Cerebral Microemboli Detection for Monitoring Structural Cardiac Disease

Cardiac structural disorders can be detected noninvasively with echocardiography or cardiac MRI. Neither of these techniques, however, visualizes emboli, although thrombi can often be seen on valves or walls. Transcranial Doppler ultrasound (TCD) has been shown to be exquisitely sensitive at detecting microemboli, which may be a harbinger of impending macroembolization resulting in stroke.1,2 This report demonstrates the presence of a major valvular thrombus not visualized on echocardiography, but detected by TCD microemboli detection.