Essential Echocardiography: A Companion to Braunwald's Heart Disease

Cover
Copyright
Dedication
Contributors
Preface
Braunwald’s Heart Disease Family of Books
Section I: Principles of Ultrasound and Instrumentation
	Chapter 1: Physical Principles of Ultrasound and Generation of Images
		Introduction
		Generation of Images By Ultrasound
			Resolution of Echocardiographic Images
			Phased Array and Matrix Array Transducers
			Second Harmonic Imaging
		Principles of Doppler Imaging
			Continuous Wave Doppler
			Pulsed Wave Doppler
			Color Flow Doppler
			Doppler Tissue Imaging
			2D Speckle Tracking Echocardiography
		Suggested Readings
		References
	Chapter 2: M-Mode Imaging
		Normal M-Mode Measurements
			Normal M-Mode Examination of the Aortic Root, Aortic Cusp Separation, and Left Atrial Dimension
		M-Mode Echocardiography in the Identification of Abnormal Cardiac Structure and Function
			Bicuspid Aortic Valve
			Subaortic Membrane
			Mitral Valve Prolapse
			Systolic Anterior Motion of the Mitral Valve
			Valvular Vegetations
			Rheumatic Mitral Valve Deformity
			Left Ventricular Dyssynchrony
			Constrictive Pericarditis
			Cor Pulmonale
			Severe Pulmonary Hypertension
			Ebstein Anomaly
			Increased Right Atrial Pressure
			M-Mode Examination of Prosthetic Valves
			Color M-Mode Echocardiography
		Summary
		Suggested Readings
	Chapter 3: Principles of Contrast Echocardiography
		Introduction
		Microbubble Contrast Agents
		Microvascular Behavior of Microbubbles
			Detection of Microbubble Ultrasound Signal
			Contrast-Specific Imaging Methods
		Safety of Microbubble Contrast Agents
		Suggested Readings
		References
	Chapter 4: Principles of Transesophageal Echocardiography
		Introduction
		Indications
		Complications
		Patient Management
		The Comprehensive Tee Exam
		Mid- and Upper-Esophageal Imaging
		Transgastric Imaging
		Thoracic Aorta
		Interventional Echocardiography
		Conclusion
		Suggested Reading
		References
	Chapter 5: Principles of Three-Dimensional Ultrasound
		Introduction
			Fully Sampled Matrix Array Transducers
		Physics of Three-Dimensional Ultrasound
			Multibeat ECG-Gated Acquisition
			Real-Time Zoom Acquisition
			Parallel Receive Beamforming
		Display of Three-Dimensional Echocardiographic Images
			Volume Rendering
			Surface Rendering
			Wireframe Rendering
		Clinical Applications of Three-Dimensional Echocardiography
			Quantification of Cardiac Chambers
		Clinical Applications of Three-Dimensional Echocardiography
			Left Ventricular Structure and Function
			Right Ventricular Structure and Function
			Left and Right Atria
			Valvular Heart Disease
			Mitral Valve
			Aortic Valve
			Tricuspid Valve
			Prosthetic Valves
		Conclusion
		Suggested Reading
		References
	Chapter 6: Principles and Practical Aspects of Strain Echocardiography
		Introduction
		Principles of Strain Imaging
		Twist and Torsion
		Regional and Global Function
			Left Ventricle
			Right Ventricle
			Left Atrium
		Coronary Artery Disease and Ischemic Cardiomyopathy
		Nonischemic Cardiomyopathy
			Hypertrophic Cardiomyopathy
			Chemotherapy-Related Cardiotoxicity
			Other Cardiomyopathies
		Dilated Cardiomyopathy and Dyssynchrony Analysis
		Valvular Heart Disease
		Infiltrative Disease
			Amyloidosis
		Suggested Readings
		References
	Chapter 7: Understanding Imaging Artifacts
		Introduction
		B-Mode Artifacts
			Shadowing (Attenuation) and Dropout Artifacts
			Reverberation Artifacts
			Multiple Reflection Artifacts
			Side Lobe Artifacts
			Refraction Artifacts
			Beam-Width Artifacts/Partial Volume Artifacts
		(Color) Doppler Mirror Image Artifacts
		Four-Dimensional Echocardiography Stitch Artifacts
		Suggested Readings
