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 deal with the most typical pitfalls encountered with echocardiology in regimen scientific perform. The booklet covers a chain of demanding situations starting from technical problems to issues of echocardiographic interpretation with every one part proposing a sequence of simulations to check the reader's figuring out of the matter. The textual content is written in a hugely sensible and didactic variety as a way to support the busy health professional by way of featuring the knowledge in a succinct, 'essentials in simple terms' demeanour. The heavy use of high quality illustrations serves to make sure that the suggestions defined are supported by way of real-life examples and therefore effectively appropriate to the medical setting.Edited by means of a world expert.Abundant use of full-colour permits exact illustration of pictures to have enough money specific dialogue of the concepts involved.Didactic process guarantees supply of key info in doable parts therefore saving time for the busy cardiologist.Includes the main widespread pitfalls linked to more than a few suggestions therefore making sure applicability to various medical settings and gear availability.
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Additional resources for 100 Challenges in Echocardiography
Pitfalls associated with mitral stenosis when there is a discrepancy between clinical symptoms and echocardiographic data at rest These are symptomatic patients with a mild MS, or asymptomatic patients with a tight stenosis. A discrepancy between symptoms and data justifies the use of exercise echocardiography to evaluate the functional significance of the MS. The evolution of the transmitral gradient and pulmonary pressures during exercise are analysed. In exercise echocardiography, the criteria that indicate haemodynamic consequences of the MS are: • • an increase in the average gradient of > 15 mmHg at peak effort (or double the resting value) an increase in the systolic pulmonary arterial pressure of > 60 mmHg at peak stress.
The flow time in TR is longer than that of the aortic flow. Confusion between the flow in aortic stenosis and the flow in left ventricular dynamic obstruction In order to differentiate between these flows, the operator must make use of echocardiographic imaging and continuous Doppler. 21 Aortic stenosis. (a) Underestimation of the transvalvular gradient (maximum gradient: 37 mmHg) calculated using the flow recorded with continuous Doppler coupled with 2D imaging (incorrect alignment). (b) Correct evaluation of the gradient (63 mmHg) obtained using the Pedoff probe, which enables good alignment with the stenotic jet (recorded in the same patient as in (a)).
Suboptimal adjustment of the spectrum speed Echocardiographic traces can be collected at various speeds, the most commonly used being between 20 and 50 mm/s. In the case of rapid event analysis, it is possible to adjust the speed to 75 or 100 mm/s. This adjustment makes it possible to improve the precision of the Doppler measurements and to interpret correctly the data collected. It is vital to analyse the spectral curve simultaneously with an electrocardiographic trace, which provides a time reference for the cardiac cycle.
100 Challenges in Echocardiography by Christophe Klimczak MD PhD, Petros Nihoyannopoulos MD FRCP FACC FESC