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Additional Description
Preface
Acknowledgments
Chapter 1 History of Echocardiography
Harvey Feigenbaum, MD Development of Various Echocardiographic Technologies
Recording Echocardiograms
Cardiac Sonographers
Echocardiographic Education and Organizations
References
Chapter 2 Physics and Instrumentation
Physical Principles
Interaction Between Ultrasound and Tissue
The Transducer
Manipulating the Ultrasound Beam
Resolution
Creating the Image
Transmitting Ultrasound Energy
Display Options
Tradeoffs in Image Creation
Signal Processing
Tissue Harmonic Imaging
Artifacts
Doppler Echocardiography
Principles of Doppler Ultrasound
Doppler Formats
Color Flow Imaging
Technical Limitations of Color Doppler Imaging
Doppler Artifacts
Tissue Doppler Imaging
Biologic Effects of Ultrasound
Suggested Readings
Chapter 3 Specialized Echocardiographic Techniques and Methods
Imaging Devices and Methods
M-Mode Echocardiography
Two-dimensional Echocardiography
Color B-Mode Scanning
Doppler Interrogation
Color Flow Doppler Imaging
Color Doppler M-Mode Imaging
Doppler Tissue Imaging
Speckle Tracking
Tissue Characterization
Acquisition of Cardiac Ultrasound Information
Transthoracic Echocardiography
Hand-Carried Ultrasound
Dedicated Single-Line Interrogation Transducers
Transesophageal Echocardiography
Three-dimensional Echocardiography
Epicardial Imaging
Intracardiac Echocardiography
Intravascular Ultrasound
The Digital Echo Laboratory
Suggested Readings
Chapter 4 Contrast Echocardiography
Source of Ultrasound Contrast
Contrast Agents
Safety
Clinical Use
Ultrasound Interaction with Contrast Agents
Detection Methods
Machine Settings
Intermittent Imaging
Low Mechanical Index Imaging
Other Mechanical Factors Affecting Contrast Detection
Doppler Imaging
Contrast Artifacts
Detection and Utilization of Intracavitary Contrast
Intramural Cavity Flow, Trabeculation, Incomplete Filling
Enhancement of Doppler Signals
Shunt Detection
Detection of Miscellaneous Conditions
Myocardial Perfusion Contrast Echocardiography
Suggested Readings
Chapter 5 The Echocardiographic Examination
Selecting the Transducers
Patient Position
Placement of the Transducer
An Approach to the Transthoracic Examination
Parasternal Long-Axis Views
Parasternal Short-Axis Views
Apical Views
The Subcostal Examination
Suprasternal Views
Orientation of Two-Dimensional Images
Echocardiographic Measurements
Left Ventricular Wall Segments
M-Mode Examination
Transesophageal Echocardiography
Transesophageal Echocardiographic Views
Echocardiography as a Screening Test
Training in Echocardiography
Suggested Readings
Chapter 6 Evaluation of Systolic Function of the Left Ventricle
General Principles
Linear Measurements
Indirect M-Mode Markers of Left Ventricular Function
Two-dimensional Measurements
Assessment of Left Ventricular Function with Three-dimensional Echocardiography
Determination of Left Ventricular Mass
Physiologic Versus Pathologic Hypertrophy
Regional Left Ventricular Function
Quantitative Techniques
Nonischemic Wall Motion Abnormalities
Premature Ventricular Contractions
Paced Rhythms
Ventricular Preexcitation
Postoperative Cardiac Motion
Posterior Compression
Pericardial Constriction
Doppler Evaluation of Global Left Ventricular Function
Myocardial Performance Index
Other Techniques for Determination of Left Ventricular Systolic Function
Determination of Left Ventricular dP/dt
Newer and Advanced Methods for Evaluating Left Ventricular Function
Strain and Strain Rate Imaging
Ventricular torsion
Conclusion
Suggested Readings
Chapter 7 Evaluation of Left Ventricular Diastolic Function
Normal Diastolic Function
Stages of Diastolic Dysfunction
Normal Diastolic Function
Impaired Relaxation, Grade I
Pseudonormalization, Grade II
Restrictive Filling (Reversible), Grade III
Restrictive Filling (Irreversible), Grade IV
Echo-Doppler Parameters of Diastolic Function
Isovolumic Relaxation Time
Mitral Inflow
Color M-mode Flow Propagation Velocity (Vp)
Tissue Doppler Mitral Annular Velocity
Pulmonary Venous Flow Patterns
Left Atrial Volume
The Valsalva Maneuver
Other Markers of Diastolic Dysfunction
