TCD with embolic detection is an alternative to TEE with bubble. It has more sensitivity than TTE with bubble but it lacks specificity. It cannot tell if the right to left shunt is coming from a PFO or an AV malformation in the lungs. Also, if there is a PFO causing this right to left shunt, it’s not able to tell you the size of the PFO or whether there are ominous features such as an associated intra-septal aneurysm. https://www.facebook.com/share/r/177TALwjWE/ | Neurology
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