Patent foramen ovale diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ifeoma Odukwe, M.D. [2]

Overview

The diagnostic study of choice for patent foramen ovale is contrast-enhanced transesophageal echocardiography (c-TEE).

Diagnostic Study of Choice

Study of choice

The diagnostic study of choice for patent foramen ovale is contrast-enhanced transesophageal echocardiography (c-TEE).[1]

The comparison of various diagnostic studies for patent foramen ovale

Test Sensitivity Specificity
Transesophageal echocardiography 89% 100%
Transthoracic echocardiography 46% 99%
Transcranial doppler 96% 93%

Diagnostic results

The following finding on performing contrast-enhanced transesophageal echocardiography is confirmatory for patent foramen ovale:[2][3][4]

  • Presence of bubbles across the inter-atrial septum into the left atrium: A diagnosis is made with the appearance of at least three micro-bubbles within three cardiac cycles after the complete opacification of the right atrium.

References

  1. Pearson AC, Labovitz AJ, Tatineni S, Gomez CR (1991). "Superiority of transesophageal echocardiography in detecting cardiac source of embolism in patients with cerebral ischemia of uncertain etiology". J Am Coll Cardiol. 17 (1): 66–72. doi:10.1016/0735-1097(91)90705-e. PMID 1987242.
  2. Pinto FJ (2005). "When and how to diagnose patent foramen ovale". Heart. 91 (4): 438–40. doi:10.1136/hrt.2004.052233. PMC 1768819. PMID 15772190.
  3. Mas, Jean-Louis; Arquizan, Caroline; Lamy, Catherine; Zuber, Mathieu; Cabanes, Laure; Derumeaux, Geneviève; Coste, Joël (2001). "Recurrent Cerebrovascular Events Associated with Patent Foramen Ovale, Atrial Septal Aneurysm, or Both". New England Journal of Medicine. 345 (24): 1740–1746. doi:10.1056/NEJMoa011503. ISSN 0028-4793.
  4. Yuan, Kristy; Kasner, Scott Eric (2018). "Patent foramen ovale and cryptogenic stroke: diagnosis and updates in secondary stroke prevention". Stroke and Vascular Neurology. 3 (2): 84–91. doi:10.1136/svn-2018-000173. ISSN 2059-8688.

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