Patent foramen ovale echocardiography

Jump to navigation Jump to search

Patent Foramen Ovale Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Patent Foramen Ovale from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

PFO and Stroke

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Patent foramen ovale echocardiography On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Patent foramen ovale echocardiography

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Patent foramen ovale echocardiography

CDC on Patent foramen ovale echocardiography

Patent foramen ovale echocardiography in the news

Blogs on Patent foramen ovale echocardiography

Directions to Hospitals Treating Patent foramen ovale

Risk calculators and risk factors for Patent foramen ovale echocardiography

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [3]

Overview

Transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and transcranial Doppler (TCD) are the commonly used diagnostic tools for patent foramen ovale[1]. Each method has its own advantage and disadvantages in diagnosing patent foramen ovale. Transesophageal echocardiography is more sensitive in visualizing the interatrial septum, than transthoracic echocardiography and is the imaging modality of choice. Patients with clinical suspicion of patent foramen ovale and negative results with transthoracic echocardiography should be referred for a transesophageal echocardiography [2][3]. Transthoracic echocardiography (TTE) with contrast at rest, with cough, and after valsalva maneuver is generally considered the most definitive diagnostic test for patent foramen ovale. The performance of a bubble study on echocardiography is especially useful with small patent foramen ovale.

Echocardiography

Transesophageal Echocardiography

  • It is the imaging study of choice in adults with suspected paradoxical embolism.[4]
  • It may be difficult to use when diagnosing right-to-left shunts with contrast echocardiography because sedation makes valsalva maneuver more difficult to perform.[4]

Advantage

  • Gold standard in diagnosing patent foramen ovale.
  • It detects other associated lesions like aortic atheroma, left atrial appendage thrombus and spontaneous left atrial contrast. Thus, helps in finding other occult causes for stroke.

Transthoracic Echocardiography

Advantage

Disadvantage

  • Poor image quality can lead to missing some of the patent foramen ovale.

Contrast Echocardiography

  • It is used in detecting the presence of a right-to-left shunt across a patent foramen ovale. This is done by injecting a contrast medium into a peripheral vein. During the strain phase of the valsalva maneuver, the contrast is injected and the atrial septum is imaged during the release phase of the maneuver.[4]
  • If at least three contrast bubbles appear in the left atrium, a patent foramen ovale is said to be present.[4]

Transcranial Doppler

Advantage

Disadvantage

References

  1. Sastry S, Daly K, Chengodu T, McCollum C (2007). "Is transcranial Doppler for the detection of venous-to-arterial circulation shunts reproducible?". Cerebrovasc Dis. 23 (5–6): 424–9. doi:10.1159/000101466. PMID 17406112.
  2. Thanigaraj S, Valika A, Zajarias A, Lasala JM, Perez JE (2005). "Comparison of transthoracic versus transesophageal echocardiography for detection of right-to-left atrial shunting using agitated saline contrast". Am J Cardiol. 96 (7): 1007–10. doi:10.1016/j.amjcard.2005.05.061. PMID 16188533.
  3. Van Camp G, Franken P, Melis P, Cosyns B, Schoors D, Vanoverschelde JL (2000). "Comparison of transthoracic echocardiography with second harmonic imaging with transesophageal echocardiography in the detection of right to left shunts". Am J Cardiol. 86 (11): 1284–7, A9. PMID 11090813.
  4. 4.0 4.1 4.2 4.3 Pinto FJ (2005). "When and how to diagnose patent foramen ovale". Heart. 91 (4): 438–40. doi:10.1136/hrt.2004.052233. PMC 1768819. PMID 15772190.


Template:WikiDoc Sources