ASE’s Comprehensive Echocardiography

Description

Written and endorsed by world experts from the American Society of Echocardiography (ASE), this unique multimedia resource uses text, case studies, and online components to cover the latest uses of echocardiography, including the most recent 2D and 3D advances. Unlike other existing textbooks in echocardiography, including the predecessor of this volume, entitled Dynamic Echocardiography, this 2nd edition, with its new title, covers a full range of topics, reflected in its 200 chapters that include essential material in a succinct format. Dr. Roberto M. Lang and his expert colleagues provide everything you need to assess cardiac anatomy and function and obtain clinically useful, noninvasive information for more accurate diagnosis and evaluation of heart disease. "I am also very proud that this textbook illustrates what is great about the ASE. We are a society with more than 16,000 members worldwide, dedicated to quality in cardiovascular ultrasound and education, both of which are prominently demonstrated throughout this textbook. ASE is also a village made up of many different people from many different backgrounds, all united and energized about the value of cardiovascular ultrasound in caring for people worldwide." Foreword by: Neil J. Weissman, American Society of Echocardiography, July 2015 Take advantage of an outstanding online library of slides and videos of case presentations that correspond to crisp, full-color images, allowing you to view dynamic echocardiographic clips of various cardiac pathologies. Tap into the knowledge and skills of a team of experts from the ASE, led by world-renowned authorities in echocardiography. Access the fully searchable text online at expertconsult.com, along with additional cases, images, and an extensive library of cine images. Get fully up to date with the latest echo practice guidelines and advanced technologies, including 3D echocardiography and myocardial strain. Gain a better understanding of the latest methods to assess cardiac chamber size and function, valvular stenosis/regurgitation, cardiomyopathies, coronary artery disease, complications of myocardial infarction, and much more – all in a practical, well-illustrated brief yet comprehensive format extensively supported by multimedia material. Stay up to date with hot topics in this rapidly evolving field: interventional/intraoperative echocardiography, transesophageal echocardiography, cardiac resynchronization therapy, and more. Set the pace with enhanced technologies and guidelines Title Page I Physics and Instrumentation General Principles of Echocardiography Transducer Instrument Artifacts Safety Reference Three-Dimensional Echocardiography Comparison between 2DE and 3DE ultrasound transducers 3D Echocardiography physics Image acquisition and display Doppler Principles Color doppler displays Spectral doppler displays Aliasing References Tissue Doppler Imaging and Speckle Tracking Echocardiography Principles of tissue doppler imaging Strain rate, strain, and displacement Speckle tracking echocardiography Evaluations of LV mechanics by TDI and STE References Tissue Harmonic Imaging Advantages of tissue harmonic imaging Disadvantages of tissue harmonic imaging Key application principles for tissue harmonic imaging Conclusions References II Transthoracic Echocardiography Transthoracic Echocardiography: Nomenclature and Standard Views Parasternal window Long Axis: Left Ventricle Long Axis: Right Ventricular Inflow and Outflow Short Axis Right Parasternal Window Apical window Four-Chamber View Two-Chamber View Three-Chamber (Long-Axis) View Subcostal window Suprasternal notch window References Technical Quality Optimizing 2D images Optimizing spectral doppler traces Optimizing color doppler images Summary References Transthoracic Echocardiography Tomographic Views Parasternal window: long-axis, right ventricular inflow and outflow, and short-axis views Transthoracic apical window Subcostal window Transthoracic suprasternal window Off-axis views References M-Mode Echocardiography Left ventricle Mitral valve Normal Motion Mitral Stenosis Mitral Valve Prolapse Systolic Anterior Motion of the Anterior Mitral