Chlumský J, Bojar M, Sváb P, Holá D
I. interní klinika FN Motol, Praha.
Vnitr Lek. 1997 Apr;43(4):211-3.
Atrial fibrillation is an important risk factor of embolization into the CNS. Thus affected patients should receive permanent anticoagulant therapy. Oesophageal echocardiography (TEE) can help our decision in patients with relative contraindications of anticoagulant therapy. TEE was performed in 52 patients with atrial fibrillation and cerebrovascular attack (CMP) with an ischaemic aetiology. Transthoracic echocardiography did not reveal the source of embolization. In 10% patients a thrombus was found in the appendage of the left atrium, in another 9% patients a spontaneous echocontrast was found in the left atrium (prethrombotic condition) and in 5% patients an open foramen ovale. The results indicate the highly probable etiology of embolization in patients with cerebrovascular attacks and atrial fibrillation. This supports the recommendation of absolute indication of anticoagulant treatment in patients with cerebrovascular attacks and atrial fibrillation.
心房颤动是中枢神经系统栓塞的重要危险因素。因此，受影响的患者应接受长期抗凝治疗。食管超声心动图（TEE）有助于我们对有抗凝治疗相对禁忌症的患者做出决策。对52例患有心房颤动和缺血性病因的脑血管意外（CVA）患者进行了TEE检查。经胸超声心动图未发现栓塞源。10%的患者在左心耳发现血栓，另外9%的患者在左心房发现自发回声增强（血栓前状态），5%的患者发现卵圆孔未闭。结果表明，脑血管意外和心房颤动患者栓塞的病因极有可能如此。这支持了对脑血管意外和心房颤动患者进行抗凝治疗绝对适应症的建议。