		References
Section II: The Echocardiographic Examination
	Chapter 8: Principles of Transthoracic Imaging Acquisition: The Standard Adult Transthoracic Echocardiographic Examination
		Introduction
			Transducer Positions
			Cardiac Imaging Plane
			Region or Structure of Interest
		Image Orientation Standards
		Two-Dimensional Echocardiography: Tomographic Scan Plane Orientation and Display Protocol
		Complementary Protocols: Doppler, Three-Dimensional Echocardiography, and Myocardial Segmentation
		Suggested Reading
		References
	Chapter 9: The Transthoracic Examination, View by View
		Introduction
		Left Parasternal Views
		Apical Views
		Subcostal Views
		Suprasternal Notch Views
		Suggested Reading
		References
	Chapter 10: Three-Dimensional Echocardiography: Image Acquisition
		Introduction
		The Three-Dimensional Transthoracic Echocardiography Data Acquisition Protocol
		Two-Dimensional Image Optimization
		Acquisition Modes
		Cropping and Rendering
		Image Display and Analysis
		Challenges and Optimization in Three-Dimensional Data Acquisition
		Electrocardiography Gating and Breath Hold
		Three-Dimensional Gain Optimization
		Live Three-Dimensional Optimization
		Suggested Reading
	Chapter 11: Optimization of the Patient and Equipment
		Introduction
		Optimizing Patient and Transducer Positions
		Optimizing Two-Dimensional Imaging: Machine Settings
		Use of Contrast
		Optimizing the Spectral Doppler Examination
		Optimizing the Color Flow Doppler Examination
		Summary
		Suggested Reading
	Chapter 12: Utilizing Contrast Echocardiography in Practice
		Introduction
		Left Ventricular Opacification
			Endocardial Enhancement
			Stress Echocardiography
			Left Ventricular Opacification for Masses and Miscellaneous Left Ventricular Abnormalities
		Contrast Echocardiography For Doppler Spectral Enhancement
		Safety of Microbubble Contrast Agents
			General Recommendations for the Use of Contrast
		Myocardial Contrast Echocardiography
			General Considerations
			Assessment of Myocardial Blood Volume
			Quantification of Myocardial Blood Flow
			Myocardial Viability
		Summary
		Suggested Readings
		References
	Chapter 13: Echo On-Call: Echocardiographic Emergencies
		Introduction
		Cardiovascular Emergencies
			Acute Mitral Regurgitation (Flail Leaflet)
			Ventricular Septal Defect
			Pseudoaneurysm
			Free Wall Rupture
			Nonmechanical Causes of Cardiogenic Shock
			Tamponade
			Aortic Dissection
			Pulmonary Embolus
		Codes and Shock: Where Does Stat Echocardiography Fit in?
		Trauma
			Blunt Trauma
			Penetrating Trauma
		Suggested Reading
		References
Section III: Assessment of Cardiac Structure and Function
	Chapter 14: Assessment of Left Ventricular Systolic Function
		Introduction
		Left Ventricular Systole: Cardiac Cycle and Hemodynamics
			Measurements of the Left Ventricle
			Left Ventricular Structure: Size and Mass
			Assessment of Cardiac Function
		Global Measures of Left Ventricular Systolic Function
			Myocardial Strain Imaging
		Regional Measures of Left Ventricular Systolic Function
		Suggested Reading
	Chapter 15: Left Ventricular Diastolic Function
		Introduction
		What Is Diastolic Function and Dysfunction?
			Transmitral Doppler: E Wave Peak Velocity, A Wave Peak Velocity, and E/A Ratio
			Tissue Doppler Imaging e′
			E/e′ Ratio
			Left Atrial Size
			Color M-Mode Propagation Velocity
			Pulmonary Venous Flow
			Tricuspid Regurgitation Velocity
			Grading Diastolic Function
			Estimation of Left Ventricle Filling Pressures in Specific Patient Populations
				Atrial Fibrillation
				AV Block and Pacing
				Valvular Disease
		Diastolic Stress Testing in Patients With Normal Diastolic Function at Rest: Is There a Role?
