Original Article

Irish Journal of Medical Science

, 178:457

First online:

The role of transthoracic echocardiography in embolic acute limb ischaemia

  • A. LewisAffiliated withRegional Vascular Surgery Unit, Royal Victoria Hospital Belfast
  • , G. KirkAffiliated withRegional Vascular Surgery Unit, Royal Victoria Hospital Belfast
  • , A. McKinleyAffiliated withRegional Vascular Surgery Unit, Royal Victoria Hospital Belfast
  • , P. H. BlairAffiliated withRegional Vascular Surgery Unit, Royal Victoria Hospital Belfast
  • , D. W. HarkinAffiliated withRegional Vascular Surgery Unit, Royal Victoria Hospital Belfast Email author 

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Abstract

Introduction

Embolic acute limb ischaemia (ALI) is commonly treated by re-vascularization and long-term anticoagulant therapy. Transthoracic echocardiography (TTE) is commonly used to screen for cardiac embolic source, but may not affect management.

Report

We reviewed 115 consecutive patients with embolic ALI, 61% underwent TTE, with cardiac thrombus identified in only 3%. Incidental severe abnormalities requiring further cardiological investigation were detected in 19% of patients. Inpatient TTE did not affect mortality, morbidity, amputation rate, or anticoagulation.

Discussion

Transthoracic echocardiography seldom identifies a cardiac embolic source, but identifies many patients with severe incidental cardiac abnormalities, suggesting cardiology screening of these patients remains important.

Keywords

Acute limb ischaemia Embolism Embolectomy Transthoracic echocardiogram