Cardiologia (Rome, Italy)
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Cardiologia (Rome, Italy) · Dec 1993
Review Comparative Study[Role of transesophageal echography in the study of embolism of cardiac origin].
In the total population, cerebrovascular ischemic diseases account for 0.2-0.3% cases per year, and in the 20-40% of them it is possible to recognize a cardioembolic mechanism. The cardiological examination in patients with stroke is, therefore, aimed at detecting cardiac sources of emboli (left atrial, valvular, and ventricular thrombosis, atherosclerotic plaques of ascending aorta), and at identifying the cardiovascular disease directly or indirectly associated with ischemic stroke. Transesophageal echocardiography (TEE) is particularly suitable for this purpose, due to the proximity of the transducer to the posterior cardiac structures and to its better resolution. ⋯ The role of TEE before and immediately after cardioversion in patients with atrial fibrillation has been recently studied by several papers. Cardioversion was proved at low risk of stroke when TEE did not show left atrial or left appendage thrombosis. Therefore, the transesophageal approach identifies patients needing prolonged anticoagulation (roughly 20%), avoiding an undue, potentially dangerous therapy.
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Cardiologia (Rome, Italy) · Dec 1993
Clinical Trial[Pulmonary venous flow in atrial fibrillation evaluated by transesophageal Doppler echocardiography].
Pulmonary venous flow (PVF) can be recorded by transesophageal echocardiography. In normal subjects the PVF is triphasic with 2 peaks in systole and 1 peak in diastole. At atrial contraction it is possible to record a reversal flow (A wave). ⋯ The diastolic wave was increased and prolonged. We also observed that the A wave seems to disappear. The loss of atrial contraction deeply modifies the Doppler PVF.