Transesophageal echocardiography is the imaging technique of choice to detect thrombus presence.

• A. True
• B. False
• C. It detects thrombus less reliably than transthoracic echo
• D. It cannot visualize the left atrial appendage

Answer: (A)

Transesophageal echocardiography is favored because it places the ultrasound probe close to the left atrium, especially the left atrial appendage, giving higher-resolution images of thrombus than transthoracic echo. This proximity yields superior sensitivity and specificity for detecting thrombus in these posterior cardiac structures, which is why TEE is the imaging technique of choice, particularly before procedures like cardioversion or atrial fibrillation ablation. The statement that it detects thrombus less reliably than transthoracic echo is not true, since TEE is more reliable for this purpose. It also can visualize the left atrial appendage, so claiming it cannot is incorrect.