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Board Stiff TEE E-Book

Board Stiff TEE E-Book

Christopher Gallagher | John C Sciarra | Steven Ginsberg

(2012)

Additional Information

Book Details

Abstract

Learn TEE the fun and effortless way! Dr. Gallagher returns with the 2nd edition of Board Stiff TEE: Transesophageal Echocardiography, following the same humorous, digestible writing style that made the last edition a runaway best seller. This highly effective, enjoyable, and affordable medical reference book is not only ideal for those taking the boards; it is also a great overview for anyone looking to stay up-to-date on this increasingly important monitoring modality.

  • Consult this title on your favorite e-reader, conduct rapid searches, and adjust font sizes for optimal readability. Compatible with Kindle®, nook®, and other popular devices.
  • Get a detailed review of all of the PTEeXAM topics listed by the National Board of Echocardiography, written in a digestible, humorous, and engaging style. 
  • Understand difficult concepts and problems with the help of 150 schematic drawings. 
  • Access comprehensive, problem-solving guidance on quantitative aspects of TEE through a practical appendix that includes gradients, valve areas, and chamber pressures.
  • Master TEE and confidently take the PTEeExam with Board Stiff TEE: Transesophageal Echocardiography!
  • Stay current on the latest advances with a new chapter covering 3D TEE.
  • Search the complete contents online, and access additional exam-type questions and cases, at www.expertconsult.com!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Board Stiff TEE iii
Copyright Page iv
Contents v
Preface to the First Edition vii
Preface to the Second Edition ix
List of Contributors xi
Introduction: Neither Rain nor Snow xv
1 The Yellow Brick Road 1
2 Principles of Ultrasound 3
Nature of Ultrasound: Compression and Rarefaction 3
Frequency, Wavelength, and Tissue Propagation Velocity 3
Properties of Ultrasound Waves 5
Ultrasound–Tissue Interactions 5
Reflection 5
Refraction 6
Scatter 6
Attenuation 6
Tissue Characterization 6
Questions 7
Answers 7
3 Transducers and Instrumentation 9
Piezoelectric Effect 9
Crystal Thickness and Resonance 10
Damping 11
Sound Beam Formation 11
Focusing 11
Axial and Lateral Resolution 11
Axial Resolution 12
Lateral Resolution 12
Arrays 12
Instrumentation 13
Depth 14
Frequency 14
Gain 14
Depth Gain Compensation 14
A Million More 15
Displays 15
B-Mode, M-Mode, and Two-dimensional Echocardiography 15
B-mode 15
M-mode 16
Two-dimensional 16
Signal Processing and Related Factors 16
Questions 16
Answers 17
4 Equipment, Infection Control, and Safety 19
The Good: Safety First 19
Set up an Echo Service 19
Move it from Place to Place 20
The Ugly (Bad Will Come Later): Cleaning—You Need a System 20
The Physical Probe: How’s it Look? 20
Eyeball the Probe 20
It won’t Plug in? 21
Use the Probe 21
Insert: How’s it Go? 21
Ergonomics 21
The Bad 22
Questions (Echo Safety)—True/False 22
Answers 23
5 Principles of Doppler Ultrasound 25
The Doppler Shift Equation 26
Basic Principle for Tissue Reconstruction Using Ultrasound 26
B-Mode 27
M-Mode 27
Two-Dimensional Imaging 27
Color Doppler 28
Continuous Wave Doppler 28
Pulse Wave Doppler 29
Range Ambiguity 29
Nyquist Limit and Aliasing 30
HPRF (High Pulse Repetition Frequency) Mode 31
Beam Angle 32
Derivation of the Doppler Shift Equation 32
Derivation of the Nyquist Limit for PW Echo 35
Questions (Doppler Physics) 36
True or False 36
Answers 36
References 37
6 Quantitative M-mode and Two-dimensional Echocardiography 39
Edge Recognition 39
Edge Components 39
Temporal Resolution 40
Aortic Valve in M-Mode 40
Mitral Valve in M-Mode 41
Ventricular Wall Assessment with M-Mode 42
Global Function: Measurements and Calculations 42
Geometric, Spectral, and Other Measurements 43
Questions 44
Answers 45
References 46
7 Quantitative Doppler 47
Types of Velocity Measurements 47
High-Frame Rate-Doppler 47
Volumetric Measurements and Calculations 48
Valve Gradients, Areas, and Other Measurements 49
Cardiac Chamber and Great Vessel Pressures 50
Tissue Doppler 51
Questions 52
Answers 52
Bibliography 52
8 Doppler Profiles and Assessment of Diastolic Function 55
Tricuspid Valve and Right Ventricular Inflow 55
Pulmonary Valve and Right Ventricular Outflow 56
Mitral Valve and Left Ventricular Inflow 57
The Groovy Heart 58
The Heart with Impaired Filling 58
The Yet-More-Noncompliant Heart 59
History and Physical 59
Size of the Left Atrium 59
Valsalva Maneuver 59
Inflow Pattern of Pulmonary Veins 60
