| Transthoracic echocardiography using second harmonic imaging with Valsalva manoeuvre for the detection of right to left shunts. | |
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MedLine Citation:
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PMID: 15147659 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To assess transthoracic echocardiography (TTE) using second harmonic imaging with Valsalva manoeuvre compared to transesophageal echocardiography (TEE) for the diagnosis of right to left cardiac and pulmonary shunts. METHODS AND RESULTS: One hundred and ten patients referred for TEE underwent TTE with bubble contrast. Bubbles in the left atrium within three cardiac cycles were considered diagnostic for a patent foramen ovale (PFO) and later as a pulmonary shunt. Greater than 20 bubbles in the left atrium was considered a large shunt and less than 20 a small shunt. TEE was performed immediately afterwards and read blinded to the TTE results. Pick-up rates were similar with 19 TEE positive (13 PFO) and 18 TTE positive (14 PFO) patients. There were five TEE positive/TTE negative cases who had significantly poorer TTE image quality score (2.7 +/- 0.8 vs 1.9 +/- 0.6, p < 0.05). There were six TEE negative/TTE positive cases, two cases requiring Valsalva manoeuvre to become positive. The Valsalva manoeuvre significantly increased the number of bubbles shunting (10 +/- 11 vs 20 +/- 19, p < 0.005). CONCLUSION: TTE with Valsalva manoeuvre is as good as TEE in diagnosing shunts. Valsalva manoeuvre increases the size of shunt. Both techniques produce false negative results. |
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Authors:
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N R A Clarke; J Timperley; A D Kelion; A P Banning |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology Volume: 5 ISSN: 1525-2167 ISO Abbreviation: Eur J Echocardiogr Publication Date: 2004 Jun |
Date Detail:
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Created Date: 2004-05-18 Completed Date: 2004-10-08 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100890618 Medline TA: Eur J Echocardiogr Country: England |
Other Details:
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Languages: eng Pagination: 176-81 Citation Subset: IM |
Affiliation:
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Department of Cardiology, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Cardiac Output / physiology Coronary Circulation / physiology Coronary Thrombosis / ultrasonography Echocardiography / methods* Embolism, Paradoxical / diagnosis, ultrasonography* Female Heart Septal Defects, Atrial / diagnosis, ultrasonography* Humans Male Middle Aged Pulmonary Embolism / ultrasonography Sodium Chloride / diagnostic use Valsalva Maneuver* |
| Chemical | |
Reg. No./Substance:
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7647-14-5/Sodium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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