		Conclusion
		Suggested Readings
		References
	Chapter 16: Assessment of Right Ventricular Structure and Function
		Introduction
		Clinical Assessment of Right Ventricular Anatomy and Function
		Summary
		Suggested Reading
		References
	Chapter 17: Assessment of the Atria
		Introduction
		Left Atrium
			Structure
			Function
		Right Atrium
		The Interatrial Septum and Congenital Abnormalities of the Atria
		Atrial Masses
		Suggested Reading
		References
Section IV: Echocardiography for Diseases of the Myocardium
	Chapter 18: Acute Myocardial Infarction
		Introduction
		Establishing the Diagnosis, Extent, and Location of Myocardial Infarction
		Patterns of Myocardial Infarction By Coronary Artery Territory
			Anterior Myocardial Infarcts (Left Anterior Descending Territory)
			Inferior Myocardial Infarcts
		Urgent Consequences of Acute Myocardial Infarction
		Limitations to Echocardiography in the Acute Setting
		Suggested Reading
		References
	Chapter 19: Mechanical Complications of Myocardial Infarction
		Introduction
		Acute Mitral Regurgitation
		Ventricular Septal Defect
		Pseudoaneurysm
		Free Wall Rupture
		Tamponade
		Other Causes of Cardiogenic Shock After Myocardial Infarction
		Suggested Reading
		References
	Chapter 20: Long-Term Consequences and Prognosis After Myocardial Infarction
		Introduction
		Left Ventricular Scar and Aneurysm
		Left Ventricular Thrombus
		Left Ventricular Remodeling (Ischemic Cardiomyopathy)
		Functional (Secondary) Mitral Regurgitation
		Rare Complications of Myocardial Infarction
		Prognosis After Myocardial Infarction
		Suggested Reading
		References
	Chapter 21: Echocardiography in Heart Failure
		Assessment of Cardiac Structure and Function
			Assessment of Ejection Fraction
			Determination of Heart Failure Etiology
		Assessment of Valvular Function in Heart Failure
		Mitral Regurgitation in Heart Failure
		Doppler Assessment in Patients With Heart Failure
		Assessment of Left Atrial and Right Ventricular Function
		Assessment of Ventricular Synchrony
		Deformation Imaging in Heart Failure
		Assessment After Orthotopic Heart Transplant
		Assessment of Ventricular Assist Devices
		Echocardiography in the Context of Other Diagnostic Measures in Heart Failure
		Lung Ultrasound in Heart Failure
			Utility of Lung Ultrasound in Heart Failure
			Limitations of Lung Ultrasound
			Assessment of Pleural Effusions
		Suggested Reading
		References
	Chapter 22: Dilated Cardiomyopathies
		Introduction
		Common Features of Dilated Cardiomyopathies
			Left Ventricular Dilation and Systolic Functional Impairment
		Elevation of Left Ventricular Filling Pressures
			Left Atrial Dilation
			Right Heart Dilation and Functional Impairment
			Functional Mitral Regurgitation
		Arrhythmogenic Cardiomyopathy
		Left Ventricular Noncompaction
		Tachycardia-induced Cardiomyopathy
		Peripartum Cardiomyopathy
		Takotsubo Cardiomyopathy
		Alcoholic Cardiomyopathy
		Cardiomyopathy in Chagas Disease
		Chemotherapy-induced Cardiomyopathy
		Suggested Reading
		References
	Chapter 23: Hypertrophic Cardiomyopathy
		Introduction
		Sarcomere Gene Mutations Cause Hypertrophic Cardiomyopathy
		Cardiac Morphology
		Left Ventricular Systolic and Diastolic Function
		Development of Hypertrophic Cardiomyopathy
		Left Ventricular Outflow Obstruction and Mitral Valve Abnormalities
		Treatment of Hypertrophic Cardiomyopathy
		Using Echocardiography in the Differential Diagnosis of Hypertrophic Cardiomyopathy
			Athlete’s Heart
			Focal Upper Septal Hypertrophy
			Infiltrative and Metabolic Cardiomyopathies
		Conclusion
		Suggested Reading
		References
	Chapter 24: Restrictive and Infiltrative Cardiomyopathies
		Introduction
		Spectrum of Restrictive Cardiomyopathy
			Diagnosis of Restrictive Cardiomyopathy
		Echocardiography in Restrictive Cardiomyopathy
			Doppler Features
		Cardiac Amyloidosis
		Mitochondrial Cardiomyopathy