Leaflet The Mitral Valve in Aortic Insufficiency The Mitral Valve in Left Ventricular Dysfunction Color M-Mode Aortic valve Normal Motion The Aortic Valve in Hypertrophic Obstructive Cardiomyopathy Premature Aortic Valve Opening Pulmonic valve Normal Motion Severe Pulmonary Hypertension Pericardial disease Cardiac tamponade Constrictive pericarditis References Doppler Echocardiography: Normal Antegrade Flow Patterns Basic concepts Technical considerations for optimal doppler recordings Individual flow profiles LV Outflow RV Outflow LV Inflow RV Inflow Pulmonary Venous Flow Hepatic Vein Flow Descending Thoracic Aortic Flow References III Transesophageal Echocardiography Protocol, Probe Insertion and Manipulation, Risks and Complications Protocol Topical anesthesia Sedation Probe insertion Probe manipulation General Points in Probe Manipulation Risks and complications References Transesophageal Echocardiography: Tomographic View Midesophageal five-chamber view Midesophageal four-chamber view Midesophageal mitral commissural view Midesophageal two-chamber view Midesophageal long-axis view Midesophageal AV LAX view Midesophageal ascending aorta LAX view Midesophageal ascending aorta short-axis view Midesophageal right pulmonary vein view Midesophageal AV SAX view Midesophageal right ventricle inflow-outflow view Midesophageal modified bicaval TV view Midesophageal bicaval view Midesophageal right and left pulmonary veins view Midesophageal left atrial appendage view Transgastric basal SAX view Transgastric midpapillary SAX view Transgastric apical SAX view Transgastric RV basal view Transgastric RV inflow-outflow view Deep transgastric five-chamber view Transgastric two-chamber view Transgastric right ventricle inflow view Transgastric long-axis view Descending aorta SAX and LAX views Upper esophageal aortic arch long-axis view Upper esophageal aortic arch short-axis view References Applications of Transesophageal Echocardiography Valvular heart disease Aortic Valve Disease Mitral Valve Disease Tricuspid and Pulmonic Valve Disease Prosthetic Valve Disease Interventional imaging Atrial Fibrillation Ablation and Left Atrial Appendage Closure Patent Foramen Ovale or Atrial/Ventricular Septal Defect Closure Transcatheter Aortic and Mitral Valve Interventions Intraoperative imaging Valvular and Aortic Surgery and Congenital Heart Disease Repair Cardiac thrombus and embolus evaluation Precardioversion in Atrial Fibrillation and Cardiac Source of Emboli Endocarditis and cardiac mass investigation Aortic evaluation Critically ill patients Summary References Pitfalls and Artifacts in Transesophageal Echocardiography Tee pitfalls Crista Terminalis Eustachian Valve and Chiari Network Lipomatous Hypertrophy of the Atrial Septum Coumadin Ridge Moderator Band Lambl Excrescences Prosthetic Valve Structures Pericardial Fat Pleural Effusion Hiatal Hernia Tee artifacts Low Imaging Quality Acoustic Shadowing Side Lobe and Beam Width Artifacts Reverberation Artifacts concerning spectral and color flow doppler echocardiography Aliasing Acoustic Shadowing Beam Angle and Width Artifacts Mirroring Color Flow Reverberation and Gain-Related Anomalies Conclusions References IV Intracardiac Echocardiography Applications of Intracardiac Echocardiography Device closure of interatrial communications Electrophysiologic ablation procedures Transcatheter aortic valve replacement Rare and investigational applications Summary References Limitations of Intracardiac Echocardiography Technical limitations Operator-dependent limitations Cost-benefit ratio Current limitations of three-dimensional intracardiac echocardiography References V Intravascular Ultrasound Intravascular Ultrasound: Instrumentation and Technique Intravascular ultrasound imaging technology Performance of the IVUS procedure Modalities of IVUS imaging Conclusions References Intravascular Ultrasound: Applications and Limitations Current applications Types of IVUS Imaging and Basics of Image Interpretation IVUS for Assessment of Lesion Severity IVUS for Assessment of Plaque Characteristics Pre- and Post-PCI Assessment Using IVUS Limitations Conclusions References V I Hand-Held Echocardiography Hand-Carried Cardiac Ultrasound: