Echocardiography

An echocardiogram is a recording of the position and motion of the heart walls, valves, internal structures, and neighboring tissues by the echo obtained from beams of ultrasonic waves directed through the chest wall.

Transthoracic and transeosophageal echocardiography are important ancillary tests to screen for cardiogenic causes of cerebral embolism [Adams HP, et al, 1994]. Because the esophagus lies just behind and contiguous with the left atrium, transeosophageal echocardiography is superior to transthoracic echocardiography in detecting abnormalities in the left atrium, left atrial appendage, on the mitral and aortic valves, and a right-to-left intracardiac shunt [Bruno A, 1993].

This transeosophageal echocardiographic sequence demonstrates a left atrial myxoma. Myxomas are mobile, gelatinous tumors that are usually benign, and most often attached by a stalk to the left side of the atrial septum in the fossa ovalis region. Myxomas may occlude the mitral orifice, and/or the tricuspid orifice when the tumor is either bilateral or on the right side of the septum. Parts of the friable tumor may embolize with devastating consequences.