		Endomyocardial Fibrosis and Löffler (Eosinophilic) Endocarditis
		Idiopathic Restrictive Cardiomyopathy
		Mucopolysaccharidoses
		Anderson-Fabry Disease
		Glycogen Storage Diseases
		Iron Overload Cardiomyopathy
		Carcinoid Syndrome
		Postradiation Therapy and Chemotherapy-Related Cardiac Dysfunction
		Systemic Sclerosis
		Pseudoxanthoma Elasticum
		Suggested Reading
		References
	Chapter 25: Echocardiography in Assessment of Cardiac Synchrony
		Introduction
		Echocardiographic Methods to Assess Dyssynchrony
		New Understanding of Mechanical Dyssynchrony
		Myocardial Substrates of Synchrony and Discoordination
		Lack of Synchrony and Risk For Ventricular Arrhythmias
		Dyssynchrony Associated With Right Ventricular Pacing
		Future Applications of Echocardiographic Synchrony
		Suggested Reading
		References
	Chapter 26: Echocardiography in Assessment of Ventricular Assist Devices
		Introduction
		Types of Ventricular Assist Devices
			Short-Term Ventricular Assist Devices
		Planning For a Left Ventricular Assist Device
			Left Ventricular Structure and Function
			Right Ventricular Structure and Function
			Valves
			Endocarditis
			Aorta
			Congenital Heart Disease
		Intraoperative
			Preimplantation
		Postimplant
		Conclusions
		Suggested Reading
		References
	Chapter 27: Stress Echocardiography and Echo in Cardiopulmonary Testing
		Introduction
			Ischemic Cascade
			Stress Protocols
				Exercise Protocols
				Pharmacologic Stress Protocols
			Assessment of Ischemia
				Image Interpretation
		Utility of Exercise Echocardiography Beyond Ischemia
			Valvular Disease
				Left Ventricle Function
					Exercise-Induced Pulmonary Hypertension
					Clinical Significance
					Low-Flow, Low-Gradient Aortic Stenosis With Preserved Left Ventricle Ejection Fraction
				Aortic Regurgitation
					Exercise-Induced Pulmonary Hypertension
					Clinical Significance
					Left Ventricle Function
					Exercise-Induced Pulmonary Hypertension
					Clinical Significance
					Secondary Mitral Regurgitation
			Hypertrophic Cardiomyopathy
			Pulmonary Arterial Hypertension
			Heart Failure With Preserved Ejection Fraction
		Suggested Reading
		References
Section V: Valvular Heart Disease
	Chapter 28: Mitral Valve Disease
		Introduction
		Mitral Valve Anatomy
		Echocardiographic Views of the Mitral Valve
			Transthoracic Echocardiography
		Mitral Regurgitation
			Primary Mitral Regurgitation
			Secondary Mitral Regurgitation
		Mitral Stenosis
			Rheumatic Mitral Stenosis
			Calcific Mitral Stenosis
			Radiation-Associated Mitral Valve Disease
		Congenital Mitral Valve Disorders
			Mitral Valve Cleft
			Mitral Valve Parachute
			Mitral Arcade
			Supravalvular Mitral Ring
		Conclusion
		Suggested Reading
		References
	Chapter 29: Aortic Valve Disease
		Introduction
		Normal Aortic Valve Anatomy and Common Congenital Anomalies
		Valvular Aortic Stenosis
			Quantitation of Aortic Stenosis Severity
				Additional Measures of Aortic Stenosis Severity
				Body Surface Area Correction for Aortic Valve Area
			Low Gradient Severe Aortic Stenosis
		Subvalvular Or Supravalvular Aortic Stenosis
		Aortic Regurgitation
		Suggested Reading
		References
	Chapter 30: Tricuspid and Pulmonic Valve Disease
		Introduction
		Normal Tricuspid Valve Anatomy
		Two-Dimensional Echo Views For Assessing the Tricuspid Valve
		Three-Dimensional Echo of the Tricuspid Valve
		Abnormalities of the Tricuspid Valve
			Carcinoid Valve Disease
			Rheumatic Valve Disease
			Tricuspid Valve Endocarditis
			Flail Tricuspid Leaflet
			Functional Tricuspid Regurgitation
			Ebstein Anomaly of the Tricuspid Valve
			Tricuspid Atresia
		Echo Doppler Assessment of Tricuspid Regurgitation Severity
		Role of Echocardiography in Percutaneous Tricuspid Valve Replacement
		Abnormalities of the Pulmonic Valve
		Three-Dimensional Echo of the Pulmonic Valve
		Pulmonic Valve Endocarditis