A Comprehensive Approach to Diastolic Dysfunction
Estimating Left Ventricular Filling Pressures
Stress Testing to Assess Diastolic Function
The Differential Diagnosis of Heart Failure with Normal Ejection Fraction
Evaluation of Diastolic Dysfunction in Specific Patient Groups
Sinus Tachycardia
Atrial Fibrillation
Mitral Valve Disease
Hypertrophic Cardiomyopathy
Prognosis in Patients with Diastolic Dysfunction
Suggested Readings
Chapter 8 Left and Right Atrium, and Right Ventricle
Left Atrium
Left Atrial Dimensions and Volume
Left Atrial Function
Atrial Septum
Pulmonary Veins
Right Atrium
Right Atrial Thrombi
Right Atrial Blood Flow
Right Ventricle
Right Ventricular Dimensions and Volumes
Right Ventricular Overload
Right Ventricular Dysplasia
Suggested Readings
Chapter 9 Hemodynamics
Use of M-Mode and Two-Dimensional Echocardiography
Quantifying Blood Flow
Clinical Application of Blood Flow Measurement
Measuring Pressure Gradients
Applications of the Bernoulli Equation
Determining Pressure Half-Time
The Continuity Equation
Proximal Isovelocity Surface Area
Myocardial Performance Index
Suggested Readings
Chapter 10 Pericardial Diseases
Clinical Overview
Echocardiographic Evaluation of the Pericardium
Detection and Quantitation of Pericardial Fluid
Direct Visualization of the Pericardium
Differentiation of Pericardial from Pleural Effusion
Cardiac Tamponade
Echocardiographic Findings in Cardiac Tamponade
Doppler Findings in Tamponade
Pericardial Constriction
Echocardiographic Diagnosis
Doppler Echocardiographic Findings in Constriction
Effusive Constrictive Pericarditis
Constrictive Pericarditis Versus Restrictive Cardiomyopathy
Miscellaneous Pericardial Disorders and Observations
Postoperative Effusions
Echocardiography-Guided Pericardiocentesis
Congenital Absence of the Pericardium
Pericardial Cysts
Suggested Readings
Chapter 11 Aortic Valve Disease
Aortic Stenosis
Doppler Assessment of Aortic Stenosis
Other Approaches to Quantifying Stenosis
Defining the Severity of Aortic Stenosis
Dobutamine Echocardiography in the Evaluation of Aortic Stenosis
Natural History of Aortic Stenosis
Clinical Decision Making
Aortic Regurgitation
Appropriateness Criteria
M-Mode and Two-dimensional Imaging
Establishing a Diagnosis of Aortic Regurgitation
Evaluating the Severity of Aortic Regurgitation
Acute versus Chronic Aortic Regurgitation
Assessing the Left Ventricle
Miscellaneous Abnormalities of the Aortic Valve
Suggested Readings
Chapter 12 Mitral Valve Disease
Anatomy of the Mitral Valve
Physiology of Mitral Valve Disease
Mitral Stenosis
Two-Dimensional Echocardiography in Rheumatic Mitral Stenosis
Congenital Mitral Stenosis
M-Mode Echocardiography
Transesophageal Echocardiography
Role of Three-Dimensional Echocardiography
Anatomic Determination of Severity
Doppler Echocardiographic Determination of Severity
Exercise Gradients
Secondary Features of Mitral Stenosis
Atrial Fibrillation
Secondary Pulmonary Hypertension
Decision Making Regarding Intervention
Mitral Regurgitation
Doppler Evaluation of Mitral Regurgitation
Flail Leaflets
Functional Mitral Regurgitation
Determination of Mitral Regurgitation Severity
Other Considerations in Assessing Mitral Regurgitation
Mitral Valve Prolapse
Miscellaneous Mitral Valve Abnormalities
Calcification of the Mitral Annulus
Tumors of the Mitral Valve
Aneurysms of the Mitral Valve
Endocarditis and Valve Perforation
Anular Dehiscence
Radiation Damage
Carcinoid and Diet Drug Valvulopathy
Suggested Readings
Chapter 13 Tricuspid and Pulmonary Valves
Clinical Overview
Pulmonary Valve
Pulmonary Valve Stenosis
Pulmonary Valve Regurgitation
Miscellaneous Abnormalities of the Pulmonary Valve
Evaluation of the Right Ventricular Outflow Tract
Tricuspid Valve
Doppler Evaluation of the Tricuspid Valve
Tricuspid Stenosis
Tricuspid Regurgitation
Pacemaker and Catheter-Induced Tricuspid Regurgitation
Ischemic Heart Disease
Quantitation of Tricuspid Regurgitation
Determination of Right Ventricular Systolic Pressure
Other Specific Conditions Resulting in Tricuspid and Pulmonary Valve Disease
Carcinoid Heart Disease
Endocardial Fibroelastosis
Ebstein Anomaly
Tricuspid Valve Resection
Cardiac Biopsy
