Provocative maneuvers to improve patent foramen ovale detection: A brief review of the literature

Echocardiography
Ashwin K ThiagarajRobert W W Biederman

Abstract

Patent foramen ovale (PFO) is the most common type of inter-atrial shunt, with prevalence as high as 30%. Detection of PFO has implications in patients with stroke, peripheral embolism, decompression illness, and other conditions. Transesophageal echo (TEE) with saline contrast injection is the current standard for PFO detection, but even with TEE, PFOs are sometimes missed. With advances in percutaneous PFO closure therapies and proven long-term benefit of closure, accurate PFO detection takes on cardinal importance. Various provocative maneuvers to enhance PFO detection are in clinical use and have been studied. The Valsalva maneuver has long-held position as the ideal provocation to unmask PFO, but other maneuvers such as cough, sniff, Müller's, and more have gained relevance. In this article, we will examine various maneuvers and discuss their utility in PFO detection.

References

Sep 1, 1984·Journal of the American College of Cardiology·O DubourgJ C Bardet
Mar 8, 2002·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·S PflegerM Borggrefe
Apr 7, 2004·Mayo Clinic Proceedings·Rick A Nishimura, A Jamil Tajik
Oct 12, 2007·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Magnus C JohanssonPeter Eriksson
Oct 18, 2012·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Kate MarriottRoess Pascoe
Sep 3, 2013·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Ana Clara RodriguesJosé L Andrade
Nov 2, 2013·The American Journal of Cardiology·Roy BeigelRobert J Siegel
Jul 6, 2014·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Magnus C Johansson, Cecilia Wallentin Guron
Jul 23, 2016·Journal of Clinical Ultrasound : JCU·Silvia MongodiFrancesco Mojoli
Sep 28, 2016·JAMA : the Journal of the American Medical Association·Peter BentzerNajib T Ayas
Nov 20, 2016·Annals of Intensive Care·Xavier MonnetJean-Louis Teboul
Dec 28, 2016·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Eiji YamashitaShigeru Oshima
Sep 10, 2017·Interventional Cardiology Clinics·Matthew J Price
Dec 2, 2017·Journal of the American College of Cardiology·Jonathan M TobisJohn C Gurley
Jun 19, 2018·Journal of the American Heart Association·Fareed Moses S ColladoClifford J Kavinsky

❮ Previous
Next ❯

Citations

Nov 15, 2019·Current Treatment Options in Cardiovascular Medicine·Nicholas D OsteraasSarah Song

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
Stephan Windecker, Bernhard Meier
Giornale italiano di cardiologia : organo ufficiale della Federazione italiana di cardiologia : organo ufficiale della Società italiana di chirurgia cardiaca
Arianna GiardinaAchille Gaspardone
© 2022 Meta ULC. All rights reserved