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Transesophageal Echocardiography

It is estimated that up to 20% of strokes are from intracardiac causes with the majority associated with atrial fibrillation...

In a relatively brief span of 3 decades, major advances and technologic breakthroughs in echocardiography have occurred, including high-resolution imaging, pulsed- and continuous-wave Doppler studies, color flow imaging, and, most recently, transesophageal echocardiography (TEE). Because echocardiography is, in general, readily available, noninvasive, portable, and without the risks of irradiation and because it provides high-resolution tomographic images of the cardiac morphologic features, function, and hemodynamics, it has become the most commonly…

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 Utility of Transesophageal Echocardiography in Cardiac Arrest

The use of point of care ultrasound (POCUS) or focused cardiac ultrasound (FOCUS) during cardiac arrest is increasingly reported in emergency and critical care medicine literature over the last decade. The main impact of echocardiography in cardiac arrest is to distinguish true-PEA from “pseudo-PEA.” The latter condition represents a group of causes of “treatable cardiac arrest” with present ventricular activity, which portend better survival rates.

Articles of Interest

An update on transesophageal echocardiography views 2016: 2D versus 3D tee views

3D echocardiography, a relatively new technology enables the echocardiographer to provide the real time images that contains all pertinent information.

Cardiac Workup of Ischemic Stroke

The relative ease of the performance of transthoracic echocardiogram (TTE) and the higher sensitivity of transesophageal echocardiogram (TEE) are well established. TTE is widely available, noninvasive, cheaper, and easier to perform than TEE, but it is clearly less sensitive for the detection of cardiac SOE. TEE is not as widely available, is invasive, more expensive, and takes longer to perform than TTE, but has a much higher diagnostic yield. Although the sensitivity of TTE and TEE for LV thrombi is similar, LA thrombi are detected on TTE in only 39% to 73% of patients, versus 93% to 100% on TEE

Echocardiogram Spots Risk of Valve Narrowing, Stroke

Standard echocardiograms which image the heart using ultrasound waves -- much like the ultrasound images used during pregnancy to monitor fetal development -- can be used as a screening tool to spot aortic valve abnormalities and to identify people at high risk for stroke and heart valve disease, according to a Mayo Clinic study published in September's Journal of the American College of Cardiology.

MRI and Echocardiography Together Can ID More Causes of Stroke

Based on a new study released today, researchers urge more comprehensive imaging for patients presenting to hospitals with stroke symptoms. Using both MRI and echocardiography to image the heart greatly enhances the detection of the cause and selection of the best treatment of cardioembolic strokes, the "meanest" type of stroke.

Resources

Virtual Transesophageal Echocardiography

This site is intended to be a resource for educators and students looking for tools to facilitate the teaching and learning of transesophageal echocardiography.

National Heart, Lung, and Blood Institute

TEE involves a flexible tube (probe) with a transducer at its tip. Your doctor will guide the probe down your throat and into your esophagus (the passage leading from your mouth to your stomach). This approach allows your doctor to get more detailed pictures of your heart because the esophagus is directly behind the heart.

American Nurse Today

Transesophageal echocardiography (TEE) is a minimally invasive diagnostic study that can be done quickly and easily in most patients. Unlike transthoracic echocardiography (TTE), the more common echocardiographic study, TEE provides a clear view of virtually all cardiac structures unobstructed by bones, lungs, or the pericardial chest wall.

Heart.org

Doctors use TEE to find problems in your heart’s structure and function. TEE can give clearer pictures of the upper chambers of the heart, and the valves between the upper and lower chambers of the heart, than standard echocardiograms.

MedlinePlus

An abnormal echocardiogram can mean many things. Some abnormalities are very minor and do not pose significant risks. Other abnormalities are signs of very serious heart disease that will require further evaluation by a specialist.

The Internet Stroke Center

Doctors often use TTE on patients in whom they suspect blood clotting (called cardiac embolus), since clots that form in the heart can be detected using this procedure. Blood clots are a leading cause of stroke, as 80% of all clots in the heart eventually come loose and travel to the brain. An echocardiogram can help determine how to treat or prevent a stroke (if a blood clot is found in the heart, a blood-thinner such as Warfarin may be prescribed). TTE is performed routinely after heart attack and as part of a stroke evaluation.

Up To Date

Intracardiac sources of cerebrovascular ischemic events are increasingly being recognized and may account for 15 to 20 percent of the 500,000 strokes which occur annually in the United States. Although transthoracic echocardiography (TTE) remains the cornerstone of noninvasive cardiac imaging, transesophageal echocardiography (TEE) has been shown to be a superior method for the identification of most cardiac sources of emboli and more cost effective.