Vascular studies

Carotid duplex
Findings: 1-15% diameter reduction of the right ICA. 16-49% diameter reduction of the left ICA. Both vertebral arteries are antegrade and patent.

Transcranial doppler (TCD)
Findings: Normal flow through the basilar artery; and PCAs, MCAs and ACAs bilaterally. Ophthalmic arteries have antegrade flow. No emboli seen after 20 minutes of monitoring the left MCA.

Transthoracic echocardiogram
Findings: Adequate study. Inferior wall akinesis. Ejection fraction estimated at 50%. Mild concentric hypertrophy. Trace TR. Trace MR. Left atrial size normal. No source of clot identified. Agitated saline does not reveal a right-to-left shunt.