The positions of the patients in the diagnosis of patent foramen ovale by transcranial Doppler.
OBJECTIVE
There is no information about the optimal position of a patient for the performance of a transcranial Doppler (TCD) examination to detect patent foramen ovale (PFO). Such information is important to improving the sensitivity of the test in comparison to the gold standard of transesophageal echocardiography (TEE).


METHODS
Thirty-four patients with TEE-proved PFO were examined by contrast TCD. Examinations were done in both the sitting and supine positions in random order.


RESULTS
Eight hundred ninety-two microemboli were recorded. Patients' positions and the sequence of testing did not affect the number of microemboli detected. Yet for each individual, 1 of the 2 positions was more sensitive.


CONCLUSIONS
To improve the sensitivity of TCD in the detection of PFO, it is recommended, in the case of a first negative test, to change the patient's position for a repeated TCD examination.
Department of Neurology, Rambam Medical Center, PO Box 9602, Haifa 31096, Israel. g_telman@rambam.health.gov.il
Gregory
G
Telman
Efim
E
Kouperberg
Eliott
E
Sprecher
David
D
Yarnitsky
D003287:Contrast Media; D017548:Echocardiography, Transesophageal; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011187:Posture / Q000502:physiology*; D012680:Sensitivity and Specificity; D016683:Supine Position / Q000502:physiology; D017585:Ultrasonography, Doppler, Transcranial; D014636:Valsalva Maneuver
D003287:Contrast Media