By Christophe Klimczak MD PhD, Petros Nihoyannopoulos MD FRCP FACC FESC
This e-book bargains either skilled cardiologists and trainees alike the chance to spot and tackle the commonest pitfalls encountered with echocardiology in regimen medical perform. The publication covers a chain of demanding situations starting from technical problems to issues of echocardiographic interpretation with each one part offering a sequence of simulations to check the reader's realizing of the matter. The textual content is written in a hugely sensible and didactic kind with a purpose to aid the busy general practitioner through proposing the knowledge in a succinct, 'essentials purely' demeanour. The heavy use of fine quality illustrations serves to make sure that the strategies defined are supported via real-life examples and therefore without problems appropriate to the scientific setting.Edited by means of a world expert.Abundant use of full-colour permits actual illustration of pictures to come up with the money for special dialogue of the innovations involved.Didactic process guarantees supply of key details in workable parts therefore saving time for the busy cardiologist.Includes the main common pitfalls linked to more than a few ideas hence making sure applicability to various medical settings and kit availability.
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Additional info for 100 Challenges in Echocardiography
98 cm. Zoomed 2D images (longitudinal, parasternal cross-section). a major source of errors. 5). Conversely, a value for the subaortic diameter that is falsely too low will lead to an underestimation of the valve surface area. Finally, in cases of AS where the measurement of the subaortic diameter is not possible via the transthoracic route, it is possible to quantify the stenosis using the permeability index. This may be done using the VTI ratio: subaortic VTI/transaortic VTI. This easily calculated parameter is independent of the cardiac output and its sensitivity is satisfactory, but its specificity remains poor.
It is desirable to relate the valve surface area calculated using echo Doppler (cm2) to the body surface area of the subject examined (m2). This indexing of the stenotic surface area enables the calculation to be refined and the results to be interpreted at the level of the individual. Monitoring of the valvular stenosis by means of repeated examinations is also improved. 25 is suggestive of a tight AS. Nevertheless, this value is less reliable than the measure of aortic surface area in judging the severity of a stenosis.
29 30 Cardiac valves • • • • • – The tracking of the early diastole, which corresponds to the maximum opening of the mitral valve. Mid-diastolic planimetry leads to an underestimation of the actual MSA. The particular morphological form of the stenotic valve (Fig. 9). An inappropriate 2D cross-section of a very thin valve (known as non-calcified (softvalve) MS) may incorrectly overestimate the area when compared with the rigid-valve (calcified valve) MS in the form of a funnel (Fig. 10). The presence of major calcifications of the mitral orifice, the reflected echoes of which can lead to an underestimation of the actual MSA.