Doppler ultrasound assessment of minor atrial septal defects in patients with paradoxical embolism

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Abstract

Minor atrial septal defect (ASD) may be one of the pathways of paradoxical embolism in the brain. Few scientific papers have investigated the relationship between ASD (excluding patent foramen ovale) and the occurrence of ischemic stroke. There is no definite opinion as to how functionally important such shunts are and how the shunt changes with age. The review analyzes modern ideas about the probability of paradoxical embolism in small ASDs from the viewpoint of pathophysiology, and also demonstrates the technological capabilities of assessing the functional significance of such shunts based on our own clinical observations.

About the authors

Alina R. Karshieva

Research Center of Neurology

Author for correspondence.
Email: alinakarshieva@yandex.ru
ORCID iD: 0000-0002-0274-9694

Cand. Sci. (Med.), doctor of Ultrasound diagnostic laboratory

Russian Federation, Moscow

Andrey O. Chechetkin

Research Center of Neurology

Email: alinakarshieva@yandex.ru
ORCID iD: 0000-0002-8726-8928

D. Sci. (Med.), Head, Ultrasound diagnostic laboratory

Russian Federation, Moscow

Anastasia V. Belopasova

Research Center of Neurology

Email: alinakarshieva@yandex.ru
ORCID iD: 0000-0003-3124-2443

PhD (Med.), 3rd Neurological department

Russian Federation, Moscow

Larisa A. Dobrynina

Research Center of Neurology

Email: alinakarshieva@yandex.ru
ORCID iD: 0000-0001-9929-2725

D. Sci. (Med.), Head, 3rd Neurology department

Russian Federation, Moscow

References

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Supplementary files

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2. Fig. 1. Transthoracic echocardiography. Parasternal short-axis view. Colour Doppler ultrasound of the atrial septum reveals a secondary ASD with a right-to-left blood shunt and a maximum size of 6.5 mm.

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3. Fig. 2. Bilateral transcranial Doppler ultrasound monitoring with contrast enhancement at rest. Recording of the right (А) and left (В) middle cerebral artery blood flow. The images on the left show separate microembolic signals (red), which merge on the right to create a "curtain" effect.

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Copyright (c) 2021 Karshieva A.R., Chechetkin A.O., Belopasova A.V., Dobrynina L.A.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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