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Cardiovascular Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Transthoracic echocardiography is a non-invasive technique for analysing cardiac structure and function. It is particularly important for assessing ventricular function, presence of MI and valvular function, and can non-invasively assess pulmonary artery pressure. In patients with poor-quality images, IV contrast can be used to improve assessment of ventricular function. Advanced technologies, including strain imaging and 3D echocardiography, provide more detailed assessment of ventricular function.
Stroke
Published in Henry J. Woodford, Essential Geriatrics, 2022
Transthoracic echocardiography can be used to detect structural cardiac abnormalities in people who either have suggestive features on clinical examination or ECG recording; or those with an unexplained stroke mechanism where cardioembolism is thought to be likely.6
Cardiac Diagnostic Testing in Pregnancy
Published in Afshan B. Hameed, Diana S. Wolfe, Cardio-Obstetrics, 2020
Transthoracic echocardiography can be used to evaluate ventricular function, valvular abnormalities, and pericardial disease. It uses high-frequency sound waves to image cardiac structures. Ultrasound waves are harmless to the tissues at the intensities used in diagnostic imaging. Echocardiography should be obtained in pregnant women who complain of chest pain, syncope, shortness of breath out of proportion to pregnancy, and palpitations. Furthermore, an echocardiogram should be performed on women with documented arrhythmia during pregnancy and those with known heart disease, stroke, or prior history of chemotherapy or radiation [20]. Serial echocardiography may be indicated during pregnancy based on the underlying cardiac disease.
Rationale and design of the Brazilian diabetes study: a prospective cohort of type 2 diabetes
Published in Current Medical Research and Opinion, 2022
Joaquim Barreto, Vaneza Wolf, Isabella Bonilha, Beatriz Luchiari, Marcus Lima, Alessandra Oliveira, Sofia Vitte, Gabriela Machado, Jessica Cunha, Cynthia Borges, Daniel Munhoz, Vicente Fernandes, Sheila Tatsumi Kimura-Medorima, Ikaro Breder, Marta Duran Fernandez, Thiago Quinaglia, Rodrigo B. Oliveira, Fernando Chaves, Carlos Arieta, Gil Guerra-Júnior, Sandra Avila, Wilson Nadruz, Luiz Sergio F. Carvalho, Andrei C. Sposito
Transthoracic echocardiography is performed by fully licensed cardiologists with specialization in cardiovascular imaging, following technical recommendations and measurement techniques according to the latest American Society of Echocardiography guidelines29. Heart scan images were acquired with a 1.5–4.5 MHz phased array transducer (Epiq CVX, Philips, Eindhoven, The Netherlands), and images processing with the Echo PAC software version 8.0 (GE Healthcare). Variable assessment and interpretation followed their respective guidelines: cardiac chambers diameters, chambers volumes, left ventricle (LV) mass, LV and right ventricular (RV) systolic function and global longitudinal, circumferential, and radial strain assessed by speckle tracking. For the LV diastolic function analysis, it considered tissue Doppler myocardial velocities, mitral wave inflow velocities, indexed left atrial volume, and tricuspid regurgitation peak velocities as recommended in ASE guidelines30,31.
Nurse Led Sedation: The Clinical and Echocardiographic Outcomes of the 5-Year Emory Experience
Published in Structural Heart, 2020
Patricia Keegan, John C. Lisko, Norihiko Kamioka, Samuel Maidman, Jose N. Binongo, Jane Wei, Ratna Vadlamudi, J. Kirk Edwards, Nishant Vatsa, Aneesha Maini, Shawn Reginauld, Patrick Gleason, James Stewart, Chandan Devireddy, Peter C. Block, Adam Greenbaum, Robert A. Guyton, Vasilis C. Babaliaros
We queried the Emory Healthcare database for all patients undergoing TAVR for severe calcific aortic stenosis with a balloon-expandable valve from 2012 to 2017 under a previously described minimalist protocol.5 The diagnosis of severe aortic stenosis was made using standard transthoracic echocardiographic parameters. All patients were deemed to be TAVR candidates by a Heart Team comprised of interventional cardiologists, cardiothoracic surgeons, and other stakeholders. The multi-disciplinary heart team selected both the method of implantation and the anesthesia plan. Our institution’s procedural technique has been previously reported and is standard among operators.5 Briefly, patients undergo transfemoral TAVR in a cardiac catheterization laboratory under conscious sedation without the routine placement of an arterial blood pressure monitoring line. Transthoracic echocardiography is used to guide valve deployment, to assess for complications, and to evaluate paravalvular leak. Following TAVR, patients are transferred to a telemetry floor with four hours of bedrest. Pending clinical stability and a stable EKG, patients are discharged within 24–48 hours of the procedure.
Reduced longitudinal cardiac strain in asthma patients
Published in Journal of Asthma, 2019
I. Tuleta, N. Eckstein, F. Aurich, G. Nickenig, C. Schaefer, D. Skowasch, R. Schueler
Transthoracic echocardiography was performed using a commercially available ultrasound equipment with a 2.5-MHz phased array transducer (Vivid 7, General Electric Medical Health, Waukesha, Wisconsin, United States; iE 33 Philips Medical Systems, Koninklijke N.V.), according to the recommendations of the American Society of Echocardiography (13). Parasternal, apical and subcostal views were acquired. LVEF was calculated using the modified Simpson's method from apical four-chamber view. Diastolic function was determined by the measurements of the peak early (E) and late (A) mitral inflow velocity by the pulsed-wave Doppler and of the peak early (E′) and late (A′) diastolic velocity of the septal and lateral mitral valve annuli by the pulsed-wave tissue Doppler. Based on the guidelines of the American Society of Echocardiography (13), the diastolic function was classified as follows: grade 0 (normal) if E/A ratio > 0.8 and average E/E′ ratio < 10, grade I if E/A ratio ≤ 0.8 and average E/E′ ratio < 10, grade II if E/A ratio > 0.8–< 2.0 and average E/E′ ratio = 10–14, and grade III if E/A ratio ≥ 2.0 and average E/E′ ratio > 14. Right ventricular systolic function was assessed as the TAPSE in the apical four-chamber view. TAPSE < 20 mm determined right ventricular systolic dysfunction. The systolic pulmonary artery pressure (sPAP) was calculated using the tricuspid regurgitation peak velocity measured by the continuous wave Doppler. sPAP > 30 mmHg was defined as pulmonary hypertension.