Tumors and Other Masses
Suggested Readings
Chapter 14 Infective Endocarditis
Clinical Perspective
Echocardiographic Characteristics of Vegetation
Diagnostic Accuracy of Echocardiography
Evolution of the Diagnostic Criteria
Complications of Endocarditis
Prognosis and Predicting Risk
Prosthetic Valve Endocarditis
Infected Intracardiac Devices
Right-Sided Endocarditis
Approach to the Patient with Endocarditis
Suggested Readings
Chapter 15 Prosthetic Valves
Types of Prosthetic Valves
Normal Prosthetic Valve Function
Application of Echocardiography to Patients with Prosthetic Valves
General Approach to Prosthetic Valves
Prosthetic Aortic Valves
Prosthetic Mitral Valves
Specific Causes of Dysfunction
Obstruction
Infective Endocarditis
Mechanical Failure
Right-Sided Prosthetic Valves
Valved Conduits
Mitral Valve Repair
Suggested Readings
Chapter 16 Echocardiography and Coronary Artery Disease
Clinical Overview
Pathophysiology of Coronary Syndromes
Detection and Quantitation of Wall Motion Abnormalities
Role of the Three-dimensional Echocardiography
Doppler Tissue Imaging and Speckle Tracking
Other Methods for Evaluating Ischemic Myocardium
Echocardiographic Evaluation of Clinical Syndromes
Angina Pectoris
Acute Myocardial Infarction
Natural History of Wall Motion Abnormalities
Prognostic Implications
Doppler Evaluation of Systolic and Diastolic Function in Acute Myocardial Infarction
Complications of Acute Myocardial Infarction
Pericardial Effusion
Infarct Expansion/Acute Remodeling
Free-Wall Rupture
Ventricular Thrombus
Right Ventricular Infarction
Acute Mitral Regurgitation
Ventricular Septal Rupture
Cardiogenic Shock
Chronic Coronary Artery Disease
Left Ventricular Aneurysm
Left Ventricular Pseudoaneurysm
Chronic Remodeling
Mural Thrombus
Mitral Regurgitation
Chronic Ischemic Dysfunction
Direct Coronary Visualization
Kawasaki Disease
Direct Visualization of Atherosclerosis
Suggested Readings
Chapter 17 Stress Echocardiography
Physiologic Basis
Methodology
Treadmill
Bicycle Ergometry
Dobutamine Stress Echocardiography
Dipyridamole and Adenosine
Three-dimensional Stress Echocardiography
Choosing among the Different Stress Modalities
Interpretation of Stress Echocardiography
Categorization of Wall Motion
Wall Motion Response to Stress
Localization of Coronary Artery Lesions
Correlation with Symptoms and Electrocardiographic Changes
Detection of Coronary Artery Disease
Role of Myocardial Perfusion Imaging
Comparison with Nuclear Techniques
Applications of Stress Echocardiography
Prognostic Value of Stress Echocardiography
Stress Echocardiography After Myocardial Infarction
Stress Echocardiography After Revascularization
Preoperative Risk Assessment
Stress Echocardiography in Women
Assessment of Myocardial Viability
Stress Echocardiography in Valvular Heart Disease
Diastolic Stress Echocardiography
Suggested Readings
Chapter 18 Dilated Cardiomyopathies
Clinical and Echocardiographic Overview
Dilated Cardiomyopathy
Doppler Evaluation of Systolic and Diastolic Function
Assessment of Diastolic Function
Myocardial Performance Index
Secondary Findings in Dilated Cardiomyopathy
Etiology of Dilated Cardiomyopathy
Determination of Prognosis in Dilated Cardiomyopathy
The Role of Echocardiography in Basic and Advanced Therapy
Biventricular Pacing for Congestive Heart Failure
Cardiac Transplantation and Other Advanced Support
Ventricular Assist Devices
Myocarditis
Peripartum Cardiomyopathy
Chagas Myocarditis
Suggested Readings
Chapter 19 Hypertrophic and Other Cardiomyopathies
Overview
Hypertrophic Cardiomyopathy
Echocardiographic Evaluation of Hypertrophic Cardiomyopathy
Assessment of the Left Ventricular Outflow Tract in Obstructive Cardiomyopathy
Mitral Regurgitation in Hypertrophic Cardiomyopathy
Variants of Hypertrophic Cardiomyopathy
Mid-Cavitary Obstruction
Screening of Family Members
Conditions Mimicking Hypertrophic Cardiomyopathy
End-Stage Hypertrophic Cardiomyopathy
Hypertrophic Cardiomyopathy Therapy
Infiltrative and Restrictive Cardiomyopathy
Echocardiographic Evaluation of Restrictive Cardiomyopathy
Cardiac Amyloid
Restrictive Cardiomyopathy
Constrictive Versus Restrictive Heart Disease
