BOOK
Essential Echocardiography: A Companion to Braunwald’s Heart Disease E-Book
Scott D Solomon | Justina Wu | Linda D. Gillam
(2017)
Additional Information
Book Details
Abstract
Echocardiography remains the most commonly used imaging technique to visualize the heart and great vessels, and this clinically oriented text by Drs. Scott D. Solomon, Justina C. Wu, and Linda D. Gillam helps you make the most of its diagnostic and prognostic potential for your patients. Part of the highly regarded Braunwald’s family of cardiology references, Essential Echocardiography expertly covers basic principles of anatomy and physiology, the appearance of normal variants across a wide range of cardiovascular diseases, and the hands-on approaches necessary to acquire and interpret optimal echocardiographic images in the clinical setting.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| Essential Echocardiography | i | ||
| ESSENTIAL ECHOCARDIOGRAPHY: A Companion to Braunwald’s Heart Disease | iii | ||
| Copyright | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| Preface | xi | ||
| Contents | xiii | ||
| Video Contents | xv | ||
| Braunwald’s Heart Disease Family of Books | xxiii | ||
| I - PHYSICAL PRINCIPLES OF ULTRASOUND AND GENERATION OF IMAGES | 1 | ||
| 1 - Physical Principles of Ultrasound and Generation of Images | 1 | ||
| INTRODUCTION | 1 | ||
| GENERATION OF IMAGES BY ULTRASOUND | 1 | ||
| Resolution of Echocardiographic Images | 2 | ||
| Phased Array and Matrix Array Transducers | 4 | ||
| Second Harmonic Imaging | 4 | ||
| PRINCIPLES OF DOPPLER IMAGING | 4 | ||
| Continuous Wave Doppler | 6 | ||
| Pulsed Wave Doppler | 6 | ||
| Color Flow Doppler | 8 | ||
| Doppler Tissue Imaging | 14 | ||
| 2D Speckle Tracking Echocardiography | 15 | ||
| Suggested Readings | 15 | ||
| References | 15.e1 | ||
| 2 - M-Mode Imaging | 16 | ||
| NORMAL M-MODE MEASUREMENTS | 16 | ||
| Normal M-Mode Examination of the Aortic Root, Aortic Cusp Separation, and Left Atrial Dimension | 16 | ||
| M-MODE ECHOCARDIOGRAPHY IN THE IDENTIFICATION OF ABNORMAL CARDIAC STRUCTURE AND FUNCTION | 17 | ||
| Bicuspid Aortic Valve | 17 | ||
| Subaortic Membrane | 17 | ||
| Mitral Valve Prolapse | 17 | ||
| Systolic Anterior Motion of the Mitral Valve | 17 | ||
| Valvular Vegetations | 18 | ||
| Rheumatic Mitral Valve Deformity | 18 | ||
| Left Ventricular Dyssynchrony | 22 | ||
| Constrictive Pericarditis | 22 | ||
| Cor Pulmonale | 22 | ||
| Severe Pulmonary Hypertension | 23 | ||
| Ebstein Anomaly | 23 | ||
| Increased Right Atrial Pressure | 23 | ||
| M-Mode Examination of Prosthetic Valves | 23 | ||
| Color M-Mode Echocardiography | 24 | ||
| SUMMARY | 26 | ||
| Suggested Readings | 26 | ||
| 3 - Principles of Contrast Echocardiography | 27 | ||
| INTRODUCTION | 27 | ||
| MICROBUBBLE CONTRAST AGENTS | 27 | ||
| MICROVASCULAR BEHAVIOR OF MICROBUBBLES | 29 | ||
| Detection of Microbubble Ultrasound Signal | 30 | ||
| Contrast-Specific Imaging Methods | 31 | ||
| SAFETY OF MICROBUBBLE CONTRAST AGENTS | 32 | ||
| Suggested Readings | 33 | ||
| References | 33.e1 | ||
| 4 - Principles of Transesophageal Echocardiography | 34 | ||
| INTRODUCTION | 34 | ||
| INDICATIONS | 34 | ||
| COMPLICATIONS | 34 | ||
| PATIENT MANAGEMENT | 36 | ||
| THE COMPREHENSIVE TEE EXAM | 37 | ||
| MID- AND UPPER-ESOPHAGEAL IMAGING | 39 | ||
| TRANSGASTRIC IMAGING | 40 | ||
| THORACIC AORTA | 42 | ||
| INTERVENTIONAL ECHOCARDIOGRAPHY | 42 | ||
| CONCLUSION | 42 | ||
| Suggested Reading | 42 | ||
| References | 42.e1 | ||
| 5 - Principles of Three-Dimensional Ultrasound | 43 | ||
| INTRODUCTION | 43 | ||
| Fully Sampled Matrix Array Transducers | 43 | ||
| PHYSICS OF THREE-DIMENSIONAL ULTRASOUND | 43 | ||
| Multibeat ECG-Gated Acquisition | 43 | ||
| Real-Time Zoom Acquisition | 44 | ||
| Parallel Receive Beamforming | 44 | ||
| DISPLAY OF THREE-DIMENSIONAL ECHOCARDIOGRAPHIC IMAGES | 45 | ||
| Volume Rendering | 45 | ||
| Surface Rendering | 46 | ||
| Wireframe Rendering | 46 | ||
| CLINICAL APPLICATIONS OF THREE-DIMENSIONAL ECHOCARDIOGRAPHY | 46 | ||
| Quantification of Cardiac Chambers | 46 | ||
| CLINICAL APPLICATIONS OF THREE-DIMENSIONAL ECHOCARDIOGRAPHY | 47 | ||
| Left Ventricular Structure and Function | 47 | ||
| Right Ventricular Structure and Function | 48 | ||
| Left and Right Atria | 49 | ||
| Valvular Heart Disease | 50 | ||
| Mitral Valve | 50 | ||
| Aortic Valve | 51 | ||
| Tricuspid Valve | 52 | ||
| Prosthetic Valves | 53 | ||
| CONCLUSION | 53 | ||
