Coronary artery disease is common in elderly patients with ischemic stroke. Most patients with ischemic stroke undergo transesophageal echocardiography to rule out cardiac sources of cerebral embolism. Transesophageal echocardiography has been shown to be very accurate in diagnosing significant proximal coronary artery stenosis, and may be used to evaluate the coronary arteries for the presence of stenosis in elderly patients with ischemic stroke. Transesophageal echocardiographic detection of these lesions might lead to subsequent coronary angiography and revascularization, dramatically changing the management and out- come of these patients. (C) 2000 by Cardiovascular Reviews and Reports, Inc.