Endocardial Fibroelastosis and Hypereosinophilic Syndrome
Suggested Readings
Chapter 20 Congenital Heart Diseases
The Echocardiographic Examination: A Segmental Approach to Anatomy
Cardiac Situs
Ventricular Morphology
Great Artery Connections
Abnormalities of Right Ventricular Inflow
Abnormalities of Left Ventricular Inflow
Pulmonary Veins
Left Atrium
Mitral Valve
Abnormalities of Right Ventricular Outflow
Right Ventricle
Pulmonary Valve
Pulmonary Artery
Abnormalities of Left Ventricular Outflow
Subvalvular Obstruction
Valvular Aortic Stenosis
Supravalvular Aortic Stenosis
Coarctation of the Aorta
Abnormalities of Cardiac Septation
Atrial Septal Defect
Ventricular Septal Defect
Endocardial Cushion Defect
Abnormal Vascular Connections and Structures
Patent Ductus Arteriosus
Abnormal Systemic Venous Connections
Abnormal Pulmonary Venous Connections
Abnormalities of the Coronary Circulation
Conotruncal Abnormalities
Tetralogy of Fallot
Transposition of the Great Arteries
Double-Outlet Right Ventricle
Persistent Truncus Arteriosus and Aortopulmonary Window
Abnormalities of Ventricular Development
Single Ventricle
Tricuspid Atresia
Echocardiographic Evaluation During and After Surgery
Systemic Artery to Pulmonary Artery Shunts
The Fontan Procedure
Right Ventricle to Pulmonary Artery Conduits
Suggested Readings
Chapter 21 Diseases of the Aorta
Normal Aortic Anatomy
Echocardiographic Evaluation
Aortic Dilation and Aneurysm
Marfan Syndrome
Sinus of Valsalva Aneurysm
Aortic Dissection
Echocardiographic Diagnosis
Intramural Hematoma
Complications and Natural History of Aortic Dissection
Aortic Atheroma
Miscellaneous Conditions
Coarctation of the Aorta
Aortic Pseudoaneurysm
Aortic Trauma
Infections of the Aorta
Aortic Thrombus
Takayasu Arteritis
Suggested Readings
Chapter 22 ICU and Operative/Perioperative Applications
Evaluation of Patients in the Medical Intensive Care Unit
Hypotension and Shock
Evaluation of Hypoxia
Echocardiography in the Emergency Department
Echocardiography Following Cardiac Arrest
Pre-, Intra-, and Postoperative Echocardiography
Role of Echocardiography in Mitral Valve Surgery
Tricuspid Valve Repair
Role of Echocardiography in Aortic Valve Procedures
Miscellaneous Applications
Other Intraoperative Complications of Cardiac Surgery
Intraoperative Monitoring for Noncardiac Procedures
Delayed Cardiac Surgery Complications
Monitoring of Nonoperative and Interventional Procedures
Interventional Cardiac Procedures
Other Applications in the Catheterization Laboratory
Suggested Readings
Chapter 23 Masses, Tumors, and Source of Embolus
Normal Variants and Artifacts: Sources of False-Positive Findings
Role of Echocardiography
Cardiac Tumors
Primary Tumors
Metastatic Tumors to the Heart
Intracardiac Thrombi
Left Ventricular Thrombi
Left Atrial Thrombi
Right Atrial Thrombi
Spontaneous Echo Contrast
Role of Echocardiography in Systemic Embolus
Pseudotumors and Other Cardiac Masses
Suggested Readings
Chapter 24 Echocardiography in Systemic Disease and Clinical Problem Solving
Echocardiography and Systemic Disease
Hypertension
Diabetes Mellitus
Thyroid Disease
Chronic Renal Insufficiency
Connective Tissue/Autoimmune Disease
Systemic Lupus Erythematosus
Antiphospholipid Antibody Syndrome
Scleroderma/Raynaud Phenomenon
Marfan Syndrome
Chronic Liver Disease and Cirrhosis
Chronic Obstructive Pulmonary Disease
Pulmonary Hypertension
Miscellaneous Diseases
Sarcoidosis
Hemochromatosis
Muscular Dystrophy/Glycogen Storage Disease
Hypereosinophilia
Carcinoid Syndrome
Sickle Cell Anemia
Human Immunodeficiency Virus
Diet-Drug Valvulopathy
Obesity
Clinical Presentations and Problem Solving
Congestive Heart Failure
Evaluation of Dyspnea
Acute Pulmonary Embolus
Echocardiographic Findings
Atrial Fibrillation
Neurogenic Myocardial Stunning
Syncope
Evaluation of Cardiac Arrhythmias
Evaluation of Patients Before and During Chemotherapy
Radiation-Induced Cardiac Disease
Screening for Athletic Competition and the Athlete’s Heart
The Heart in Pregnancy
Effects of Advanced Age
Suggested Readings
INDEX
DVD CONTENTS
Lectures
Acute Myocardial Infarction
Aortic Syndromes
Atrial Fibrillation
Mitral Regurgitation
Video Atlas