| Suggested Reading | 54 | ||
| References | 54.e1 | ||
| 6 - Principles and Practical Aspects of Strain Echocardiography | 55 | ||
| INTRODUCTION | 55 | ||
| PRINCIPLES OF STRAIN IMAGING | 55 | ||
| TWIST AND TORSION | 55 | ||
| REGIONAL AND GLOBAL FUNCTION | 55 | ||
| Left Ventricle | 55 | ||
| Right Ventricle | 56 | ||
| Left Atrium | 56 | ||
| CORONARY ARTERY DISEASE AND ISCHEMIC CARDIOMYOPATHY | 57 | ||
| NONISCHEMIC CARDIOMYOPATHY | 57 | ||
| Hypertrophic Cardiomyopathy | 60 | ||
| Chemotherapy-Related Cardiotoxicity | 60 | ||
| Other Cardiomyopathies | 60 | ||
| DILATED CARDIOMYOPATHY AND DYSSYNCHRONY ANALYSIS | 62 | ||
| VALVULAR HEART DISEASE | 62 | ||
| INFILTRATIVE DISEASE | 62 | ||
| Amyloidosis | 62 | ||
| Suggested Readings | 63 | ||
| References | 63.e1 | ||
| 7 - Understanding Imaging Artifacts | 64 | ||
| INTRODUCTION | 64 | ||
| B-MODE ARTIFACTS | 64 | ||
| Shadowing (Attenuation) and Dropout Artifacts | 64 | ||
| Reverberation Artifacts | 64 | ||
| Multiple Reflection Artifacts | 65 | ||
| Side Lobe Artifacts | 67 | ||
| Refraction Artifacts | 68 | ||
| Beam-Width Artifacts/Partial Volume Artifacts | 71 | ||
| (COLOR) DOPPLER MIRROR IMAGE ARTIFACTS | 71 | ||
| FOUR-DIMENSIONAL ECHOCARDIOGRAPHY STITCH ARTIFACTS | 72 | ||
| Suggested Readings | 72 | ||
| References | 72.e1 | ||
| II - The Echocardiographic Examination | 73 | ||
| 8 - Principles of Transthoracic Imaging Acquisition: The Standard Adult Transthoracic Echocardiographic Examination | 73 | ||
| INTRODUCTION | 73 | ||
| Transducer Positions | 73 | ||
| Cardiac Imaging Plane | 73 | ||
| Region or Structure of Interest | 73 | ||
| IMAGE ORIENTATION STANDARDS | 77 | ||
| TWO-DIMENSIONAL ECHOCARDIOGRAPHY: TOMOGRAPHIC SCAN PLANE ORIENTATION AND DISPLAY PROTOCOL | 77 | ||
| COMPLEMENTARY PROTOCOLS: DOPPLER, THREE-DIMENSIONAL ECHOCARDIOGRAPHY, AND MYOCARDIAL SEGMENTATION | 77 | ||
| Suggested Reading | 95 | ||
| References | 95.e1 | ||
| 9 - The Transthoracic Examination, View by View | 96 | ||
| INTRODUCTION | 96 | ||
| LEFT PARASTERNAL VIEWS | 96 | ||
| APICAL VIEWS | 96 | ||
| SUBCOSTAL VIEWS | 96 | ||
| SUPRASTERNAL NOTCH VIEWS | 96 | ||
| Suggested Reading | 108 | ||
| References | 108.e1 | ||
| 10 - Three-Dimensional Echocardiography: Image Acquisition | 109 | ||
| INTRODUCTION | 109 | ||
| THE THREE-DIMENSIONAL TRANSTHORACIC ECHOCARDIOGRAPHY DATA ACQUISITION PROTOCOL | 109 | ||
| TWO-DIMENSIONAL IMAGE OPTIMIZATION | 110 | ||
| ACQUISITION MODES | 110 | ||
| CROPPING AND RENDERING | 112 | ||
| IMAGE DISPLAY AND ANALYSIS | 112 | ||
| CHALLENGES AND OPTIMIZATION IN THREE-DIMENSIONAL DATA ACQUISITION | 112 | ||
| ELECTROCARDIOGRAPHY GATING AND BREATH HOLD | 112 | ||
| THREE-DIMENSIONAL GAIN OPTIMIZATION | 114 | ||
| LIVE THREE-DIMENSIONAL OPTIMIZATION | 114 | ||
| Suggested Reading | 118 | ||
| 11 - Optimization of the Patient and Equipment | 119 | ||
| INTRODUCTION | 119 | ||
| OPTIMIZING PATIENT AND TRANSDUCER POSITIONS | 119 | ||
| OPTIMIZING TWO-DIMENSIONAL IMAGING: MACHINE SETTINGS | 120 | ||
| USE OF CONTRAST | 121 | ||
| OPTIMIZING THE SPECTRAL DOPPLER EXAMINATION | 121 | ||
| OPTIMIZING THE COLOR FLOW DOPPLER EXAMINATION | 122 | ||
| SUMMARY | 122 | ||
| Suggested Reading | 129 | ||
| 12 - Utilizing Contrast Echocardiography in Practice | 130 | ||
| INTRODUCTION | 130 | ||
| LEFT VENTRICULAR OPACIFICATION | 131 | ||
| Endocardial Enhancement | 131 | ||
| Stress Echocardiography | 132 | ||
| Left Ventricular Opacification for Masses and Miscellaneous Left Ventricular Abnormalities | 133 | ||
| CONTRAST ECHOCARDIOGRAPHY FOR DOPPLER SPECTRAL ENHANCEMENT | 134 | ||
| SAFETY OF MICROBUBBLE CONTRAST AGENTS | 134 | ||
| General Recommendations for the Use of Contrast | 134 | ||
| MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY | 134 | ||
| General Considerations | 134 | ||
| Assessment of Myocardial Blood Volume | 135 | ||
| Quantification of Myocardial Blood Flow | 135 | ||
| Myocardial Viability | 135 | ||
| SUMMARY | 139 | ||
| Suggested Readings | 139 | ||
| References | 139.e1 | ||
| 13 - Echo On-Call: Echocardiographic Emergencies | 140 | ||
| INTRODUCTION | 140 | ||
| CARDIOVASCULAR EMERGENCIES | 140 | ||
| Acute Mitral Regurgitation (Flail Leaflet) | 140 | ||
| Ventricular Septal Defect | 141 | ||
| Pseudoaneurysm | 141 | ||
| Free Wall Rupture | 142 | ||
| Nonmechanical Causes of Cardiogenic Shock | 143 | ||
| Tamponade | 143 | ||
| Aortic Dissection | 146 | ||
| Pulmonary Embolus | 147 | ||
