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Descending thoracic aortic atherothrombus, a forgotten source of mesenteric embolism: role of three-dimensional transoesophageal echocardiography
  1. Wai-ee Thai,
  2. John S Gelman
  1. MonashHeart, Monash Medical Centre, Victoria, Australia
  1. Correspondence to Dr John S Gelman, MonashHeart, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, 3168, Australia; jgelman{at}

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A 68-year-old man with previous multiple transient ischaemic attacks presented with 3 days of worsening abdominal pain and subsequently developed septic shock. An emergency laparotomy revealed a perforated small intestine secondary to infarction of the terminal ileum. Transthoracic echocardiography showed normal left ventricular systolic function during sinus rhythm, satisfactory valvular function, no evidence of intracardiac thrombus and no interatrial shunting on colour Doppler analysis or with agitated saline contrast study. Transoesophageal (TOE) two-dimensional (figure 1A) and three-dimensional …

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