		Congenital Valvular Pulmonic Stenosis
		Pulmonic Stenosis S/P Valvuloplasty
		Carcinoid Involvement of the Pulmonic Valve
		Echo Doppler Assessment of Pulmonic Regurgitation Severity
		Summary
		Suggested Reading
		References
	Chapter 31: Prosthetic Valves
		Introduction
		Normal Appearance and Function
		Prosthetic Valve Stenosis
			Gradients
				Pressure Recovery
			Patient-Prosthesis Mismatch
				Causes of Prosthetic Valve Stenosis
		Prosthetic Valve Regurgitation
		Prosthetic Valve Endocarditis
		Suggested Reading
		References
	Chapter 32: Echocardiography in Percutaneous Valvular Intervention
		Introduction
		Transcatheter Aortic Valve Replacement
			Preimplantation Assessment
		Intraprocedural Imaging
			Wire and Cannulation Position
			Balloon Aortic Valvuloplasty
			Ventricular and Baseline Valvular Function
			Transcatheter Valve Positioning
		Postimplantation Assessment
			Paravalvular Regurgitation
		Transcatheter Mitral Valve Repair
		Preprocedural Imaging
		Intraprocedural Guidance
			Transseptal Puncture
			Positioning and Orienting the MitraClip
			Grasping the Mitral Leaflets
			Prerelease Assessment
			Post-MitraClip Assessment
		Other Transcatheter Mitral Valve Repair Devices and Transcatheter Mitral Valve Replacement
		Tricuspid Repair Devices
		Echocardiography in Transcatheter Valve-in-Surgical-Valve Procedures
		Intraprocedural Imaging
		Procedural Approach
		Intraprocedural Imaging
		Conclusion
		Suggested Reading
		References
Section VI: Diseases of the Pericardium and Great Vessels
	Chapter 33: Pericardial Disease
		Introduction
		Pericardial Fluid
			Fluid Characteristics
			Effusion Size
			Distinguishing Features
		Acute Pericarditis
		Recurrent Pericarditis
		Pericardial Tamponade
		Pericardial Constriction
		Other Pericardial Disorders and Abnormalities
			Congenital Absence of Pericardium
			Pericardial Cysts
			Pericardial Involvement in Malignancy
		Multimodality Imaging
		Conclusion
		Suggested Reading
		References
	Chapter 34: Diseases of the Aorta
		Introduction
		Anatomy, Nomenclature, and Dimensions
			Aortic Measurements and Dimensions
		Echocardiographic Views
			Transthoracic Echocardiography
		Transesophageal Echocardiography
			Doppler Flows in the Aorta
		Aortic Aneurysms
			Sinus of Valsalva Aneurysms
			Associated Abnormalities
			Surveillance of Thoracic Aortic Aneurysms
		Aortic Disruptions (acute Aortic Syndromes)
		Perioperative and Postoperative Imaging
			Postoperative Imaging
		Intraluminal Pathology
			Atheroma
			Aortic Thrombus
			Aortic Tumors
		Coarctation of the Aorta
		Suggested Reading
		References
Section VII: Diseases of the Pulmonary Artery and Veins
	Chapter 35: Pulmonary Embolism
		Introduction
		Utility of Echocardiography in Pulmonary Embolism
			Identification of Thrombus by Echocardiography
			Assessment of the Right Ventricle in Pulmonary Embolism
		Regional Right Ventricular Dysfunction: The “McConnell” Sign
			The Influence of Elevated Pulmonary Pressures on Echocardiographic Features in Pulmonary Embolism
		Echocardiography in Prognosis and Management of Pulmonary Embolism
			Echocardiography in Assessment of Response to Therapy in Pulmonary Embolism
			Novel Methods to Assess Right Ventricular Function in Pulmonary Embolism
			Transesophageal Echocardiography in Pulmonary Embolism
		Distinguishing Pulmonary Embolism from Pulmonary Hypertension
		Suggested Reading
	Chapter 36: Pulmonary Hypertension
		Introduction
		Assessment of Right Ventricle Afterload/Pulmonary Vascular Function
			Pulmonary Artery Systolic Pressure
			Diastolic Pulmonary Artery Pressure
			Mean Pulmonary Artery Pressure
			The Right Atrium and Right Atrial Pressure
		Other Measures of Right Ventricle Afterload
			Pulmonary Arterial Acceleration Time
		Right Ventricular Structure and Function
			Right Ventricular Wall Thickness
			Tricuspid Annular Plane Systolic Excursion
