Transesophageal Echocardiography Flashcards

Which TEE view best demonstrates the left atrial appendage (LAA) for thrombus detection?

Answer: Midesophageal two-chamber view

The midesophageal two-chamber view at 90° provides the best visualization of the LAA for thrombus detection.

During TEE, spontaneous echo contrast ('smoke') in the left atrium is associated with:

Answer: Low flow states and increased thromboembolic risk

Spontaneous echo contrast reflects erythrocyte aggregation under low-shear flow conditions, indicating increased stasis and thromboembolic risk.

What is the normal emptying velocity of the left atrial appendage on pulsed-wave Doppler during TEE?

Answer: Greater than 40 cm/s

Normal LAA emptying velocity is greater than 40 cm/s; values below 20 cm/s indicate significant stasis.

In TEE, the coronary sinus is best visualized in which view?

Answer: Midesophageal four-chamber view

The coronary sinus appears as a circular structure at the posterior atrioventricular groove in the midesophageal four-chamber view.

Which artifact is most commonly encountered when imaging the ascending aorta with TEE due to the interposition of the trachea?

Answer: Blind spot artifact

The trachea and left main bronchus create a 'blind spot' in the ascending aorta, limiting TEE visualization of this segment.

Which TEE finding is most consistent with severe mitral regurgitation?

Answer: Pulmonary vein systolic flow reversal

Pulmonary vein systolic flow reversal on TEE Doppler is a hallmark of severe mitral regurgitation.

The descending thoracic aorta is best assessed with TEE by:

Answer: Rotating the probe 180° posteriorly from standard positions

Rotating the probe 180° (leftward) from standard positions brings the descending thoracic aorta into view along the posterior spine.