The role of transthoracic echocardiography in embolic acute limb ischaemia.

INTRODUCTION: Embolic acute limb ischaemia (ALI) is commonly treated by re-vascularization and long-term anticoagulant therapy. Transthoracic echocardiography (TTE) is commonly used to screen for cardiac embolic source, but may not affect management. REPORT: We reviewed 115 consecutive patients with embolic ALI, 61% underwent TTE, with cardiac thrombus identified in only 3%. Incidental severe abnormalities requiring further cardiological investigation were detected in 19% of patients. Inpatient TTE did not affect mortality, morbidity, amputation rate, or anticoagulation. DISCUSSION: Transthoracic echocardiography seldom identifies a cardiac embolic source, but identifies many patients with severe incidental cardiac abnormalities, suggesting cardiology screening of these patients remains important.