Background, Instrumentation, and Technique Background Instrumentation Technique References Applications Limitations References VII Contrast Echocardiography Contrast Echocardiography: Introduction References Ultrasound Contrast Agents Ultrasound contrast agent composition Technical considerations and responsibilities Role of the physician Role of the sonographer or nurse Safety of ultrasound contrast agents References Physical Properties of Microbubble Ultrasound Contrast Agents Microbubble contrast agents Contrast-specific imaging techniques Clinical perspective References Applications of Ultrasound Contrast Agents Clinical applications Assessment of Cardiac Function Delineation of Intracardiac Pathology Summary References Stress Echocardiography and Contrast Contrast stress echocardiography: methodology and interpretation Methodology Interpretation Contrast left ventricular opacification stress echocardiography Diagnostic Efficacy Prognostic Role Cost-Effectiveness Contrast off-label use for myocardial perfusion stress echocardiography Diagnostic Efficacy Prognostic Role Conclusion References Contrast-Enhanced Carotid Imaging Clinical applications of carotid ultrasound Methodology of contrast-enhanced carotid ultrasound Detection of plaques Improvement of the Doppler signal Assessment of plaque vulnerability Limitations of contrast-enhanced carotid ultrasound Future perspectives Conclusions References VIII Left Ventricular Systolic Function Introduction Indications for systolic function evaluation Limitations of ejection fraction Choice for assessment tool of lv systolic function in multimodality ERA Conclusions References Left Ventricular Systolic Function: Basic Principles Functional anatomy of the left ventricle Left ventricular volume and its dynamic geometry Cardiac cycle Determinants of LV performance Response to exercise References Global Left Ventricular Systolic Function Echocardiographic methods used to assess lv global systolic function M-Mode Echocardiography Two-Dimensional Echocardiography Three-Dimensional Echocardiography Doppler Echocardiography Tissue Doppler Imaging Speckle Tracking Echocardiography Global LV systolic functional parameters Fractional Shortening and Ejection Fraction Ejection Acceleration Time Myocardial Performance Index Strain and Strain Rate Limitations and technical considerations Conclusion and recommendations References Regional Left Ventricular Systolic Function LV myocardial segmentation Methods for assessment of regional lv systolic function Visual Assessment of Regional LV Systolic Function Assessment of the Myocardial Contractile Function by Speckle Tracking Echocardiography Other Techniques Correlation with coronary blood supply Correlation with extent of infarction Nonischemic causes of regional LV systolic dysfunction References Assessment of Left Ventricular Dyssynchrony Electrical dispersion and mechanical dyssynchrony Echocardiographic approaches to assess mechanical dyssynchrony Interventricular mechanical delay Tissue doppler imaging Speckle tracking strain Dyssynchrony in patients with widened QRS complex for prognosis Dyssynchrony as a marker for arrhythmias Mechanical dyssynchrony in myocardial disease with narrow QRS complex Mapping latest mechanical activation for left ventricular lead placement Three-dimensional speckle tracking imaging References IX Right Heart Right Ventricular Anatomy Coronary flow to the right ventricle Echocardiographic assessment of right ventricular anatomy Reference values for right ventricular structure References The Physiologic Basis of Right Ventricular Echocardiography Structure and anatomy of the right ventricle Ejection and function of the right ventricle Right ventricular hemodynamics RV Preload RV Contractility RV Afterload Coronary blood flow of the right ventricle Interventricular dependence RV diastolic function Rhythm disturbances originating from the RV Newer imaging modalities to image RV Conclusion References Assessment of Right Ventricular Systolic and Diastolic Function Introduction Anatomy and physiology Quantitative evaluation by echocardiography Right Ventricular Size Two-Dimensional Measurements Volume of the Right Ventricle Right ventricular systolic