Cardiac tests and procedures
Clive Handler, Gerry Coghlan, Nick Brown in Management of Cardiac Problems in Primary Care, 2018
Echocardiography is an ultrasound examination of the heart. It is the same test as ultrasound done in pregnancy, and is completely harmless and painless. The test provides useful information about the structure and strength of the heart muscle, the heart valves and the size of the heart chambers. It is useful in all age groups. It tells us if your heart is weak and whether you might benefit from certain tablets. You will be asked to lie fairly flat on a couch, and some ultrasound jelly will be put on your chest. A probe is then pressed fairly hard on the chest wall and ultrasound pictures are displayed on a TV screen. If you hear a ‘whooshing’ noise, this is due to a Doppler test being done at the same time, which provides useful information about the flow of blood through the heart valves. It tells us whether the valves are working properly or if they are narrowed or leaky. The test does not usually take longer than 10 to 15 minutes. You can eat and drink normally before and after the test.
Echocardiogram
Neeraj Parakh, Ravi S. Math, Vivek Chaturvedi in Mitral Stenosis, 2018
In this chapter, we will be discussing the various aspects of echocardiographic examination that are relevant to MS in day-to-day practice, as well as in special situations. Besides a targeted examination of the mitral valve, a thorough evaluation of cardiac structures and function is essential for the comprehensive management of MS; however, this would not be the emphasis or focus of this chapter. Several excellent general and valvular echocardiography references are available for the same. This work is also practice-oriented with an emphasis on practical situations and techniques. As such, it assumes a certain knowledge and familiarity of the clinician with echocardiographic examination. Further, as congenital MS and degenerative MS have been dealt elsewhere, this chapter focuses on MS due to rheumatic heart disease (RHD).
Echocardiography of the Aortic Valve
Mano Thubrikar in The Aortic Valve, 2018
Two-dimensional echocardiography offers an advantage over M-mode echocardiography because it identifies cardiac anatomy. Unlike the series of wiggles and waves seen in M-mode, in 2-D echocardiography one sees tomograms or cross sections of the structure. The aortic valve is studied by placing a transducer on the anterior chest wall along the left sternal border. Recently, however, some studies have been performed with the transesophageal technique in which the transducer is placed in the esophagus.5 The transducers used for two-dimensional echocardiography could be either phased array sector scanners or mechanical scanners.6 In a long axis view (i.e., when the plane of scanning is parallel to the long axis of the aorta), one can see the left ventricle, the left atrium, and the aortic root (Figure 7). By turning the transducer 90°, one can obtain a short axis view where the plane of scanning is perpendicular to the long axis of the aorta. The aortic root, the left atrium, the right atrium, and the right ventricle can be seen in this view (Figure 8).
Peak V’O2 is an independent predictor of survival in patients with cardiac amyloidosis
Published in Amyloid, 2018
Selina Hein, Fabian Aus Dem Siepen, Ralf Bauer, Hugo A. Katus, Arnt V. Kristen
Echocardiography is a noninvasive diagnostic tool well established for assessment of cardiac morphology and function. Thus, it is widely used for evaluation of diverse cardiac diseases, including systemic amyloidosis. However, in cardiac amyloidosis (CA) the association of morphological alterations (e.g. thickness of interventricular septum) with clinical symptoms and finally survival is limited. This might be related to the highly variable course of different types of amyloidosis, e.g. patients more severe symptoms despite minor morphological alterations in AL amyloidosis when compared to ATTR amyloidosis. Moreover, even within the individual types of amyloidosis the course of the disease is highly variable [2]. Evaluation of functional parameters, including left and right ventricular longitudinal function as well as serum levels of natriuretic peptides, have been reported to be superior to risk stratification if simply done by assessment of cardiac morphology [3]. Moreover, the extent of amyloid load does not correlate with the functional disability of a small cohort of patients with CA [4].
Mitral valve prolapse
Published in Expert Review of Cardiovascular Therapy, 2019
Aeshah Althunayyan, Steffen E Petersen, Guy Lloyd, Sanjeev Bhattacharyya
An X-linked, recessive form with a locus Xq28 has been identified. Typically, this is associated multi-valvar defects with myxomatous change [18]. Further work using linkage analysis on a family affected by X-linked myxomatous mitral valve disease identified a P637Q mutation in the filamin-A (FLNA) gene in all affected members. Two other missense mutations (G288R and V711D) and a 1944-base pair in-frame deletion were also identified in three additional, smaller, and unrelated families [19]. Le Tourneau et al. [20] studied 246 subjects from 4 FLNA mitral valve dystrophy families. The authors identified specific echocardiographic characteristics. In addition to classical features of MVP, they found mitral leaflet motion was restricted in diastole and papillary muscles position was closer to mitral annulus.
DISCOVERY: prevalence of transthyretin (TTR) mutations in a US-centric patient population suspected of having cardiac amyloidosis
Published in Amyloid, 2020
Ola Akinboboye, Keyur Shah, Alberta L. Warner, Thibaud Damy, Herman A. Taylor, Jared Gollob, Christine Powell, Verena Karsten, John Vest, Mathew S. Maurer
Demographic details were obtained from all patients at the initial study visit and a blood sample was taken for TTR genotyping. The genotyping results were discussed at a follow-up visit scheduled within 30–90 days of the initial visit. Patients with a confirmed pathogenic TTR mutation were offered genetic counseling as part of the center’s usual practice and underwent the following assessments: detailed medical history and medication use in the 12 months before enrollment; quantification of serum cardiac biomarkers; echocardiogram; NYHA functional classification; and 6-MWD (optional). Cardiac biomarkers were analyzed by a central laboratory: serum N-terminal prohormone of brain natriuretic peptide (NT-proBNP) by an electrochemiluminescence immunoassay (Cobas); troponin I by a chemiluminescence assay (Centaur). Echocardiography was performed according to a standardized manual and analyzed by a cardiac imaging core laboratory (Brigham and Women’s Hospital, Boston, MA). No further assessments were performed for patients without a pathogenic TTR mutation. All study visits were conducted in the outpatient setting.
Related Knowledge Centers
- Doppler Echocardiography
- Myocardial Infarction
- Cardiovascular Disease
- Diastole
- Ejection Fraction
- Heart
- Cardiac Output
- Heart Failure
- Medical Ultrasound
- Medical Imaging