| CODES AND SHOCK: WHERE DOES STAT ECHOCARDIOGRAPHY FIT IN? | 148 | ||
| TRAUMA | 149 | ||
| Blunt Trauma | 149 | ||
| Penetrating Trauma | 152 | ||
| Suggested Reading | 152 | ||
| References | 152.e1 | ||
| III - Assessment of Cardiac Structureand Function | 153 | ||
| 14 - Assessment of Left Ventricular Systolic Function | 153 | ||
| INTRODUCTION | 153 | ||
| LEFT VENTRICULAR SYSTOLE: CARDIAC CYCLE AND HEMODYNAMICS | 155 | ||
| Measurements of the Left Ventricle | 155 | ||
| Left Ventricular Structure: Size and Mass | 155 | ||
| Assessment of Cardiac Function | 159 | ||
| GLOBAL MEASURES OF LEFT VENTRICULAR SYSTOLIC FUNCTION | 164 | ||
| Myocardial Strain Imaging | 164 | ||
| REGIONAL MEASURES OF LEFT VENTRICULAR SYSTOLIC FUNCTION | 169 | ||
| Suggested Reading | 170 | ||
| 15 - Left Ventricular Diastolic Function | 171 | ||
| INTRODUCTION | 171 | ||
| WHAT IS DIASTOLIC FUNCTION AND DYSFUNCTION? | 171 | ||
| Transmitral Doppler: E Wave Peak Velocity, A Wave Peak Velocity, and E/A Ratio | 171 | ||
| Tissue Doppler Imaging e′ | 172 | ||
| E/e′ Ratio | 173 | ||
| Left Atrial Size | 173 | ||
| Color M-Mode Propagation Velocity | 173 | ||
| Pulmonary Venous Flow | 174 | ||
| Tricuspid Regurgitation Velocity | 175 | ||
| Grading Diastolic Function | 175 | ||
| Estimation of Left Ventricle Filling Pressures in Specific Patient Populations | 177 | ||
| Atrial Fibrillation | 177 | ||
| AV Block and Pacing | 177 | ||
| Valvular Disease | 177 | ||
| DIASTOLIC STRESS TESTING IN PATIENTS WITH NORMAL DIASTOLIC FUNCTION AT REST: IS THERE A ROLE? | 177 | ||
| CONCLUSION | 177 | ||
| Suggested Readings | 179 | ||
| References | 179.e1 | ||
| 16 - Assessment of Right Ventricular Structure and Function | 180 | ||
| INTRODUCTION | 180 | ||
| CLINICAL ASSESSMENT OF RIGHT VENTRICULAR ANATOMY AND FUNCTION | 180 | ||
| SUMMARY | 189 | ||
| Suggested Reading | 189 | ||
| References | 189.e1 | ||
| 17 - Assessment of the Atria | 190 | ||
| INTRODUCTION | 190 | ||
| Left Atrium | 190 | ||
| Structure | 190 | ||
| Function | 190 | ||
| Right Atrium | 192 | ||
| The Interatrial Septum and Congenital Abnormalities of the Atria | 192 | ||
| Atrial Masses | 193 | ||
| Suggested Reading | 194 | ||
| References | 194.e1 | ||
| IV - Echocardiography for Diseases of theMyocardium | 195 | ||
| 18 - Acute Myocardial Infarction | 195 | ||
| INTRODUCTION | 195 | ||
| ESTABLISHING THE DIAGNOSIS, EXTENT, AND LOCATION OF MYOCARDIAL INFARCTION | 195 | ||
| Patterns of Myocardial Infarction By Coronary Artery Territory | 196 | ||
| Anterior Myocardial Infarcts (Left Anterior Descending Territory) | 196 | ||
| Inferior Myocardial Infarcts | 196 | ||
| Urgent Consequences of Acute Myocardial Infarction | 198 | ||
| Limitations to Echocardiography In the Acute Setting | 199 | ||
| Suggested Reading | 199 | ||
| References | 199.e1 | ||
| 19 - Mechanical Complications of Myocardial Infarction | 200 | ||
| INTRODUCTION | 200 | ||
| ACUTE MITRAL REGURGITATION | 200 | ||
| VENTRICULAR SEPTAL DEFECT | 200 | ||
| PSEUDOANEURYSM | 201 | ||
| FREE WALL RUPTURE | 201 | ||
| TAMPONADE | 202 | ||
| OTHER CAUSES OF CARDIOGENIC SHOCK AFTER MYOCARDIAL INFARCTION | 202 | ||
| Suggested Reading | 203 | ||
| References | 203.e1 | ||
| 20 - Long-Term Consequences and Prognosis After Myocardial Infarction | 204 | ||
| INTRODUCTION | 204 | ||
| LEFT VENTRICULAR SCAR AND ANEURYSM | 204 | ||
| LEFT VENTRICULAR THROMBUS | 205 | ||
| LEFT VENTRICULAR REMODELING (ISCHEMIC CARDIOMYOPATHY) | 205 | ||
| FUNCTIONAL (SECONDARY) MITRAL REGURGITATION | 206 | ||
| RARE COMPLICATIONS OF MYOCARDIAL INFARCTION | 207 | ||
| PROGNOSIS AFTER MYOCARDIAL INFARCTION | 207 | ||
| Suggested Reading | 208 | ||
| References | 208.e1 | ||
| 21 - Echocardiography in Heart Failure | 209 | ||
| ASSESSMENT OF CARDIAC STRUCTURE AND FUNCTION | 209 | ||
| Assessment of Ejection Fraction | 209 | ||
| Determination of Heart Failure Etiology | 209 | ||
| ASSESSMENT OF VALVULAR FUNCTION IN HEART FAILURE | 211 | ||
| MITRAL REGURGITATION IN HEART FAILURE | 212 | ||
| DOPPLER ASSESSMENT IN PATIENTS WITH HEART FAILURE | 212 | ||
| ASSESSMENT OF LEFT ATRIAL AND RIGHT VENTRICULAR FUNCTION | 212 | ||
| ASSESSMENT OF VENTRICULAR SYNCHRONY | 213 | ||
| DEFORMATION IMAGING IN HEART FAILURE | 213 | ||
| ASSESSMENT AFTER ORTHOTOPIC HEART TRANSPLANT | 214 | ||
| ASSESSMENT OF VENTRICULAR ASSIST DEVICES | 214 | ||
| ECHOCARDIOGRAPHY IN THE CONTEXT OF OTHER DIAGNOSTIC MEASURES IN HEART FAILURE | 215 | ||
