Transoesophageal echo-Doppler in patients suspected of a cardiac source of peripheral emboli.
The initial results of a controlled and partly blinded study aimed at evaluating the accuracy of transoesophageal echo-Doppler in detecting cardiac sources of peripheral emboli are reported. A total of 120 consecutive patients suspected of acute embolic events were entered. After completion of all investigations, the patients were classified into three groups: patients who had definitely not suffered an embolic event (controls; n = 56); patients in whom the differentiation between local thrombosis, embolic event originating from a diseased infarct-related artery or embolic event from a cardiac source was not possible (questionable cases; n = 24) and patients in whom a cardiac source of a definite embolic event was highly suspected (cardiac emboli; n = 40). Isolated interatrial septum anomaly and mitral valve prolapse were as frequent in the control group as in the embolism group. Transoesophageal echo-Doppler had a sensitivity of 83% and a specificity of 86% in correctly assigning a patient to the cardiac embolism group or to the control group. The positive and negative predictive values were 80% and 87% respectively. It is concluded that transoesophageal echo-Doppler is highly sensitive but is also specific in demonstrating cardiac sources of peripheral emboli.
Vandenbogaerde
J
J
Departments of Cardiology, University Hospital Ghent, Belgium.
De Bleecker
J
J
Decoo
D
D
François
K
K
Cambier
B
B
Bergen
J M
JM
Vandermersch
C
C
De Reuck
J
J
Clement
D L
DL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015150:Echocardiography, Doppler / Q000379:methods*; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D004947:Esophagus; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D006343:Heart Septal Defects / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008945:Mitral Valve Prolapse / Q000150:complications / Q000000981:diagnostic imaging; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013927:Thrombosis / Q000150:complications / Q000000981:diagnostic imaging*