Indications for transesophageal examination
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Evaluation of suspected acute aortic pathology including dissection/transsection.
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To determine mechanism of regurgitation and determine suitability of valve repair.
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To diagnose/manage endocarditis with a moderate or high pre-test probability (e.g., bacteremia, especially staph
bacteremia or fungemia).
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Persistent fever in patient with intracardiac device.
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Evaluation of patient with atrial fibrillation/flutter to facilitate clinical decision-making with regards to
anticoagulation and/or cardioversion and/or radiofrequency ablation.
Indications for stress echocardiographic examination
(some score 8 indications also included here)
Initial evaluation of chest pain syndrome or anginal equivalent
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Intermediate pre-test probability of CAD, ECG uninterpretable OR unable to exercise.
Worsening symptoms: abnormal catheterization OR abnormal prior stress imaging study
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Re-evaluation of medically managed patients.
Chest pain syndrome or anginal equivalent, prior test result
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Coronary artery stenosis of unclear significance (cardiac catheterization or CT angiography).
Preoperative evaluation for noncardiac surgery, high-risk nonemergent surgery
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Poor exercise tolerance (< 4 METs, < 75 Watts at bicycle exercise).
Risk assessment post-revascularization (PCI or CABG), symptomatic
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Evaluation of chest pain syndrome, not in the early post-procedure period.
Ischemic cardiomyopathy, assessment of viability/ischemia
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Known CAD on catheterization, patient eligible for revascularization.
Valvular stenosis
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Evaluation of equivocal aortic stenosis, evidence of low cardiac output, use of dobutamine.
Use of contrast with stress echo
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Selective use of contrast, 2 or more contiguous segments are NOT seen on noncontrast images.
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