clinically actionable findings.

Conclusions While TTE is a valuable tool in stroke evaluation, in low-resource settings where patients’ financial resources are often limited, our results suggest that routine use of TTEs as part of standard first-line test in ischemic stroke or TIA should be reconsidered. Rigorous selection of patients for TTE will ensure that limited resources are allocated efficiently and effectively.

Authors/Disclosures
Mundih N. Njohjam, MD (University of Cheikh Anta Diop) PRESENTER	Dr. Njohjam has nothing to disclose.
NGOULE Mark Olivier, MD	Dr. Mark Olivier has nothing to disclose.
Falonne Tiffany Niakam Mbouleup, MD	Dr. Niakam Mbouleup has nothing to disclose.

��ɫ��

��ɫ��