Atrial septal defect transcranial doppler ultrasound: Difference between revisions
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==Overview== | ==Overview== | ||
Trans-cranial doppler ultrasound is a diagnostic tool that involves a simple intravenous injection of saline under minimal sedation. It is | Trans-cranial doppler ultrasound is a diagnostic tool that involves a simple intravenous injection of saline under minimal sedation. It is primarily utilized to further diagnostically evaluate a patent foramen ovale defect. | ||
== | ==Transcranial Doppler Ultrasound== | ||
* Non-invasive ultrasound method | |||
* Operated by a hand-held Doppler transducer that functions on a pulsating low-frequency | |||
* Requires no sedation | |||
* Involves a simple intravenous injection of saline solution | |||
* Testing standard in clinical trials of patent foramen voale closure devices and in studies ivestigating the relationship and interconnectivity of patent foramen ovale, stroke and migraines. | |||
* Effectively assesses the intracranial circulation by recording blood velocities from intracranial arteries as they travel through cranial foramina and regions of the skull cavity | |||
* '''Transcranial Doppler ultrasound Bubble test''' can be used to determine hemodynamic interaction between atriums of the heart | |||
==Indications== | |||
* Effective in detecting narrowing of cerebral arteries | |||
* Effective in measuring hemodynamic circulation patterns within occluded diseased cerebral arteries | |||
* Effectively measures: | |||
:* Peak systolic velocity | |||
:* Peak diastolic velocity | |||
:* Mean velocity | |||
:* Pulsitility | |||
==Advantages== | |||
* Usage of Valsalva manuever during testing can increase the visibility and overall detection of an atrial septal defect | |||
* Less invasive than other methods | |||
* Cost effective | |||
* Can be completed in under an hour | |||
==Common Findings== | |||
* A defect may present in two ways: | |||
:* Small right-to-left shunt at start of systole ('''biphasic'''), associated with patent foramen ovale | |||
:* Larger left-to-right shunt, associated primarily with atrial septal defect | |||
* Visualization of bubbles in the left atrium and left ventricle | |||
==Supportive Trial Data== | |||
* Transcranial Doppler ultrasound Bubble study has minimal or no complications.<ref name="pmid20971751">{{cite journal| author=Tsivgoulis G, Stamboulis E, Sharma VK, Heliopoulos I, Voumvourakis K, Teoh HL et al.| title=Safety of transcranial Doppler 'bubble study' for identification of right to left shunts: an international multicentre study. | journal=J Neurol Neurosurg Psychiatry | year= 2010 | volume= | issue= | pages= | pmid=20971751 | doi=10.1136/jnnp.2010.219733 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20971751 }} </ref> | |||
:* One study which detected an incidence of adverse events of 0.3% or greater and found 0 events; indicating a high confidence interval (alpha value was 0.05).<ref name="pmid20971751">{{cite journal| author=Tsivgoulis G, Stamboulis E, Sharma VK, Heliopoulos I, Voumvourakis K, Teoh HL et al.| title=Safety of transcranial Doppler 'bubble study' for identification of right to left shunts: an international multicentre study. | journal=J Neurol Neurosurg Psychiatry | year= 2010 | volume= | issue= | pages= | pmid=20971751 | doi=10.1136/jnnp.2010.219733 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20971751 }} </ref> | |||
==References== | ==References== | ||
{{reflist}} | {{reflist|2}} | ||
[[Category: Cardiology]] | [[Category: Cardiology]] |
Revision as of 15:46, 29 August 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [[4]]
Overview
Trans-cranial doppler ultrasound is a diagnostic tool that involves a simple intravenous injection of saline under minimal sedation. It is primarily utilized to further diagnostically evaluate a patent foramen ovale defect.
Transcranial Doppler Ultrasound
- Non-invasive ultrasound method
- Operated by a hand-held Doppler transducer that functions on a pulsating low-frequency
- Requires no sedation
- Involves a simple intravenous injection of saline solution
- Testing standard in clinical trials of patent foramen voale closure devices and in studies ivestigating the relationship and interconnectivity of patent foramen ovale, stroke and migraines.
- Effectively assesses the intracranial circulation by recording blood velocities from intracranial arteries as they travel through cranial foramina and regions of the skull cavity
- Transcranial Doppler ultrasound Bubble test can be used to determine hemodynamic interaction between atriums of the heart
Indications
- Effective in detecting narrowing of cerebral arteries
- Effective in measuring hemodynamic circulation patterns within occluded diseased cerebral arteries
- Effectively measures:
- Peak systolic velocity
- Peak diastolic velocity
- Mean velocity
- Pulsitility
Advantages
- Usage of Valsalva manuever during testing can increase the visibility and overall detection of an atrial septal defect
- Less invasive than other methods
- Cost effective
- Can be completed in under an hour
Common Findings
- A defect may present in two ways:
- Small right-to-left shunt at start of systole (biphasic), associated with patent foramen ovale
- Larger left-to-right shunt, associated primarily with atrial septal defect
- Visualization of bubbles in the left atrium and left ventricle
Supportive Trial Data
- Transcranial Doppler ultrasound Bubble study has minimal or no complications.[1]
- One study which detected an incidence of adverse events of 0.3% or greater and found 0 events; indicating a high confidence interval (alpha value was 0.05).[1]
References
- ↑ 1.0 1.1 Tsivgoulis G, Stamboulis E, Sharma VK, Heliopoulos I, Voumvourakis K, Teoh HL; et al. (2010). "Safety of transcranial Doppler 'bubble study' for identification of right to left shunts: an international multicentre study". J Neurol Neurosurg Psychiatry. doi:10.1136/jnnp.2010.219733. PMID 20971751.