Patent foramen ovale diagnostic study of choice: Difference between revisions
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{{Patent foramen ovale}} | {{Patent foramen ovale}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{IO}} | ||
== Overview == | ==Overview== | ||
The diagnostic study of choice for patent foramen ovale is contrast-enhanced transesophageal echocardiography (c-TEE). | |||
== Diagnostic Study of Choice == | == Diagnostic Study of Choice == | ||
=== Study of choice === | === Study of choice === | ||
The diagnostic study of choice for patent foramen ovale is contrast-enhanced transesophageal echocardiography (c-TEE). | The diagnostic study of choice for patent foramen ovale is contrast-enhanced transesophageal echocardiography (c-TEE).<ref name="pmid1987242">{{cite journal| author=Pearson AC, Labovitz AJ, Tatineni S, Gomez CR| title=Superiority of transesophageal echocardiography in detecting cardiac source of embolism in patients with cerebral ischemia of uncertain etiology. | journal=J Am Coll Cardiol | year= 1991 | volume= 17 | issue= 1 | pages= 66-72 | pmid=1987242 | doi=10.1016/0735-1097(91)90705-e | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1987242 }} </ref> | ||
==== The comparison of various diagnostic studies for | ==== The comparison of various diagnostic studies for patent foramen ovale ==== | ||
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|- style="background: #4479BA; color: #FFFFFF; text-align: center;" | |- style="background: #4479BA; color: #FFFFFF; text-align: center;" | ||
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity | ! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity | ||
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! style="background: #696969; color: #FFFFFF; text-align: center;" | | ! style="background: #696969; color: #FFFFFF; text-align: center;" |Transesophageal echocardiography | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |89% | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |100% | ||
|- | |||
! style="background: #696969; color: #FFFFFF; text-align: center;" |Transthoracic echocardiography | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |46% | |||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |99% | |||
|- | |- | ||
! style="background: #696969; color: #FFFFFF; text-align: center;" | | ! style="background: #696969; color: #FFFFFF; text-align: center;" |Transcranial doppler | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |96% | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" | | | style="background: #DCDCDC; padding: 5px; text-align: center;" |93% | ||
|} | |} | ||
< | |||
====Diagnostic results==== | |||
The following finding on performing contrast-enhanced transesophageal echocardiography is confirmatory for patent foramen ovale:<ref name="pmid15772190">{{cite journal| author=Pinto FJ| title=When and how to diagnose patent foramen ovale. | journal=Heart | year= 2005 | volume= 91 | issue= 4 | pages= 438-40 | pmid=15772190 | doi=10.1136/hrt.2004.052233 | pmc=1768819 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15772190 }} </ref><ref name="MasArquizan2001">{{cite journal|last1=Mas|first1=Jean-Louis|last2=Arquizan|first2=Caroline|last3=Lamy|first3=Catherine|last4=Zuber|first4=Mathieu|last5=Cabanes|first5=Laure|last6=Derumeaux|first6=Geneviève|last7=Coste|first7=Joël|title=Recurrent Cerebrovascular Events Associated with Patent Foramen Ovale, Atrial Septal Aneurysm, or Both|journal=New England Journal of Medicine|volume=345|issue=24|year=2001|pages=1740–1746|issn=0028-4793|doi=10.1056/NEJMoa011503}}</ref><ref name="YuanKasner2018">{{cite journal|last1=Yuan|first1=Kristy|last2=Kasner|first2=Scott Eric|title=Patent foramen ovale and cryptogenic stroke: diagnosis and updates in secondary stroke prevention|journal=Stroke and Vascular Neurology|volume=3|issue=2|year=2018|pages=84–91|issn=2059-8688|doi=10.1136/svn-2018-000173}}</ref> | |||
*Presence of bubbles across the inter-atrial septum into the left atrium: A diagnosis is made with the appearance of at least three micro-bubbles within three cardiac cycles after the complete opacification of the right atrium. | |||
==References== | ==References== | ||
Latest revision as of 18:12, 27 February 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2]
Overview
The diagnostic study of choice for patent foramen ovale is contrast-enhanced transesophageal echocardiography (c-TEE).
Diagnostic Study of Choice
Study of choice
The diagnostic study of choice for patent foramen ovale is contrast-enhanced transesophageal echocardiography (c-TEE).[1]
The comparison of various diagnostic studies for patent foramen ovale
| Test | Sensitivity | Specificity |
|---|---|---|
| Transesophageal echocardiography | 89% | 100% |
| Transthoracic echocardiography | 46% | 99% |
| Transcranial doppler | 96% | 93% |
Diagnostic results
The following finding on performing contrast-enhanced transesophageal echocardiography is confirmatory for patent foramen ovale:[2][3][4]
- Presence of bubbles across the inter-atrial septum into the left atrium: A diagnosis is made with the appearance of at least three micro-bubbles within three cardiac cycles after the complete opacification of the right atrium.
References
- ↑ Pearson AC, Labovitz AJ, Tatineni S, Gomez CR (1991). "Superiority of transesophageal echocardiography in detecting cardiac source of embolism in patients with cerebral ischemia of uncertain etiology". J Am Coll Cardiol. 17 (1): 66–72. doi:10.1016/0735-1097(91)90705-e. PMID 1987242.
- ↑ 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.
- ↑ Mas, Jean-Louis; Arquizan, Caroline; Lamy, Catherine; Zuber, Mathieu; Cabanes, Laure; Derumeaux, Geneviève; Coste, Joël (2001). "Recurrent Cerebrovascular Events Associated with Patent Foramen Ovale, Atrial Septal Aneurysm, or Both". New England Journal of Medicine. 345 (24): 1740–1746. doi:10.1056/NEJMoa011503. ISSN 0028-4793.
- ↑ Yuan, Kristy; Kasner, Scott Eric (2018). "Patent foramen ovale and cryptogenic stroke: diagnosis and updates in secondary stroke prevention". Stroke and Vascular Neurology. 3 (2): 84–91. doi:10.1136/svn-2018-000173. ISSN 2059-8688.