			Right Ventricular Area Assessment
			Three-Dimensional Volume Assessment
			Doppler Tissue Imagings’ cm/s
			Iso-Volumetric Acceleration
			Right Ventricular E/e′
			Strain/Strain Rate
		Timing Measurements
			Right Ventricular Isovolumetric Relaxation Time Measurement
			Myocardial Performance Index or Tei Index
			Right Ventricular Assessment During Exercise
		Suggested Reading
		References
Section VIII: Cardiac Masses
	Chapter 37: Primary and Secondary Tumors
		Introduction
		Tumor Types
			Primary Versus Secondary Tumors
			Primary Benign Tumors
				Myxoma
				Lipoma
		Papillary Fibroelastoma
			Benign Versus Malignant
				Primary Malignant Tumors
				Secondary Tumors
		Tumor Locations: Site-Specific Differential
			Atrial Tumors
			Ventricular Tumors
			Valvular Tumors
			Pericardial Tumors
		Clinical Presentation of Tumors
		Suggested Reading
		References
	Chapter 38: Identification of Intracardiac Thrombus
		Introduction
		Intracardiac Sources of Emboli
			Left Ventricle
			Left Atrium
			Right Ventricle/Right Atrium
			Prosthetic Valves
		Interatrial and Interventricular Septum
			Nonthrombotic Causes of Embolism
		Prevalence of and Risk Factors For Left Ventricular and Atrial Thrombi
		Echocardiographic Appearance
		Risk Factors For Embolization
		Choice of Initial Test
		Role of Follow-up Imaging
		Prevention of Thromboembolism
		Conclusions
		Suggested Reading
		References
	Chapter 39: Other Cardiac Masses
		Introduction
		Variants of Normal Structure
		Degenerative/Acquired Masses
		Postsurgical Masses
		Extracardiac Structures
		Ultrasound Artifacts
		Suggested Reading
		References
Section IX: Systemic Diseases Involving the Heart
	Chapter 40: Echocardiography in Infective Endocarditis
		Introduction
		Diagnosis
			Indications for Transthoracic Echocardiography and Transesophageal Echocardiography
		Vegetations
		Complications of Endocarditis
			Abscess, Pseudoaneurysm, and Fistula
		Right-sided Endocarditis
		Nonvalvular Endocarditis
			Device-Related Infective Endocarditis
			Infection of Cardiac Shunts
		Purulent Pericarditis
		Echocardiographic Predictors of Outcomes
			Embolism
			Overall Prognosis
		Surgery For Endocarditis
			Echocardiographic Indicators for Surgery
			Frequency of Echocardiography
			Role of 3D Echocardiography
		Suggested Reading
		References
	Chapter 41: Other Systemic Diseases and the Heart
		Introduction
		Sarcoidosis
		Hypereosinophilic Syndrome (Loeffler Endocarditis)
		Thyroid Disease
		Carcinoid Heart Disease (see Also Chapter 30)
		Hemochromatosis
		Muscular Dystrophies
		Lysosomal Storage Diseases
			Glycogen Storage Diseases
			Fabry Disease
			Mucopolysaccharidoses
			Sphingolipidoses
		Connective Tissue Disorders
			Ehlers-Danlos Syndrome
			Marfan Syndrome
		Marantic Endocarditis
		Diabetes, Hypertension, and Obesity
		Suggested Reading
		References
	Chapter 42: Echocardiography in Malignant Disease
		Introduction
		Baseline Assessment Prior to Initiation of Cancer Treatments
		During Cancer Treatment
			Contrast Echocardiography
		Three-Dimensional Echocardiography
			Other Imaging Modalities
				Left Ventricular Ejection Fraction Surveillance Schedules
					Anthracyclines
					Trastuzumab
			Left Ventricular Diastolic Function
			Other
				Right Ventricular Function
				Valvular Assessment
				Pericardial Disease
				Pulmonary Arterial Hypertension
				Cardiac Masses
				Stress Echocardiography
		After Treatment: Survivorship
			Survivors of Thoracic Radiation Therapy
			Survivors of Childhood Malignancies
		Future Directions
		Conclusion
		Suggested Reading
		References
Section X: Congenital Heart Disease in the Adult
	Chapter 43: Atrial Septal Defect
		Introduction
		Anatomy/Embryology
		Patent Foramen Ovale
		Clinical Presentation of Atrial Level Defects
		Atrial Septal Defects
		Venous Septation Defects
		Imaging Approach
		Atrial Level Shunting Closure
