Frequency of echocardiographic abnormalities in patients with ischemia of the carotid territory--a preliminary report.

Eighty-eight consecutive patients referred to a neurosurgical Department (63 men and 25 women) aged from 14 to 68 years, with cerebral ischemia in the carotid territory were subjected to M-mode and two-dimensional echocardiography, carotid angiography and assessment of risk factors. There were 27 patients (average age 54 years) in whom carotid angiography demonstrated a probable source for the ischemia. Carotid angiography was normal in 51 of the remaining 61 (average age 39 years) while 10 revealed distant emboli. Although the incidence of "abnormal echocardiograms" was similar in the two groups (56% and 54% respectively) the spectrum of abnormalities were different. Only 5 (18%) of the 27 patients with abnormal angiograms had a potential cardiac source of emboli while 24 (39%) out of the remaining 61 patients had a potential cardiac source demonstrated at echocardiography. There was a high incidence of mitral valve prolapse (34%) in this latter group of patients. Mitral valve prolapse was not seen in the present series in patients with a probable carotid source on angiography.