title: Should one use echocardiography or contrast transcranial Doppler ultrasound for the detection of a patent foramen ovale after an ischemic cerebrovascular accident?
abstract: Patent foramen ovale is frequently associated with embolic cerebrovascular accidents. The diagnosis of patent foramen ovale is easier since the advent of transesophageal echocardiography. However, this method is semi-invasive and is not readily available in all units. Contrast transcranial Doppler ultrasound enables the detection of the passage of a contrast material injected into a peripheral vein to the cerebral circulation across an orifice which is most often a patent foramen ovale. Contrast transcranial Doppler ultrasound may facilitate, with a high sensitivity and specificity, the diagnosis of a patent foramen ovale when a transesophageal echo is not possible. However, transesophageal echocardiography remains the preferred test especially in the young since other potentially embolic sources, such as a thrombus in the left atrium, may be demonstrable.
authors.affiliation: Department of Cardiology and Internal Medicine, University Hospital, Grenoble, France. JPBaguet@chu-grenoble.fr
authors.forename: J P
authors.initials: JP
authors.lastname: Baguet
authors.forename: G
authors.initials: G
authors.lastname: Besson
authors.forename: F
authors.initials: F
authors.lastname: Tremel
authors.forename: L
authors.initials: L
authors.lastname: Mangin
authors.forename: C
authors.initials: C
authors.lastname: Richardot
authors.forename: J M
authors.initials: JM
authors.lastname: Mallion
mesh_terms: D004452:Echocardiography; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging*; D006801:Humans; D020521:Stroke / Q000150:complications*; D017585:Ultrasonography, Doppler, Transcranial