title: Transesophageal echocardiography in the awake elderly patient: its role in the clinical decision-making process.
abstract: To assess the impact on the management and safety of transesophageal echocardiography (TEE) in the elderly population, the results and limitations of this technique were retrospectively analyzed in 88 patients. TEE was indicated whenever the transthoracic approach was not diagnostic or was inconsistent with the clinical setting. The most frequent clinical indications were to investigate the source of emboli, assess valvular regurgitation, and identify valvular vegetations. In 72 patients (82%) TEE significantly influenced management decisions. In selected patients TEE avoided the use of more invasive diagnostic procedures. Adverse effects included occasional premature atrial or ventricular beats (11 patients), sinus bradycardia (six patients), and protracted nausea (one patient). We conclude that in elderly patients with cardiovascular diseases, TEE plays a significant role in the decision-making process without adding a significant risk.
authors.affiliation: Department of Internal Medicine, Lakeside VA Medical Center, Chicago, Ill.
authors.forename: M
authors.initials: M
authors.lastname: Zabalgoitia
authors.forename: D K
authors.initials: DK
authors.lastname: Gandhi
authors.forename: J
authors.initials: J
authors.lastname: Evans
authors.forename: D J
authors.initials: DJ
authors.lastname: Mehlman
authors.forename: D D
authors.initials: DD
authors.lastname: McPherson
authors.forename: J V
authors.initials: JV
authors.lastname: Talano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000175:diagnosis / Q000453:epidemiology; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology; D004452:Echocardiography / Q000009:adverse effects / Q000379:methods*; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000453:epidemiology; D012189:Retrospective Studies; D013927:Thrombosis / Q000175:diagnosis / Q000453:epidemiology