Hi, In your mother s case there might be following causes of TIA: 1) Atrial fibrillation (AF): - During period of AF there might be fall in blood pressure that may lead to decreased blood supply to brain which produce symptoms of TIA. - In case of persistent AF there may be development of blood clots in heart chamber (left atria) which may get dislodged from heart in to aorta (big artery which originate from left lower chamber of heart, left ventricle and supply blood to whole body) and from there to blood vessel of brain (carotid arteries, vertebral arteries or their branches) which causes decreased blood supply to brain and produce symptoms of TIA. Presence of blood clot can be detected on 2DEcho (Transoesophageal than trans thoracic) 2) Atherosclerotic changes in blood vessel of brain (carotid arteries, vertebral arteries or their branches) this is usually due to hyperlipidemia, concomitant presence of diabetes and hypertension if any increases the risk. Dizzy spells and shortness of breath may be due to AF. AF may lead to heart failure and breathing difficulty. Following investigations may help in planning treatment: 1) ECG which may detect persistent AF. 2) 2DEcho (echocardiography of heart) transoesophageal is proffered in this case. 3) MRI Brain with Angiography it will help in detection of permanent damage to brain due to impaired blood supply and tell the condition (presence of stenosis and if present its percentage) of blood vessels of brain. 4) Carotid artery doppler: help in detection of stenosis in carotid arteries. I will advise you to consult cardiologist and neurologist for better decision making for your mother till that time 1) Continue ASA. 2) Continue statins for hyperlipidemia. 3) Regular check up of blood pressure, blood sugar levels and keep it under control.