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European Heart Journal 1992 13(1):88-94;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

Transoesophageal echo-Doppler in patients suspected of a cardiac source of peripheral emboli

J. VANDENBOGAERDE*,, J. DE BLEECKER{dagger}, D. DECOO{dagger}, K. FRANCOIS{ddagger}, B. CAMBIER*, J.-M. BERGEN§, C. VANDERMERSCH§, J. DE REUCK{dagger} and D. L. CLEMENT*

*Departments of Cardiology, University Hospital Ghent De Pintelaan 185, 9000 Gent, Belgium
{dagger}Departments of Neurology, University Hospital Ghent De Pintelaan 185, 9000 Gent, Belgium
{ddagger}Departments of Surgery, University Hospital Ghent De Pintelaan 185, 9000 Gent, Belgium
§Department of Cardiology, Kliniek Maria's Voorzienigheid Loofstraat 43, 8500 Kortrijk, Belgium

Received 13 August 1990; revised 13 December 1990; .

Correspondence Johan Vandenbogaerde, Department of Cardiology, University Hospital. De Pintelaan 185. 9000 Ghent. Belgium

Abstract

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 hada 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 specfic in demonstrating cardiac sources of peripheral emboli.

Key Words: Transoesophageal echocardiography • stroke • embolism • spontaneous contrast • interatrial septum pathology • mitral valve prolapse


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