Echocardiogram

Perform transesophageal echocardiogram (TEE) to exclude atrial clot. 

Administered to achieve an INR of 2.5 (range 2-3) in combination with low-dose aspirin pharmacotherapy (<100 mg daily [Chest guidelines] or 75-162 mg daily [Circulation guidelines]) for 3 mo postmyocardial infarction. Repeat echocardiogram before discontinuing warfarin pharmacotherapy... 

Low cardiopulmonary reserve (i.e., right-ventricular hypokinesis on echocardiogram) where an initial or repeat pulmonary embolism would be catastrophic... 

Echocardiogram Used to assess LV size, valve function, pericardial effusion, wall motion abnormalities, and ejection fraction. 

Chest x-ray Bilateral pleural effusions and cardiomegaly Echocardiogram EF = 35%... 

To assess for prevention of disease progression, practitioners may utilize serial echocardiograms every 6 months to assess cardiac function and evaluate the effects of drug therapy. 

Review available diagnostic information from the chest radiograph, ECG, and echocardiogram. 

During hospitalization, a measurement of left ventricular function, such as an echocardiogram, is performed to identify patients with low ejection fractions (less than 40%) who are at high risk of death following hospital discharge. 

Echocardiogram hypocontractile left ventricle, akinesis of anterior apical wall, ejection fraction 20%... 

DCC, direct current cardioversion IV, intravenously LVEF, left ventricular ejection fraction TEE, transesophageal echocardiogram. 

A transthoracic echocardiogram will identify whether there are heart valve abnormalities or problems with wall motion resulting in emboli to the brain. 

Echocardiogram or multiple gated Baseline and every 6-12 months ... 

Echocardiogram positive for IE [TEE recommended in patients with prosthetic valves, rated at least "possible IE" by clinical criteria, or complicated IE (paravalvular abscess) TTE as first test in other patients], defined as follows ... 

Develop a follow-up plan to determine whether the patient has achieved a cure, which includes a clinical evaluation of signs/symptoms, repeat blood cultures, and possibly a repeat echocardiogram. The patient also should be assessed for any adverse events. This should be performed usually within a few weeks after the completion of therapy. 

Transesophageal echocardiogram A procedure used to generate an image of the heart using sound waves, via a probe introduced into the esophagus (rather than the traditional transthoracic view) in order to obtain a better image of the left atrium. 

The echocardiogram is the single most useful evaluation procedure because it can identify abnormalities of the pericardium, myocardium, or heart values and quantify the left ventricular ejection fraction (LVEF) to determine if systolic or diastolic dysfunction is present. 

A transthoracic echocardiogram can detect valve or wall motion abnormalities that are sources of emboli to the brain. 

A transesophageal echocardiogram is a more sensitive test for left atrial thrombus. It is also effective in examining the aortic arch for atheroma, another potential source of emboli. 

An electrocardiogram, chest radiograph, and echocardiogram are commonly performed. Echocardiography to determine the presence of valvular vegetations plays a key role in the diagnosis of infective endocarditis it should be performed in all suspected cases. 

On September 15,1997, FDA asked the manufacturers of dexfenfluramine (Redux manufactured for Intemeuron Pharmaceuticals by Wyeth-Ayerst) and fenfluramine (Pondimin Wyeth-Ayerst) to voluntarily withdraw both treatments from the market because of findings that indicate approximately 30% of patients taking the combined drugs had abnormal echocardiograms, even if they had no symptoms. Both companies agreed. FDA is not requesting the withdrawal of phentermine, the third widely used medication for obesity. 

Redux(tm) and Pondimin(tm) were voluntarily withdrawn in September 1997 because 30% of the patients taking these two dmgs had abnormal echocardiograms, 2004. See... 

Once on medication, it is important to evaluate any new onset of treatment-emergent symptoms, especially if they are exercise related. Acute onset of dizziness, fatigue, light-headedness, sedation, syncope, and nearsyncope (especially if exercise related) require close clinical monitoring and possible evaluation using Hol-ter monitor and/or echocardiogram (Oesterheld and Tervo, 1996). 

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