Transoesophageal echocardiography gives unparalleled views of the posterior structures of the heart. It is the investigation of choice for the diagnosis of acute dissection of the aorta, in patients with endocarditis, management of the hypotensive patient in the intensive care unit, and in the search for a potential cardiac source of thromboembolism. However, it is a semi-invasive procedure, and proper training is required to carry it out safely, to ensure that maximum information is obtained at the time of examination, and to avoid diagnostic pitfalls.
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