By Christophe Klimczak MD PhD, Petros Nihoyannopoulos MD FRCP FACC FESC
This e-book deals either skilled cardiologists and trainees alike the chance to spot and tackle the commonest pitfalls encountered with echocardiology in regimen medical perform. The ebook covers a sequence of demanding situations starting from technical problems to issues of echocardiographic interpretation with each one part proposing a sequence of simulations to check the reader's knowing of the matter. The textual content is written in a hugely sensible and didactic sort so that it will aid the busy health practitioner via providing the data in a succinct, 'essentials basically' demeanour. The heavy use of top quality illustrations serves to make sure that the thoughts defined are supported by means of real-life examples and hence simply appropriate to the scientific setting.Edited through a world expert.Abundant use of full-colour permits exact illustration of pictures to have enough money precise dialogue of the suggestions involved.Didactic process guarantees supply of key details in plausible parts hence saving time for the busy cardiologist.Includes the main widespread pitfalls linked to quite a number thoughts therefore making sure applicability to numerous scientific settings and gear availability.
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Extra resources for 100 Challenges in Echocardiography
In this particular case, traditional echo Doppler does not allow differentiation between aortic pseudostenosis linked to left ventricular dysfunction with low output, and genuine tight AS with associated impaired ventricular function. Stress echocardiography under low doses of Dobutamine is very useful in this differential diagnosis. In fact, it makes it possible to identify the presence of a myocardial contractile reserve and to study the evolution of the gradients as well as the functional aortic surface area under stimulation.
Atrial fibrillation, which leads to variable values of the subaortic VTI (Fig. 19). In this case planimetry should be used, taking the mean value of at least five consecutive cardiac cycles at relatively constant R–R intervals. Finally, post-extrasystolic complexes should be avoided when measuring the subaortic VTI, as they lead to a post-extrasystolic increase in the subaortic flow. Pitfalls when recording the stenotic flow The transvalvular stenotic flow (mitral or aortic) is recorded using continuous Doppler.
This is where the operator’s experience and skill come into play. 6 Cardiac valves VALVULAR STENOSES Echocardiographic diagnosis of valvular stenoses, such as mitral stenosis (MS) or aortic stenosis (AS), is based on the study of: • • • the morphology and motion of the stenotic valve the degree of valvular stenosis the haemodynamic consequences of the valvular stenosis. PITFALLS WHEN STUDYING THE CONDITION OF THE STENOTIC VALVE These echocardiographic pitfalls comprise: • • • incomplete visualization of the stenotic valve imprecise assessment of the valvular lesions (morphology, mobility) particular cases, such as subvalvular MS or a bicuspid aortic valve.