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TABLE OF CONTENTS
Contributors III
Preface Ix
CHAPTER 1
Introduction to Echocardiography 1
Brief history 3
Present clinical applications 3
Preparing to scan 4
CHAPTER 2
Anatomy and Physiology of the Heart 9
Pericardium and external relationships 11
Internal cardiac anatomical relationships 11
Anatomical features of individual structures 14
Intercardiac flow and pressure 16
Electrocardiogram 18
Nomenclature for cardiac description 19
CHAPTER 3
Introduction to Echocardiography Modalities 21
Nature of ultrasound 23
Two-dimensional imaging 24
M-mode (Time-motion) imaging 26
Doppler ultrasound studies 27
Other basic equipment details 35
CHAPTER 4
Practical Scanning Technique 37
Choice of transducer 39
Windows 39
Electrocardiogram 39
Distance measurements 41
Standard full examination 41
Tables of normal measurements 61
CHAPTER 5
Acquired Valve Disease 63
Stenosis 65
Regurgitation 65
Mitral valve disease 66
Aortic valve disease 72
Tricuspid valve disease 78
Pulmonary valve disease 81
Pulmonary hypertension 82
Infective endocarditis 83
Prosthetic valves 85
CHAPTER 6
Heart-Muscle Disease, Pericardial Disease
and Other Acquired Conditions 91
Cardiomyopathies 93
Ischaemic heart disease 97
Myocardial infarction 97
Left ventricular hypertrophy 99
Right ventricular hypertrophy 100
Left ventricular dilatation 100
Left ventricular volume overload 100
Right ventricular dilatation 101
Pericardial disease 101
Aortic disease 105
Thrombus 107
Tumours 109
Implants 111
Interatrial aneurysm 112
CHAPTER 7
Congenital Heart Disease
Alison Heads 113
Preparing the patient 115
Echocardiography equipment 115
The echocardiographic approach 115
Description of the scan 116
CHAPTER 8
Transoesophageal Echocardiography
Stephen Evans 139
Introduction 141
Equipment 141
Indications 142
Complications 142
Patient preparation 142
Procedure 143
Clinical applications 149
Future developments 153
Conclusion 154
CHAPTER 9
Stress Echocardiography
Jayshree Joshi 157
Introduction 159
Myocardial ischaemia 159
Indications for stress testing 159
Equipment 160
Patient preparation 160
Stress test modalities and
protocols 161
Clinical applications 164
Future developments 165
CHAPTER 10
The Cardiac Surgery Environment 169
Preoperative assessment 171
Intraoperative assessment 171
Postoperative assessment
(intensive care) 173
Follow-up after cardiac surgery 175
CHAPTER 11
Clinical Overview 177
Learning echocardiography 179
Who should perform the examination? 179
Training, examination and accreditation 180
Clinical contexts 180
Communication and reporting 181
Conclusion 182
APPENDIX I 183
Report writing 185
Biological effects of ultrasound 188
Physics 189
Measurement calculations 195
Developing and future applications
of echocardiography 198
APPENDIX II
Commonly used clinical and echocardiographic
abbreviations 201
APPENDIX III
GLOSSARY 205
INDEX 209
END