function Fractional Area Change Tricuspid Annular Plane Systolic Excursion and Velocity Right Ventricular Index of Myocardial Performance Three-dimensional right ventricular ejection fraction Right ventricular strain Right ventricular diastolic function Transtricuspid Flow Hepatic Vein Flow Tissue Doppler Echocardiography and Strain Lateral Tricuspid Annulus Velocities Tricuspid E/e Ratio Grading Diastolic Function Clinical impact of right ventricular size and function: prognosis Summary and recommendations References Right Ventricular Hemodynamics Flow Pressure Resistance Pulmonary artery catheter in a box Right Atrial Pressure Secondary Indices of Right Atrial Pressure Right Ventricular Systolic Pressure Pulmonary Artery Pressure (Fig.35.2, A, B) Pulmonary Vascular Resistance Summary References The Right Atrium Introduction Anatomy Anatomic Landmarks Physiology Echocardiographic views Anatomic variants Right atrial size measurement Right Atrial Dimensions and Volume Measurement by Two-Dimensional Echocardiography Right Atrial Volume Assessment Based on Three-Dimensional Echocardiography Clinical Implications of Right Atrial Enlargement Right atrium pressure and performance Assessment of Right Atrial Pressure by Two-Dimensional Echocardiography Conclusion References Pulmonary Embolism Introduction Diagnosis Transthoracic echocardiography Transesophageal echocardiography Prognosis Summary References X Diastolic Function Physiology of Diastole LV relaxation LV stiffness Ventricular arterial coupling Diagnosis of diastolic heart failure References Methods of Assessment Invasive assessment of diastolic function Noninvasive assessment of diastolic function: echocardiography References Echo Doppler Parameters of Diastolic Function Doppler mitral flow velocity patterns Valsalva maneuver Pulmonary venous flow Systolic/Diastolic ratio Reverse Flow at Atrial Contraction Velocity Color M-mode flow propagation velocity Tissue doppler annular velocity Myocardial performance index Integration of doppler echocardiography parameters Conclusion References Estimation of Left Ventricular Filling Pressures Difficult cases References Clinical Recommendations for Echocardiography Laboratories for Assessment of Left Ventricular Diastolic Function Estimation of left ventricular filling pressures in patients with depressed ejection fraction Estimation of left ventricular filling pressures in patients with normal ejection fraction Grading of left ventricular diastolic function Estimation of left ventricular filling pressures in patients with atrial fibrillation Estimation of left ventricular filling pressures in patients with mitral regurgitation Prognostic power of the american society of echocardiography/european association of echocardiography diastolic function grade References Newer Methods to Assess Diastolic Function Myocardial muscle mechanics Three-dimensional strain Fluid mechanics Conclusion References Causes of Diastolic Dysfunction Definition Prevalence of diastolic dysfunction in common comorbid conditions Hypertension Coronary Artery Disease Diabetes Mellitus Obesity Hypertrophic cardiomyopathy Diastolic dysfunction in restrictive cardiomyopathy Amyloidosis Hemosiderosis Cardiac Sarcoidosis Hypereosinophilic Syndrome Systemic Sclerosis Impact on survival Mechanistic considerations Transition from diastolic dysfunction to overt heart failure References XI Left Atrium Assessment of Left Atrial Size Left atrial remodeling: an echocardiographic diagnosis Definition of left atrial remodeling Diastolic dysfunction and left atrial size Left atrial enlargement for outcome prediction and prognostication Echocardiographic methods of left atrial size assessment Pitfalls of left atrial volume measurement Newer modalities of echocardiographic left atrial volume assessment Reverse remodeling of LA Future directions References Assessment of Left Atrial Function Left atrial function Volumetric methods Spectral doppler Tissue doppler imaging Deformation analysis (strain and strain rate imaging) Challenges to measurement of left atrial function References XII Ischemic Heart Disease Introduction to Ischemic Heart Disease References Ischemic Heart Disease: Basic Principles Acute