		Imaging During Percutaneous Closure
		Additional Techniques and Pitfalls
			Clues To Undiagnosed Atrial Level Shunting
			Common Mistakes in Diagnosis
		Suggested Reading
		References
	Chapter 44: Ventricular Septal Defect
		Introduction
		Adult Presentation
		Types/Locations of Ventricular Septal Defects
			Perimembranous Ventricular Septal Defects
			Muscular/Trabecular Ventricular Septal Defects
			Outlet Ventricular Septal Defects
			Inlet Ventricular Septal Defects
				Diagnostic Clues to Inlet Ventricular Septal Defect or Atrioventricular Septal Defect
		Basic Imaging Approach to Ventricular Septal Defects
		Unique Ventricular Septal Defect Physiology
			Double-Chambered Right Ventricle
			Eisenmenger Syndrome
		Suggested Reading
		References
	Chapter 45: Other Common Congenital Defects in Adults
		Introduction
		Segmental Anatomy
		Patent Ductus Arteriosus
		Tetralogy of Fallot
			Imaging Approach to the Adult With Repaired Tetralogy of Fallot
			Key Imaging Views
		Transposition of the Great Arteries
		Coarctation
		Fontan
		Ebstein Anomaly
		Suggested Reading
		References
Section XI: Miscellaneous Topics in Echocardiography
	Chapter 46: Handheld Echocardiography
		Introduction
		Current Handheld Devices
		The Learning Curve
		Validation of Handheld Devices
		Suggested Protocol
		Quantitative Assessment With Handheld Echocardiography
		Specific Roles For Handheld Echocardiography
		Handheld Echocardiography as a Screening Tool
		Cost and Workflow Issues
		Future Developments
		Suggested Reading
		References
	Chapter 47: Appropriate Use of Echocardiography
		Introduction
		Development of Appropriate Use Criteria
		Application of Appropriate Use Criteria
		Future Directions For Appropriate Use Criteria
		Suggested Reading
		References
	Chapter 48: Echocardiography in the Context of Other Cardiac Imaging Modalities
		Introduction
		Chamber Quantification: Volumes and Function
		Morphology
		Tissue Characterization
		Coronary Disease
		Cardiac Masses
		Pericardial Disease
		Diseases of the Aorta
		Conclusion
		Suggested Reading
		References
	Chapter 49: Transesophageal Echocardiography for Cardiac Surgery
		Introduction
		Role of the Intraoperative Echocardiographer
		Impact of Intraoperative Transesophageal Echocardiography in Cardiac Surgery
		Objectives of the Intraoperative Tee Exam
		the Intraoperative Transesophageal Echocardiography Exam
		Impact of Intraoperative Transesophageal Echocardiography in Noncardiac Surgery
		Suggested Reading
		References
Appendices
	Appendix A: Reference Tables
	Appendix B - Commonly Utilized Equations in Echocardiography
		General Body Measures
			Body Mass Index
			Body Surface Area (Mosteller Formula)
		Echocardiography
			Left and Right Ventricle
				Left Ventricular Volume (Teicholz Formula)
				Left Ventricular Ejection Fraction (Simplified Quinones Equation)
				Left Ventricular Fractional Shortening
				Left Ventricular Mass (Linear Method, Cube Formula)
				Relative Wall Thickness
				Myocardial Performance, or Tei Index (Left Ventricular) (Fig. B.1; see also Fig. 14.12)
				Myocardial Performance, or Tei Index (Right Ventricular)
				Left Ventricular Wall Motion Score Index (for 17 Segment Left Ventricular Model)
				Stroke Volume
				Cardiac Output
			Valves, General
			Aortic Stenosis
			Aortic Regurgitation
				Regurgitant Volume by the PISA method
				Regurgitant Volume by the Continuity Equation (Volumetric Method)
				Regurgitant Fraction by the PISA/2D Method
			Mitral Stenosis
			Mitral Regurgitation
				Regurgitant Volume by PISA Method
				Regurgitant Volume by Continuity Equation (Volumetric Method) (see Fig. 28.13)
				Regurgitant Fraction by PISA/2D Method
			Tricuspid Regurgitation
			Pulmonic Regurgitation
			Pulmonary Vascular Resistance
		Exercise Stress Testing
		Suggested Reading
Index
	A
	B
	C
	D
	E
	F
	G
	H
	I
	L
	M
	N
	O
	P
	Q
	R
	S
	T
	U
	V
	W