| LUNG ULTRASOUND IN HEART FAILURE | 216 | ||
| Utility of Lung Ultrasound in Heart Failure | 217 | ||
| Limitations of Lung Ultrasound | 217 | ||
| Assessment of Pleural Effusions | 217 | ||
| Suggested Reading | 218 | ||
| References | 218.e1 | ||
| 22 - Dilated Cardiomyopathies | 219 | ||
| INTRODUCTION | 219 | ||
| COMMON FEATURES OF DILATED CARDIOMYOPATHIES | 219 | ||
| Left Ventricular Dilation and Systolic Functional Impairment | 219 | ||
| Elevation of Left Ventricular Filling Pressures | 221 | ||
| Left Atrial Dilation | 222 | ||
| Right Heart Dilation and Functional Impairment | 222 | ||
| Functional Mitral Regurgitation | 223 | ||
| ARRHYTHMOGENIC CARDIOMYOPATHY | 223 | ||
| LEFT VENTRICULAR NONCOMPACTION | 224 | ||
| TACHYCARDIA-INDUCED CARDIOMYOPATHY | 226 | ||
| PERIPARTUM CARDIOMYOPATHY | 226 | ||
| TAKOTSUBO CARDIOMYOPATHY | 226 | ||
| ALCOHOLIC CARDIOMYOPATHY | 227 | ||
| CARDIOMYOPATHY IN CHAGAS DISEASE | 228 | ||
| CHEMOTHERAPY-INDUCED CARDIOMYOPATHY | 229 | ||
| Suggested Reading | 229 | ||
| References | 229.e1 | ||
| 23 - Hypertrophic Cardiomyopathy | 230 | ||
| INTRODUCTION | 230 | ||
| SARCOMERE GENE MUTATIONS CAUSE HYPERTROPHIC CARDIOMYOPATHY | 231 | ||
| CARDIAC MORPHOLOGY | 231 | ||
| LEFT VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTION | 235 | ||
| DEVELOPMENT OF HYPERTROPHIC CARDIOMYOPATHY | 237 | ||
| LEFT VENTRICULAR OUTFLOW OBSTRUCTION AND MITRAL VALVE ABNORMALITIES | 237 | ||
| TREATMENT OF HYPERTROPHIC CARDIOMYOPATHY | 239 | ||
| USING ECHOCARDIOGRAPHY IN THE DIFFERENTIAL DIAGNOSIS OF HYPERTROPHIC CARDIOMYOPATHY | 242 | ||
| Athlete’s Heart | 242 | ||
| Focal Upper Septal Hypertrophy | 242 | ||
| Infiltrative and Metabolic Cardiomyopathies | 242 | ||
| CONCLUSION | 244 | ||
| Suggested Reading | 244 | ||
| References | 244.e1 | ||
| 24 - Restrictive and Infiltrative Cardiomyopathies | 245 | ||
| INTRODUCTION | 245 | ||
| SPECTRUM OF RESTRICTIVE CARDIOMYOPATHY | 245 | ||
| Diagnosis of Restrictive Cardiomyopathy | 245 | ||
| ECHOCARDIOGRAPHY IN RESTRICTIVE CARDIOMYOPATHY | 245 | ||
| Doppler Features | 245 | ||
| CARDIAC AMYLOIDOSIS | 247 | ||
| MITOCHONDRIAL CARDIOMYOPATHY | 248 | ||
| ENDOMYOCARDIAL FIBROSIS AND LÖFFLER (EOSINOPHILIC) ENDOCARDITIS | 248 | ||
| IDIOPATHIC RESTRICTIVE CARDIOMYOPATHY | 250 | ||
| MUCOPOLYSACCHARIDOSES | 250 | ||
| ANDERSON-FABRY DISEASE | 251 | ||
| GLYCOGEN STORAGE DISEASES | 252 | ||
| IRON OVERLOAD CARDIOMYOPATHY | 253 | ||
| CARCINOID SYNDROME | 253 | ||
| POSTRADIATION THERAPY AND CHEMOTHERAPY-RELATED CARDIAC DYSFUNCTION | 254 | ||
| SYSTEMIC SCLEROSIS | 254 | ||
| PSEUDOXANTHOMA ELASTICUM | 254 | ||
| Suggested Reading | 255 | ||
| References | 255.e1 | ||
| 25 - Echocardiography in Assessment of Cardiac Synchrony | 256 | ||
| INTRODUCTION | 256 | ||
| ECHOCARDIOGRAPHIC METHODS TO ASSESS DYSSYNCHRONY | 256 | ||
| NEW UNDERSTANDING OF MECHANICAL DYSSYNCHRONY | 258 | ||
| MYOCARDIAL SUBSTRATES OF SYNCHRONY AND DISCOORDINATION | 259 | ||
| LACK OF SYNCHRONY AND RISK FOR VENTRICULAR ARRHYTHMIAS | 260 | ||
| DYSSYNCHRONY ASSOCIATED WITH RIGHT VENTRICULAR PACING | 261 | ||
| FUTURE APPLICATIONS OF ECHOCARDIOGRAPHIC SYNCHRONY | 262 | ||
| Suggested Reading | 263 | ||
| References | 263.e1 | ||
| 26 - Echocardiography in Assessment of Ventricular Assist Devices | 264 | ||
| INTRODUCTION | 264 | ||
| TYPES OF VENTRICULAR ASSIST DEVICES | 264 | ||
| Short-Term Ventricular Assist Devices | 264 | ||
| PLANNING FOR A LEFT VENTRICULAR ASSIST DEVICE | 264 | ||
| Left Ventricular Structure and Function | 264 | ||
| Right Ventricular Structure and Function | 264 | ||
| Valves | 265 | ||
| Endocarditis | 266 | ||
| Aorta | 266 | ||
| Congenital Heart Disease | 266 | ||
| INTRAOPERATIVE | 266 | ||
| Preimplantation | 266 | ||
| POSTIMPLANT | 267 | ||
| CONCLUSIONS | 269 | ||
| Suggested Reading | 269 | ||
| References | 269.e1 | ||
| 27 - Stress Echocardiography and Echo in Cardiopulmonary Testing | 270 | ||
| INTRODUCTION | 270 | ||
| Ischemic Cascade | 270 | ||
| Stress Protocols | 270 | ||
| Exercise Protocols | 270 | ||
| Pharmacologic Stress Protocols | 270 | ||
| Assessment of Ischemia | 270 | ||
| Image Interpretation | 270 | ||
| UTILITY OF EXERCISE ECHOCARDIOGRAPHY BEYOND ISCHEMIA | 273 | ||
| Valvular Disease | 273 | ||
| Left Ventricle Function | 274 | ||
| Exercise-Induced Pulmonary Hypertension | 274 | ||
| Clinical Significance | 274 | ||
| Low-Flow, Low-Gradient Aortic Stenosis With Preserved Left Ventricle Ejection Fraction | 274 | ||
