Avoid transesophageal echocardiography to detect cardiac sources of embolization if a source has been identified and patient management will not change.
|Rationale and Comments:||Tests whose results will not alter management should not be ordered. Protocol-driven testing can be useful if it serves as a reminder not to omit a test or procedure, but should always be individualized to the particular patient. While transesophageal echocardiography is safe, even the small degree of risk associated with a procedure is not justified if there is no expected clinical benefit.|
|References:||• Douglas PS, et al. ACCF/ASE/AHA/ASNC/HFSA/HRS/ SCAI/SCCM/SCCT/SCMR 2011 appropriate use criteria for echocardiography. J Am Soc Echocardiogr. 2011;24:229-67.|