title: Guidelines for the Use of Echocardiography in the Evaluation of a Cardiac Source of Embolism.
abstract: Embolism from the heart or the thoracic aorta often leads to clinically significant morbidity and mortality due to transient ischemic attack, stroke or occlusion of peripheral arteries. Transthoracic and transesophageal echocardiography are the key diagnostic modalities for evaluation, diagnosis, and management of stroke, systemic and pulmonary embolism. This document provides comprehensive American Society of Echocardiography guidelines on the use of echocardiography for evaluation of cardiac sources of embolism. It describes general mechanisms of stroke and systemic embolism; the specific role of cardiac and aortic sources in stroke, and systemic and pulmonary embolism; the role of echocardiography in evaluation, diagnosis, and management of cardiac and aortic sources of emboli including the incremental value of contrast and 3D echocardiography; and a brief description of alternative imaging techniques and their role in the evaluation of cardiac sources of emboli. Specific guidelines are provided for each category of embolic sources including the left atrium and left atrial appendage, left ventricle, heart valves, cardiac tumors, and thoracic aorta. In addition, there are recommendation regarding pulmonary embolism, and embolism related to cardiovascular surgery and percutaneous procedures. The guidelines also include a dedicated section on cardiac sources of embolism in pediatric populations.
authors.affiliation: New York University Langone Medical Center, New York, New York.
authors.forename: Muhamed
authors.initials: M
authors.lastname: Saric
authors.affiliation: Duke University Health System, Durham, North Carolina.
authors.forename: Alicia C
authors.initials: AC
authors.lastname: Armour
authors.affiliation: American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: M Samir
authors.initials: MS
authors.lastname: Arnaout
authors.affiliation: Icahn School of Medicine at Mount Sinai Hospital, New York, New York.
authors.forename: Farooq A
authors.initials: FA
authors.lastname: Chaudhry
authors.affiliation: Learner College of Medicine, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Grimm
authors.affiliation: Lenox Hill Hospital, New York, New York.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Kronzon
authors.affiliation: University of Colorado School of Medicine, Aurora, Colorado.
authors.forename: Bruce F
authors.initials: BF
authors.lastname: Landeck
authors.affiliation: Northwestern University, Chicago, Illinois.
authors.forename: Kameswari
authors.initials: K
authors.lastname: Maganti
authors.affiliation: Mayo Clinic, Rochester, Minnesota.
authors.forename: Hector I
authors.initials: HI
authors.lastname: Michelena
authors.affiliation: University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Tolstrup
mesh_terms: D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal / Q000592:standards*; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D017410:Practice Guidelines as Topic; D013923:Thromboembolism / Q000175:diagnosis / Q000209:etiology*
keywords: Aortic atherosclerosis; Cardiac mass; Cardiac shunt; Cardiac tumor; Cardioembolism; Cryptogenic stroke; Intracardiac thrombus; Prosthetic valve; Vegetation