Transesophageal echocardiography: normal variants and mimickers

An accurate diagnosis of cardiac pathology using TEE is contingent upon the ability to recognize and differentiate normal cardiac structures and normal variants from pathologic conditions. We describe several normal cardiac structures commonly imaged using TEE of the atria, interatrial septum, aorta, valves, and extracardiac spaces that may mimic diverse pathologic states, such as intracardiac tumor and thrombus, valvular vegetations, mitral and tricuspid valve prolapse, atherosclerotic plaque, and aortic dissection. Methods to aid in the differentiation of normal cardiac structures from pathology are offered.