Critical care clinics
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Critical care clinics · Apr 1996
ReviewAssessment of endocarditis and associated complications with transesophageal echocardiography.
TEE offers many benefits in the evaluation of patients with IE. It provides increased sensitivity as compared to TTE in the detection of this disease, and is better able to identify and delineate many of the associated complications and hemodynamic aberrancies. ⋯ Continued advances in the technology of TEE instrumentation undoubtedly will lead to further improvements in our ability to assess and to treat patients stricken with this serious infection. Nevertheless, IE continues to exact a significant toll on its victims, and our efforts to diagnose, to treat, and to prevent it must not weaken.
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Unsuspected intracardiac shunts can be a cause of acute deterioration in critically ill patients. Shunts can be acquired or congenital conditions that become symptomatic only with changed physiologic conditions. Transesophageal echocardiography is an excellent tool for the diagnosis of intracardiac shunts.
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Critical care clinics · Apr 1996
ReviewStress echocardiography, contrast echocardiography, and tissue characterization: applications for the future.
During the last three decades the application of ultrasonography has expanded rapidly. The information available to the clinician from ultrasound imaging today is vastly more significant than it was in the early years of the development of this technology. In addition to automatic information, there is an increasing potential to provide functional, dynamic perfusion and even cellular information about the heart. This article attempts to summarize briefly the advances in these areas.
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Critical care clinics · Apr 1996
ReviewCritical appraisal of transesophageal echocardiography: limitations and pitfalls.
As with any imaging technology, there are limitations and pitfalls to TEE. The limitations and pitfalls of TEE can be minimized best by experience. Initial training should not be circumvented, and maintenance of competency should be monitored strictly. ⋯ Highly detailed anatomic structures, such as atrial muscle bundles, sutures, and adipose tissue, are to be recognized and differentiated from thrombi, vegetation, and masses. Although TEE has been a dramatic step forward in diagnostic imaging, there is a potential for serious misinterpretation. This article discusses most of these potential problems; however, there always will be unique situations in which the findings must be addressed consistently and differentiated as normal, artifact, new observation, or misinterpretation.
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Critical care clinics · Apr 1996
ReviewTransesophageal echocardiographic assessment of embolic sources: intracardiac and extracardiac masses and aortic degenerative disease.
The increased sensitivity of transesophageal echocardiography (TEE) makes it complementary and, in many cases, superior to transthoracic echocardiography in the detection of various sources of embolism. These sources include intracardiac thrombus, tumors, spontaneous echocardiographic contrast, and others. TEE is also helpful as an adjunctive test for the diagnosis of pulmonary embolisms.