| Aortic Regurgitation | 275 | ||
| V - Valvular Heart Disease | 279 | ||
| 28 - Mitral Valve Disease | 279 | ||
| INTRODUCTION | 279 | ||
| MITRAL VALVE ANATOMY | 279 | ||
| ECHOCARDIOGRAPHIC VIEWS OF THE MITRAL VALVE | 279 | ||
| Transthoracic Echocardiography | 279 | ||
| MITRAL REGURGITATION | 281 | ||
| Primary Mitral Regurgitation | 283 | ||
| Secondary Mitral Regurgitation | 285 | ||
| MITRAL STENOSIS | 288 | ||
| Rheumatic Mitral Stenosis | 289 | ||
| Calcific Mitral Stenosis | 290 | ||
| Radiation-Associated Mitral Valve Disease | 290 | ||
| CONGENITAL MITRAL VALVE DISORDERS | 291 | ||
| Mitral Valve Cleft | 291 | ||
| Mitral Valve Parachute | 291 | ||
| Mitral Arcade | 291 | ||
| Supravalvular Mitral Ring | 293 | ||
| CONCLUSION | 293 | ||
| Suggested Reading | 293 | ||
| References | 293.e1 | ||
| 29 - Aortic Valve Disease | 294 | ||
| INTRODUCTION | 294 | ||
| NORMAL AORTIC VALVE ANATOMY AND COMMON CONGENITAL ANOMALIES | 295 | ||
| VALVULAR AORTIC STENOSIS | 296 | ||
| Quantitation of Aortic Stenosis Severity | 296 | ||
| Additional Measures of Aortic Stenosis Severity | 298 | ||
| Body Surface Area Correction for Aortic Valve Area | 299 | ||
| Low Gradient Severe Aortic Stenosis | 299 | ||
| SUBVALVULAR OR SUPRAVALVULAR AORTIC STENOSIS | 299 | ||
| AORTIC REGURGITATION | 299 | ||
| Suggested Reading | 303 | ||
| References | 303.e1 | ||
| 30 - Tricuspid and Pulmonic Valve Disease | 304 | ||
| INTRODUCTION | 304 | ||
| NORMAL TRICUSPID VALVE ANATOMY | 304 | ||
| TWO-DIMENSIONAL ECHO VIEWS FOR ASSESSING THE TRICUSPID VALVE | 304 | ||
| THREE-DIMENSIONAL ECHO OF THE TRICUSPID VALVE | 306 | ||
| ABNORMALITIES OF THE TRICUSPID VALVE | 308 | ||
| Carcinoid Valve Disease | 308 | ||
| Rheumatic Valve Disease | 308 | ||
| Tricuspid Valve Endocarditis | 308 | ||
| Flail Tricuspid Leaflet | 309 | ||
| Functional Tricuspid Regurgitation | 309 | ||
| Ebstein Anomaly of the Tricuspid Valve | 309 | ||
| Tricuspid Atresia | 309 | ||
| ECHO DOPPLER ASSESSMENT OF TRICUSPID REGURGITATION SEVERITY | 309 | ||
| ROLE OF ECHOCARDIOGRAPHY IN PERCUTANEOUS TRICUSPID VALVE REPLACEMENT | 310 | ||
| ABNORMALITIES OF THE PULMONIC VALVE | 310 | ||
| THREE-DIMENSIONAL ECHO OF THE PULMONIC VALVE | 311 | ||
| PULMONIC VALVE ENDOCARDITIS | 312 | ||
| CONGENITAL VALVULAR PULMONIC STENOSIS | 312 | ||
| PULMONIC STENOSIS S/P VALVULOPLASTY | 313 | ||
| CARCINOID INVOLVEMENT OF THE PULMONIC VALVE | 313 | ||
| ECHO DOPPLER ASSESSMENT OF PULMONIC REGURGITATION SEVERITY | 314 | ||
| SUMMARY | 314 | ||
| Suggested Reading | 314 | ||
| References | 314.e1 | ||
| 31 - Prosthetic Valves | 315 | ||
| INTRODUCTION | 315 | ||
| NORMAL APPEARANCE AND FUNCTION | 315 | ||
| PROSTHETIC VALVE STENOSIS | 316 | ||
| Gradients | 317 | ||
| Pressure Recovery | 317 | ||
| Patient-Prosthesis Mismatch | 318 | ||
| Causes of Prosthetic Valve Stenosis | 319 | ||
| PROSTHETIC VALVE REGURGITATION | 320 | ||
| PROSTHETIC VALVE ENDOCARDITIS | 320 | ||
| Suggested Reading | 322 | ||
| References | 322.e1 | ||
| 32 - Echocardiography in Percutaneous Valvular Intervention | 323 | ||
| INTRODUCTION | 323 | ||
| TRANSCATHETER AORTIC VALVE REPLACEMENT | 323 | ||
| Preimplantation Assessment | 323 | ||
| INTRAPROCEDURAL IMAGING | 325 | ||
| Wire and Cannulation Position | 326 | ||
| Balloon Aortic Valvuloplasty | 330 | ||
| Ventricular and Baseline Valvular Function | 330 | ||
| Transcatheter Valve Positioning | 330 | ||
| POSTIMPLANTATION ASSESSMENT | 330 | ||
| Paravalvular Regurgitation | 330 | ||
| TRANSCATHETER MITRAL VALVE REPAIR | 333 | ||
| PREPROCEDURAL IMAGING | 334 | ||
| INTRAPROCEDURAL GUIDANCE | 335 | ||
| Transseptal Puncture | 336 | ||
| Positioning and Orienting the MitraClip | 338 | ||
| Grasping the Mitral Leaflets | 339 | ||
| Prerelease Assessment | 339 | ||
| Post-MitraClip Assessment | 339 | ||
| OTHER TRANSCATHETER MITRAL VALVE REPAIR DEVICES AND TRANSCATHETER MITRAL VALVE REPLACEMENT | 340 | ||
| TRICUSPID REPAIR DEVICES | 341 | ||
| ECHOCARDIOGRAPHY IN TRANSCATHETER VALVE-IN-SURGICAL-VALVE PROCEDURES | 342 | ||
| INTRAPROCEDURAL IMAGING | 342 | ||
| PROCEDURAL APPROACH | 343 | ||
| INTRAPROCEDURAL IMAGING | 344 | ||
| CONCLUSION | 345 | ||
| Suggested Reading | 345 | ||
| References | 346.e1 | ||
| VI - Diseases of the Pericardium and Great Vessels | 347 | ||
| 33 - Pericardial Disease | 347 | ||
| INTRODUCTION | 347 | ||
| PERICARDIAL FLUID | 347 | ||
| Fluid Characteristics | 347 | ||
| Effusion Size | 347 | ||