effects of myocardial ischemia Echocardiographic detection of myocardial ischemia and infarction Patterns of ischemia based on coronary artery involvement False indications of ischemia on echocardiography References Acute Chest Pain Syndromes: Differential Diagnosis Left ventricle Left Ventricular Function and Acute Coronary Syndrome Left Ventricular Function and Cardiomyopathies Right ventricle Aorta Pericardium References Echocardiography in Acute Myocardial Infarction Left ventricular thrombosis Postinfarction ventricular septal rupture Left ventricular free wall rupture Acute mitral regurgitation and papillary muscle rupture Left ventricular outflow tract obstruction Right ventricular infarction References Echocardiography in Stable Coronary Artery Disease Diagnosis Stress echocardiography Image interpretation Prognostic value of stress echocardiography Mechanisms of reversibility Role of dobutamine stress echocardiography in viability assessment Importance of viability Conclusion References Old Myocardial Infarction Chronic remodeling LV Size and Function Other Manifestations of Remodeling Risk Factors for Chronic Remodeling Treatment and Prevention of Adverse Remodeling Early Detection of Adverse Remodeling Viability Ischemic MR References End-Stage Cardiomyopathy due to Coronary Artery Disease Etiology of ventricular dysfunction Characterization of left ventricular size and function Right ventricle Diastolic function Mitral regurgitation Left ventricular aneurysm Serial evaluation References Coronary Artery Anomalies Classification of coronary artery anomalies Multimodality imaging for the identification of coronary artery anomalies Imaging protocol for transthoracic echocardiography Incidence of coronary anomalies diagnosed by echocardiography Perioperative transesophageal echocardiography Conclusion References XIII Stress Echocardiography Stress Echocardiography: Introduction References Effects of Exercise, Pharmacological Stress, and Pacing on the Cardiovascular System Hemodynamic effects Mechanisms of ischemia Left ventricular response to stress Comparisons of stressors Hypertensive response to stress Parameters to assess for noncoronary indications Mitral Regurgitation Aortic Stenosis Diastolic Dysfunction Conclusions References Diagnostic Criteria and Accuracy Diagnostic criteria Semiquantification of Left Ventricular Wall Motion Using Wall Motion Score Index Wall Motion Abnormalities at Low Heart Rates Left Atrial Size Right Ventricular Function Transient Ischemic Dilatation Diagnostic accuracy References Stress Echocardiography Methodology Exercise echocardiography Exercise protocols Treadmill Bicycle Ergometry Pharmacologic stress protocols Dobutamine Vasodilator Stress Echocardiography Other modalities Handgrip Diastolic Stress Test References Stress Echocardiography: Image Acquisition Acknowledgment References Prognosis Risk stratification and prognosis with extent and severity of wall motion abnormalities Single vessel and multivessel coronary artery disease Prediction of myocardial infarction versus cardiac death Functional parameters, including heart rate reserve, important in prognosis Heart rate when wall motion abnormality occurs Prognostic value of stress echocardiography versus stress electrocardiography Duration of regional wall motion abnormalities Role of right ventricular wall motion Transient ischemic left ventricular cavity dilatation Left atrial size Warranty time of a normal stress echocardiogram References Viability Dobutamine stress echocardiography Rationale Protocol Prognostic value Comparison with other modalities Thallium scintigraphy Fluorodeoxyglucose F 18 Positron Emission Tomography Magnetic Resonance Imaging Reasons for discordant findings between various modalities to assess viability Future advances Nitroglycerin-Enhanced Dobutamine Stress Echocardiography Enoximone Stress Echocardiography Strain Rate Measurement Myocardial Contrast Echocardiography Conclusions References Contrast-Enhanced Stress Echocardiography Ultrasound contrast applications for stress echocardiography Approaches to optimize contrast use during stress echocardiography Physiologic basis for examining myocardial perfusion with ultrasound