Cardiac MRI improves identification of etiology of ischemic stroke

Background Stroke is the third leading cause of death in the United States. Ischemic etiologies account for the vast majority of all cases of stroke from which about 20-25% have a cardiogenic cause. Transthoracic echocardiography (TTE) is widely used as the initial test for evaluating patients with a suspected cardioembolic of stroke while additional studies are often required to further detect a cardiac source in patients with unremarkable TTE. While transesophageal echocardiography (TEE) has provided clinicians with invaluable information in these cases, most physicians find it cumbersome at best and patients it extremely uncomfortable. CMR is a novel imaging modality that is increasingly being used in assessing patients with cardiovascular disease. The noninvasive nature of this test makes it an attractive option for evaluating strokes for which a TTE is non-diagnostic. In this study, we assessed the feasibility of using CMR as an imaging modality additional to TTE for detection of cardioembolic strokes.