| Distinguishing Features | 347 | ||
| ACUTE PERICARDITIS | 347 | ||
| RECURRENT PERICARDITIS | 348 | ||
| PERICARDIAL TAMPONADE | 348 | ||
| PERICARDIAL CONSTRICTION | 349 | ||
| OTHER PERICARDIAL DISORDERS AND ABNORMALITIES | 352 | ||
| Congenital Absence of Pericardium | 352 | ||
| Pericardial Cysts | 352 | ||
| Pericardial Involvement in Malignancy | 352 | ||
| MULTIMODALITY IMAGING | 352 | ||
| CONCLUSION | 353 | ||
| Suggested Reading | 353 | ||
| References | 353.e1 | ||
| 34 - Diseases of the Aorta | 354 | ||
| INTRODUCTION | 354 | ||
| ANATOMY, NOMENCLATURE, AND DIMENSIONS | 354 | ||
| Aortic Measurements and Dimensions | 354 | ||
| ECHOCARDIOGRAPHIC VIEWS | 354 | ||
| Transthoracic Echocardiography | 354 | ||
| Transesophageal Echocardiography | 355 | ||
| Doppler Flows in the Aorta | 356 | ||
| AORTIC ANEURYSMS | 356 | ||
| Sinus of Valsalva Aneurysms | 358 | ||
| Associated Abnormalities | 358 | ||
| Surveillance of Thoracic Aortic Aneurysms | 358 | ||
| AORTIC DISRUPTIONS (ACUTE AORTIC SYNDROMES) | 359 | ||
| PERIOPERATIVE AND POSTOPERATIVE IMAGING | 361 | ||
| Postoperative Imaging | 365 | ||
| INTRALUMINAL PATHOLOGY | 366 | ||
| Atheroma | 366 | ||
| Aortic Thrombus | 366 | ||
| Aortic Tumors | 366 | ||
| COARCTATION OF THE AORTA | 366 | ||
| Suggested Reading | 368 | ||
| References | 368.e1 | ||
| VII - Diseases of the Pulmonary Artery and Veins | 369 | ||
| 35 - Pulmonary Embolism | 369 | ||
| INTRODUCTION | 369 | ||
| UTILITY OF ECHOCARDIOGRAPHY IN PULMONARY EMBOLISM | 369 | ||
| Identification of Thrombus by Echocardiography | 369 | ||
| Assessment of the Right Ventricle in Pulmonary Embolism | 369 | ||
| Regional Right Ventricular Dysfunction: The “Mcconnell” Sign | 370 | ||
| The Influence of Elevated Pulmonary Pressures on Echocardiographic Features in Pulmonary Embolism | 371 | ||
| ECHOCARDIOGRAPHY IN PROGNOSIS AND MANAGEMENT OF PULMONARY EMBOLISM | 371 | ||
| Echocardiography in Assessment of Response to Therapy in Pulmonary Embolism | 372 | ||
| Novel Methods to Assess Right Ventricular Function in Pulmonary Embolism | 372 | ||
| Transesophageal Echocardiography in Pulmonary Embolism | 372 | ||
| DISTINGUISHING PULMONARY EMBOLISM FROM PULMONARY HYPERTENSION | 374 | ||
| Suggested Reading | 375 | ||
| 36 - Pulmonary Hypertension | 376 | ||
| INTRODUCTION | 376 | ||
| ASSESSMENT OF RIGHT VENTRICLE AFTERLOAD/PULMONARY VASCULAR FUNCTION | 376 | ||
| Pulmonary Artery Systolic Pressure | 376 | ||
| Diastolic Pulmonary Artery Pressure | 376 | ||
| Mean Pulmonary Artery Pressure | 376 | ||
| The Right Atrium and Right Atrial Pressure | 376 | ||
| OTHER MEASURES OF RIGHT VENTRICLE AFTERLOAD | 376 | ||
| Pulmonary Arterial Acceleration Time | 376 | ||
| RIGHT VENTRICULAR STRUCTURE AND FUNCTION | 379 | ||
| Right Ventricular Wall Thickness | 379 | ||
| Tricuspid Annular Plane Systolic Excursion | 379 | ||
| Right Ventricular Area Assessment | 380 | ||
| Three-Dimensional Volume Assessment | 380 | ||
| Doppler Tissue Imagings’ cm/s | 380 | ||
| Iso-Volumetric Acceleration | 381 | ||
| Right Ventricular E/e′ | 381 | ||
| Strain/Strain Rate | 381 | ||
| TIMING MEASUREMENTS | 381 | ||
| Right Ventricular Isovolumetric Relaxation Time Measurement | 381 | ||
| Myocardial Performance Index or Tei Index | 382 | ||
| Right Ventricular Assessment During Exercise | 383 | ||
| Suggested Reading | 384 | ||
| References | 384.e1 | ||
| VIII - Cardiac Masses | 385 | ||
| 37 - Primary and Secondary Tumors | 385 | ||
| INTRODUCTION | 385 | ||
| TUMOR TYPES | 385 | ||
| Primary Versus Secondary Tumors | 385 | ||
| Primary Benign Tumors | 385 | ||
| Myxoma | 385 | ||
| Lipoma | 385 | ||
| Papillary Fibroelastoma | 386 | ||
| Benign Versus Malignant | 388 | ||
| Primary Malignant Tumors | 388 | ||
| Secondary Tumors | 389 | ||
| TUMOR LOCATIONS: SITE-SPECIFIC DIFFERENTIAL | 389 | ||
| Atrial Tumors | 389 | ||
| Ventricular Tumors | 389 | ||
| Valvular Tumors | 389 | ||
| Pericardial Tumors | 390 | ||
| CLINICAL PRESENTATION OF TUMORS | 390 | ||
| Suggested Reading | 391 | ||
| References | 391.e1 | ||
| 38 - Identification of Intracardiac Thrombus | 392 | ||
| INTRODUCTION | 392 | ||
| INTRACARDIAC SOURCES OF EMBOLI | 392 | ||
| Left Ventricle | 392 | ||
| Left Atrium | 392 | ||
| Right Ventricle/Right Atrium | 392 | ||
| Prosthetic Valves | 392 | ||
| Interatrial and Interventricular Septum | 393 | ||
| Nonthrombotic Causes of Embolism | 394 | ||
| PREVALENCE OF AND RISK FACTORS FOR LEFT VENTRICULAR AND ATRIAL THROMBI | 394 | ||
