Guidelines for the Use of Echocardiography in the Evaluation of a Cardiac Source of Embolism

Muhamed Saric, Alicia C. Armour, M. Samir Arnaout, Farooq A. Chaudhry, Richard A. Grimm, Itzhak Kronzon, Bruce F. Landeck, Kameswari Maganti, Hector I. Michelena, Kirsten Tolstrup

Research output: Contribution to journalArticlepeer-review

278 Scopus citations


Embolism from the heart or the thoracic aorta often leads to clinically significant morbidity and mortality due to transient ischemic attack,stroke or occlusion of peripheral arteries. Transthoracic and transesophageal echocardiography are the key diagnostic modalities for evaluation, diagnosis, and management ofstroke, systemic and pulmonary embolism. This document provides comprehensive American Society of Echocardiography guidelines on the use of echocardiography for evaluation of cardiac sources of embolism. It describes general mechanisms ofstroke and systemic embolism; the specific role of cardiac and aortic sources instroke, and systemic and pulmonary embolism; the role of echocardiography in evaluation, diagnosis, and management of cardiac and aortic sources of emboli including the incremental value of contrast and 3D echocardiography; and a brief description of alternative imaging techniques and their role in the evaluation of cardiac sources of emboli. Specific guidelines are provided for each category of embolic sources including the left atrium and left atrial appendage, left ventricle, heart valves, cardiac tumors, and thoracic aorta. In addition, there are recommendation regarding pulmonary embolism, and embolism related to cardiovascular surgery and percutaneous procedures. The guidelines also include a dedicated section on cardiac sources of embolism in pediatric populations.

Original languageEnglish (US)
Pages (from-to)1-42
Number of pages42
JournalJournal of the American Society of Echocardiography
Issue number1
StatePublished - Jan 1 2016


  • Aortic atherosclerosis
  • Cardiac mass
  • Cardiac shunt
  • Cardiac tumor
  • Cardioembolism
  • Cryptogenicstroke
  • Intracardiac thrombus
  • Prosthetic valve
  • Vegetation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging


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