Others 60
The Stiff-as-Hell Heart: No Kidding End-Stage Diastolic Wipeout 61
Aortic Valve and Left Ventricular Outflow 62
Nonvalvular Flow Profiles 63
Questions 64
Answers 65
9 Cardiac Anatomy 67
Imaging Planes 67
Cardiac Chambers and Walls 71
Cardiac Valves 72
Cardiac Cycle and Relation of Events Relative to ECG 72
Questions 74
Answers 75
Reference 75
10 Pericardium and Extra-Cardiac Structures: Anatomy and Pathology 77
The Pericardium 77
The Aorta 84
Aortic Aneurysm 87
Aortic Pseudoaneurysm 87
Aortic Dissection 88
Aortic Plaque 89
Aortic Trauma 90
Aortic Thrombus 91
Aortic Inflammation, Coarctation, and Infection 91
Pulmonary Artery 91
Superior Vena Cava, Inferior Vena Cava, and their Cousins the Hepatic Veins 92
Bibliography 95
11 Pathology of the Cardiac Valves 97
Questions 111
Answers 112
Bibliography 113
12 Intra-cardiac Masses and Devices 115
Masses that are Not Really Masses 115
Atrial Anatomic Variants 115
Ventricular Anatomic Variants 116
Valvular Anatomic Variants 116
Masses that Really are Masses 116
Malignant Primary Cardiac Masses 117
Schematic Representation of Common Cardiac “Masses” 118
Metastatic Cardiac Masses 118
Imaging Modalities Utilized to Characterize Cardiac Masses 118
Questions 119
Answers 120
Bibliography 121
13 Left Ventricular Systolic Function 123
Abnormal LV Systolic Function 124
Cardiomyopathies 124
Hypertrophic 124
Restrictive 126
Dilated 127
Questions 127
Answers 129
14 Segmental Left Ventricular Systolic Function 131
Myocardial Segment Identification 131
Coronary Artery Distribution and Flow 132
Normal and Abnormal Segmental Dysfunction 133
Assessment and Methods 133
Differential Diagnosis 134
Confounding Factors 135
Left Ventricular Aneurysm 135
Left Ventricular Rupture 136
Questions 136
Answers 137
15 The 17 Segment Model 139
Questions 145
Answers 145
16 Assessment of Perioperative Events and Problems 147
Hypotension and Causes of Cardiovascular Instability 147
Cardiac Surgery: Techniques and Problems 149
Assessment of Bypass and Cardioplegia 149
Cannulas and Devices Commonly Used During Cardiac Surgery 149
What else might Show up During Cardiac Surgery? 150
Circulatory Assist Devices 150
Intracavitary Air 153
Minimally Invasive Cardiopulmonary Bypass 153
Off-pump Cardiac Surgery 153
Coronary Surgery: Techniques and Assessment 155
Valve Surgery: Techniques and Assessment 156
Valve Replacement: Mechanical, Bioprosthetic, and Other 156
Starr-Edwards 156
Medtronic-Hall and Björk-Shiley 157
St. Jude and Carbomedics 157
Hancock and Carpentier-Edwards 158
Ross Procedure 158
Valve Repair 159
Aortic Repair? 159
Mitral Repair? 159
Tricuspid Repair? 160
Pulmonic Repair? 160
Transplantation Surgery 160
Heart 160
Lung 160
Liver 161
Questions 162
Answers 162
Bibliography 162
17 Congenital Heart Disease 163
Terminology and Associations 163
History 164
Mustard Procedure 164
Physical Findings and Labs 164
More Names of Operations 165
Identification and Sites of Venous and Systemic Structures and Blood Flow 165
Using Descriptive Echocardiographic Lingo in Transposition 165
Ventricular Septal Defect 166
The Natural History May Fool You 166
Still More VSD Pitfalls 167
Atrial Septal Defects 167
Persistent Left Superior Vena Cava (No Shunt) 168
Pulmonary Valve Stenosis 168
Bicuspid Aortic Valve 169
Left Ventricular Outflow Abnormalities 169
Patent Ductus Arteriosus 169
Ebstein’s Abnormality of the Tricuspid Valve 170
Questions 170
Answers 171
18 Artifacts and Pitfalls 173
Artifacts 174
Artifacts Associated with US Beam Characteristics 174
Artifacts Associated with Multiple Echoes 176
Artifacts Associated with Velocity Errors 180
Artifacts Associated with Attenuation Errors 182
Doppler Artifacts and Pitfalls 185
Structures Mimicking Pathology 186
Questions 189
Answers 189
19 Related Diagnostic Modalities 191
Stress Echocardiography 191
Myocardial Perfusion Scanning 191
Epicardial Scanning 191
Contrast Echo 192
Utility of TEE Relative to other Diagnostic Modalities 192
TEE Versus ECG 192
TEE Versus TTE 192
TEE Versus Coronary Angiography 192
TEE Versus Swan 193
Questions 193
Answers 194
Bibliography 194
20 Intraoperative 3-D Echocardiography 195
TEE Probes 196
3-D Modes 198
Mitral Valve 199
LV Assessment 200
LV Volume 200
RV Assessment 200
Conclusion 201
21 The Structured TEE Examination 203
Ventricular Function 203
Left Ventricle 203
Right Ventricle 204
Valves 205
Mitral Valve 205
Aortic Valve 206
Tricuspid/Pulmonary Valve 207
Other Structures 207
Atrium 207
Aortic Arch 208
22 Sonographic Formulas 209
23 Hemo-dynamo Doc 211
24 Test Questions 249
Epilogue: Smooth Sailing 273
Index 275