| ECHOCARDIOGRAPHIC APPEARANCE | 395 | ||
| RISK FACTORS FOR EMBOLIZATION | 397 | ||
| CHOICE OF INITIAL TEST | 397 | ||
| ROLE OF FOLLOW-UP IMAGING | 397 | ||
| PREVENTION OF THROMBOEMBOLISM | 397 | ||
| CONCLUSIONS | 398 | ||
| Suggested Reading | 398 | ||
| References | 398.e1 | ||
| 39 - Other Cardiac Masses | 399 | ||
| INTRODUCTION | 399 | ||
| VARIANTS OF NORMAL STRUCTURE | 399 | ||
| DEGENERATIVE/ACQUIRED MASSES | 400 | ||
| POSTSURGICAL MASSES | 401 | ||
| EXTRACARDIAC STRUCTURES | 402 | ||
| ULTRASOUND ARTIFACTS | 402 | ||
| Suggested Reading | 403 | ||
| References | 404.e1 | ||
| IX - Systemic Diseases Involving the Heart | 405 | ||
| 40 - Echocardiography in Infective Endocarditis | 405 | ||
| INTRODUCTION | 405 | ||
| DIAGNOSIS | 405 | ||
| Indications for Transthoracic Echocardiography and Transesophageal Echocardiography | 405 | ||
| VEGETATIONS | 408 | ||
| COMPLICATIONS OF ENDOCARDITIS | 410 | ||
| Abscess, Pseudoaneurysm, and Fistula | 410 | ||
| RIGHT-SIDED ENDOCARDITIS | 411 | ||
| NONVALVULAR ENDOCARDITIS | 411 | ||
| Device-Related Infective Endocarditis | 411 | ||
| Infection of Cardiac Shunts | 412 | ||
| PURULENT PERICARDITIS | 412 | ||
| ECHOCARDIOGRAPHIC PREDICTORS OF OUTCOMES | 412 | ||
| Embolism | 412 | ||
| Overall Prognosis | 412 | ||
| SURGERY FOR ENDOCARDITIS | 412 | ||
| Echocardiographic Indicators for Surgery | 412 | ||
| Frequency of Echocardiography | 413 | ||
| Role of 3D Echocardiography | 413 | ||
| Suggested Reading | 415 | ||
| References | 415.e1 | ||
| 41 - Other Systemic Diseases and the Heart | 416 | ||
| INTRODUCTION | 416 | ||
| SARCOIDOSIS | 416 | ||
| HYPEREOSINOPHILIC SYNDROME (LOEFFLER ENDOCARDITIS) | 416 | ||
| THYROID DISEASE | 417 | ||
| CARCINOID HEART DISEASE (SEE ALSO CHAPTER 30) | 418 | ||
| HEMOCHROMATOSIS | 418 | ||
| MUSCULAR DYSTROPHIES | 419 | ||
| LYSOSOMAL STORAGE DISEASES | 419 | ||
| Glycogen Storage Diseases | 419 | ||
| Fabry Disease | 419 | ||
| Mucopolysaccharidoses | 419 | ||
| Sphingolipidoses | 419 | ||
| CONNECTIVE TISSUE DISORDERS | 420 | ||
| Ehlers-Danlos Syndrome | 420 | ||
| Marfan Syndrome | 420 | ||
| MARANTIC ENDOCARDITIS | 420 | ||
| DIABETES, HYPERTENSION, AND OBESITY | 421 | ||
| Suggested Reading | 421 | ||
| References | 421.e1 | ||
| 42 - Echocardiography in Malignant Disease | 422 | ||
| INTRODUCTION | 422 | ||
| BASELINE ASSESSMENT PRIOR TO INITIATION OF CANCER TREATMENTS | 422 | ||
| DURING CANCER TREATMENT | 422 | ||
| Contrast Echocardiography | 422 | ||
| Three-Dimensional Echocardiography | 423 | ||
| Other Imaging Modalities | 423 | ||
| Left Ventricular Ejection Fraction Surveillance Schedules | 423 | ||
| Anthracyclines | 423 | ||
| Trastuzumab | 423 | ||
| Left Ventricular Diastolic Function | 423 | ||
| Other | 424 | ||
| Right Ventricular Function | 424 | ||
| Valvular Assessment | 424 | ||
| Pericardial Disease | 425 | ||
| Pulmonary Arterial Hypertension | 425 | ||
| Cardiac Masses | 426 | ||
| Stress Echocardiography | 426 | ||
| AFTER TREATMENT: SURVIVORSHIP | 426 | ||
| Survivors of Thoracic Radiation Therapy | 426 | ||
| Survivors of Childhood Malignancies | 426 | ||
| FUTURE DIRECTIONS | 426 | ||
| CONCLUSION | 427 | ||
| Suggested Reading | 427 | ||
| References | 428.e1 | ||
| X - Congenital Heart Disease in the Adult | 429 | ||
| 43 - Atrial Septal Defect | 429 | ||
| INTRODUCTION | 429 | ||
| ANATOMY/EMBRYOLOGY | 429 | ||
| PATENT FORAMEN OVALE | 429 | ||
| CLINICAL PRESENTATION OF ATRIAL LEVEL DEFECTS | 429 | ||
| ATRIAL SEPTAL DEFECTS | 429 | ||
| VENOUS SEPTATION DEFECTS | 430 | ||
| IMAGING APPROACH | 430 | ||
| ATRIAL LEVEL SHUNTING CLOSURE | 430 | ||
| IMAGING DURING PERCUTANEOUS CLOSURE | 430 | ||
| ADDITIONAL TECHNIQUES AND PITFALLS | 432 | ||
| Clues To Undiagnosed Atrial Level Shunting | 432 | ||
| Common Mistakes in Diagnosis | 432 | ||
| Suggested Reading | 434 | ||
| References | 434.e1 | ||
| 44 - Ventricular Septal Defect | 435 | ||
| INTRODUCTION | 435 | ||
| ADULT PRESENTATION | 435 | ||
| TYPES/LOCATIONS OF VENTRICULAR SEPTAL DEFECTS | 435 | ||
| Perimembranous Ventricular Septal Defects | 435 | ||
| Muscular/Trabecular Ventricular Septal Defects | 435 | ||
| Outlet Ventricular Septal Defects | 435 | ||
| Inlet Ventricular Septal Defects | 435 | ||
| Diagnostic Clues to Inlet Ventricular Septal Defect or Atrioventricular Septal Defect | 435 | ||
| BASIC IMAGING APPROACH TO VENTRICULAR SEPTAL DEFECTS | 437 | ||
