Fasting is not routinely required for lipid testing because the lipid profile components under fasting and nonfasting conditions differ in non- clinically significant degrees (the exception being patients with nonfasting triglycerides of >440 mg/dL, who should have fasting levels drawn).86 HbA1c determination can detect new cases of type 2 diabetes (T2D) in 11.5% of patients pre- senting with acute ischemic stroke and prediabe- tes in 36.2%.54 Abnormal blood testing can help to stratify risk so that physicians can concentrate efforts of prevention on those at highest risk. In patients with lacunar infarction, chronic kidney dis- ease is associated with a 50% increase in risk of Testing prothrombin time and activated partial thromboplastin time screens for diverse clotting and bleeding disorders that are relevant to active management of patients with acute stroke. An isolated prolonged activated par- tial thromboplastin time can be seen with heparin use, lupus anticoagulant, or clotting factor deficien- All of these states or exposures are relevant to long-term management of patients with stroke. Liver failure, malnutrition, malabsorption, myelopro- liferative diseases, and disseminated intravascular coagulation can cause acquired factor deficiencies and would have relevance in managing patients 6. Many diseases with specific indications for specific treatment such as patent foramen ovale (PFO), papillary fibroelastoma, myxoma, endocarditis, and intracardiac thrombi are diagnosed by echocardiog- Transthoracic echocardiography is preferred over TEE for the detection of left ventricular (LV) thrombus, but TEE is superior to transthoracic echo- cardiogram in detecting left atrial thrombus, aortic atheroma, prosthetic valve abnormalities, native CLINICAL STATEMENTS AND GUIDELINES Kleindorfer valve abnormalities, atrial septal abnormalities, and A systematic review that included 65 studies concluded that transthoracic echocar- diography in the second harmonic is cost-effective relative to TEE.56 TEE findings will change manage- ment in 1 in 7 patients with ESUS.57 7. 