Téma: 

Limitations and pitfalls of transoesophageal echocardiography

Juraj Podracký

The author underlines great benefits of transoesophageal echocardiography (TEE) that has recently become the part of diagnostic and therapeutic decision making algorithms in some severe heart diseases but he mostly concentrates on limitations and pitfalls related to this examination. Generally TEE provides better spatial, time and contrast resolution and better quality of imaging in most patients and has less limitation than transthoracal examination. At the same time, there are more severe pitfalls related to this examination. Artifacts (any structures in ultrasound image not having any corresponding anatomical structure) and “pitfalls” (normal structures that are frequently wrong interpreted as pathological and pathological structures evaluated as normal or artifacts) can cause severe false diagnosis. The author gives details of clinically most important pitfalls of transoesophageal examination and states that TEE examination needs appropriate skill and experience to avoid serious consequences of potentially false interpretations of examination and diagnosis.

Ročník 2010  Témy časopisu Cardiology for practice 4 / 2010

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Examples of citations:
1. Shaheen NJ, Crosby NA, Bozymski EM, et al. Is there publication bias in the reporting cancer risk in Barrett´ esophagus? Gastroenterology 2000; 119: 333-338.
2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285: 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
5. Osborne BE. The electrocardiogram of the rat. In: Budden R, Detweiler DK, Zbinden G. The rat electrocardiogram in pharmacology and toxicology. Oxford: Pergamon Press 1981: 15-27.

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In which patients, after overcoming of a thromboembolic cerebral or peripheral event, the least suitable catheter closure is foramen ovale patents:
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b. paroxysmal fibrillation of the atrium
c. aneurysm of the atrium septum
d. origination of an event after cough

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