| UNIQUE VENTRICULAR SEPTAL DEFECT PHYSIOLOGY | 438 | ||
| Double-Chambered Right Ventricle | 438 | ||
| Eisenmenger Syndrome | 438 | ||
| Suggested Reading | 439 | ||
| References | 439.e1 | ||
| 45 - Other Common Congenital Defects in Adults | 440 | ||
| INTRODUCTION | 440 | ||
| SEGMENTAL ANATOMY | 440 | ||
| PATENT DUCTUS ARTERIOSUS | 440 | ||
| TETRALOGY OF FALLOT | 440 | ||
| Imaging Approach to the Adult With Repaired Tetralogy of Fallot | 440 | ||
| Key Imaging Views | 441 | ||
| TRANSPOSITION OF THE GREAT ARTERIES | 441 | ||
| COARCTATION | 443 | ||
| FONTAN | 444 | ||
| EBSTEIN ANOMALY | 445 | ||
| Suggested Reading | 446 | ||
| References | 446.e1 | ||
| XI - Miscellaneous Topics in Echocardiography | 447 | ||
| 46 - Handheld Echocardiography | 447 | ||
| INTRODUCTION | 447 | ||
| CURRENT HANDHELD DEVICES | 447 | ||
| THE LEARNING CURVE | 447 | ||
| VALIDATION OF HANDHELD DEVICES | 450 | ||
| SUGGESTED PROTOCOL | 450 | ||
| QUANTITATIVE ASSESSMENT WITH HANDHELD ECHOCARDIOGRAPHY | 451 | ||
| SPECIFIC ROLES FOR HANDHELD ECHOCARDIOGRAPHY | 454 | ||
| HANDHELD ECHOCARDIOGRAPHY AS A SCREENING TOOL | 454 | ||
| COST AND WORKFLOW ISSUES | 455 | ||
| FUTURE DEVELOPMENTS | 455 | ||
| Suggested Reading | 455 | ||
| References | 455.e1 | ||
| 47 - Appropriate Use of Echocardiography | 456 | ||
| INTRODUCTION | 456 | ||
| DEVELOPMENT OF APPROPRIATE USE CRITERIA | 456 | ||
| APPLICATION OF APPROPRIATE USE CRITERIA | 456 | ||
| FUTURE DIRECTIONS FOR APPROPRIATE USE CRITERIA | 458 | ||
| Suggested Reading | 459 | ||
| References | 459.e1 | ||
| 48 - Echocardiography in the Context of Other Cardiac Imaging Modalities | 460 | ||
| INTRODUCTION | 460 | ||
| CHAMBER QUANTIFICATION: VOLUMES AND FUNCTION | 460 | ||
| MORPHOLOGY | 462 | ||
| TISSUE CHARACTERIZATION | 464 | ||
| CORONARY DISEASE | 466 | ||
| CARDIAC MASSES | 469 | ||
| PERICARDIAL DISEASE | 470 | ||
| DISEASES OF THE AORTA | 472 | ||
| CONCLUSION | 472 | ||
| Suggested Reading | 473 | ||
| References | 473.e1 | ||
| 49 - Transesophageal Echocardiography for Cardiac Surgery | 474 | ||
| INTRODUCTION | 474 | ||
| ROLE OF THE INTRAOPERATIVE ECHOCARDIOGRAPHER | 474 | ||
| IMPACT OF INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN CARDIAC SURGERY | 474 | ||
| OBJECTIVES OF THE INTRAOPERATIVE TEE EXAM | 474 | ||
| THE INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY EXAM | 475 | ||
| IMPACT OF INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY IN NONCARDIAC SURGERY | 478 | ||
| Suggested Reading | 479 | ||
| References | 479.e1 | ||
| A - Reference Tables | 480 | ||
| B - COMMONLY UTILIZED EQUATIONS IN ECHOCARDIOGRAPHY | 483 | ||
| GENERAL BODY MEASURES | 483 | ||
| Body Mass Index | 483 | ||
| Body Surface Area (Mosteller Formula) | 483 | ||
| ECHOCARDIOGRAPHY | 483 | ||
| Left and Right Ventricle | 483 | ||
| Left Ventricular Volume (Teicholz Formula) | 483 | ||
| Left Ventricular Ejection Fraction (Simplified Quinones Equation) | 483 | ||
| Left Ventricular Fractional Shortening | 483 | ||
| Left Ventricular Mass (Linear Method, Cube Formula) | 483 | ||
| Relative Wall Thickness | 483 | ||
| Myocardial Performance, or Tei Index (Left Ventricular) (Fig. B.1; see also Fig. 14.12) | 483 | ||
| Myocardial Performance, or Tei Index (Right Ventricular) | 483 | ||
| Left Ventricular Wall Motion Score Index (for 17 Segment Left Ventricular Model) | 484 | ||
| Stroke Volume | 484 | ||
| Cardiac Output | 484 | ||
| Valves, General | 484 | ||
| Aortic Stenosis | 484 | ||
| Aortic Regurgitation | 485 | ||
| Regurgitant Volume by the PISA method | 485 | ||
| Regurgitant Volume by the Continuity Equation (Volumetric Method) | 485 | ||
| Regurgitant Fraction by the PISA/2D Method | 485 | ||
| Mitral Stenosis | 485 | ||
| Mitral Regurgitation | 485 | ||
| Regurgitant Volume by PISA Method | 485 | ||
| Regurgitant Volume by Continuity Equation (Volumetric Method) (see Fig. 28.13) | 485 | ||
| Regurgitant Fraction by PISA/2D Method | 485 | ||
| Tricuspid Regurgitation | 486 | ||
| Pulmonic Regurgitation | 486 | ||
| Pulmonary Vascular Resistance | 486 | ||
| EXERCISE STRESS TESTING | 486 | ||
| Suggested Reading | 486 | ||
| Index | 487 | ||
| A | 487 | ||
| B | 488 | ||
| C | 488 | ||
| D | 489 | ||
| E | 489 | ||
| F | 490 | ||
| G | 490 | ||
| H | 490 | ||
| I | 491 | ||
| L | 491 | ||
| M | 492 | ||
| N | 492 | ||
| O | 492 | ||
| P | 492 | ||
| Q | 493 | ||
| R | 493 | ||
| S | 494 | ||
| T | 495 | ||
| U | 496 | ||
| V | 496 | ||
| W | 496 | ||
| IBC | 503 |