The Comparative Value Of Transesophageal & Transthoracic Echo In Detection Of Clot In Left Atrium

Abstract

METHOD
Sixteen cases of severe M.S. who were admitt ed at Cardiology Unit of Civil Hospital Karachi between Jan. 92 - May 92 were recruited in this study. (Mean age 35±10 years).

RESULTS
Out of sixteen patients with severe M.S., only two patients were in sinus thythm, remaining fourteen were in AF and/or in A.Flutter. (Table I).

Discussion
Transesophageal echo is a safe technique and is far more sensitive than transthoracic approach in picking up LAA clot. Severe mitral stenosis where urbu1ence of blood flow in all cases produces spontaneous contrast echoes, stagnation of blood flow encouraged by the atrial fibrillation increases the chances of clot formation substantially. Left

Conclusion

Transesophageal echo is far more sensitive in picking up cardiac source of emboli, and we strongly recommend that all cases of severe mitral stenosis in atrial fibrillation should be on routine oral anticoagulants, as even the first episode of systemic embolism can be detrimental to life and health.