What are the advantages of Transthoracic echocardiography over TEE?
Transthoracic echocardiography (TTE) is preferred over TEE for the detection of left ventricular (LV) thrombus, but TEE is superior to TTE in detecting left atrial thrombus, aortic atheroma, prosthetic valve abnormalities, native Kleindorfer valve abnormalities, atrial septal abnormalities, and intracardiac thrombi. A systematic review that included 65 studies concluded that TTE in the second harmonic is cost-effective relative to TEE. Furthermore, randomized trials have shown that longer heart monitoring in patients with cryptogenic stroke results in higher detection rates for AF when using a 30-day event triggered recorder compared with standard monitoring, including 24-hour Holter electrocardiographic monitoring. However, it is important to note that improved patient outcomes with long-term rhythm monitoring has not been established. 