TEE with m-mode effectively demonstrates the exaggerated excursion of an interatrial septal aneurysm associated with a patent foramen ovale in a stroke patient.
Supports TEE with M-mode for septal mobility assessment in stroke; leaves open its value for PFO risk stratification before closure.
The above transesophageal echocardiogram (TEE) images were obtained as part of work-up for a cardiac source of embolus in a patient with stroke. The midesophageal view in figure A revealed a highly mobile interatrial septal aneurysm (IASA) with spontaneous right to left bubble shunting indicative of a patient foramen ovale (PFO). The IASA mobility is further demonstrated using TEE m-mode in the midesophageal view in figure B, revealing an exaggerated excursion of the fossa ovalis exceeding 1.5 cm. The aneurysmal fossa ovalis with a small superior communication is again demonstrated in the deep stomach view in figure C, while color flow Doppler across the septum in figure D demonstrated spontaneous left to right shunting.
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Nagaraj et al. (2025) studied this question.
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