contrast agents Technical considerations and components Role of physician Role of sonographer and nurse Advantages and disadvantages of using RTPE instead of other imaging techniques Acquisition of RTPE images Specific stress protocols Exercise Stress RTPE Acquisition Analysis of Images Dobutamine stress real-time perfusion echocardiography and left ventricular opacification protocols Acquisition Analysis of Images Vasodilator stress myocardial perfusion imaging Acquisition Analysis Pitfalls and clinical tips for all RTPE stress acquisitions References Three-Dimensional Stress Echocardiography Introduction Modes of 3D stress echocardiography Real-Time Imaging Real-Time 3D Full Volume Data Acquisition Temporal resolution 3D volume data acquisition LV segment visualization Left ventricular contrast opacification Workflow and display Analysis Other methods of 3D stress analysis and display Conclusion References Stress Echocardiography for Valve Disease: Aortic Regurgitation and Mitral Stenosis Introduction Stress echocardiography protocol Aortic regurgitation Indications Prognostic value of left ventricular contractile reserve Mitral stenosis Indications Prognostic value of changes in transmitral pressure gradient and systolic pulmonary artery pressure Impact on clinical decision making References Appropriate Use Criteria for Stress Echocardiography What are appropriate use criteria for stress echocardiography? Is the current clinical practice of stress echocardiography appropriate? Do the appropriate use criteria for stress echocardiography stratify diagnosis and prognosis? References Comparison with Other Techniques Exercise electrocardiography stress testing and stress echocardiography Nuclear stress testing Cardiac magnetic resonance perfusion imaging Coronary computed tomography angiography Advantage of stress echocardiography over other imaging techniques References XIV Cardiomyopathies Introduction to Cardiomyopathies Definition of cardiomyopathy Role for echocardiography References Pathophysiology and Variants of Hypertrophic Cardiomyopathy Anatomic variants Pathophysiology Diastolic Dysfunction Myocardial Ischemia Autonomic Dysfunction Physiologic variants Nonobstructive Hypertrophic Cardiomyopathy Hypertrophic Cardiomyopathy with Left Ventricular Outflow Tract Obstruction Mid-Ventricular Obstruction in Hypertrophic Cardiomyopathy Apical Hypertrophic Cardiomyopathy References Hypertrophic Cardiomyopathy: Pathophysiology, Functional Features, and Treatment of Outflow Tract Obstruction Pathophysiology of left ventricular outflow tract obstruction Mechanisms of mitral regurgitation Functional features of obstructive hypertrophic cardiomyopathy Echocardiographic and doppler assessment of obstructive hypertrophic cardiomyopathy Treatment strategies for obstructive hypertrophic cardiomyopathy References Differential of Hypertrophic Cardiomyopathy versus Secondary Conditions That Mimic Hypertrophic Cardiomyopathy Hypertensive heart disease Athletes´ hearts Infiltrative disorders of the myocardium Cardiac Amyloidosis Cardiac Sarcoidosis Isolated left ventricular noncompaction cardiomyopathy Storage diseases Lysosomal Storage Disorders Anderson-Fabry disease Danon Disease Glycogen Storage Diseases Syndromic hypertrophic cardiomyopathy RASopathies: Noonan Syndrome and LEOPARD Syndrome Friedreich Ataxia References Echocardiographic Features of Hypertrophic Cardiomyopathy: Mechanism of Systolic Anterior Motion The left ventricle Pathophysiologic classification Obstructive Hypertrophic Cardiomyopathy Nonobstructive Hypertrophic Cardiomyopathy Echocardiographic Features of Obstructive Hypertrophic Cardiomyopathy with Left Ventricular Outflow Obstruction The Mitral Leaflets The Mitral Annulus Mechanisms of Systolic Anterior Motion Doppler Assessment of Left Ventricular Outflow Obstruction Role of Intraoperative Echocardiography to Guide Surgical Myectomy Echocardiographic Features of Obstructive Hypertrophic with Mid-Ventricular Obstruction Nonobstructive Hypertrophic Cardiomyopathy Prognostic Implications of Echocardiographic Findings Doppler Assessment of Diastolic Function The right ventricle Conclusion References Hypertrophic Cardiomyopathy: Assessment of Therapy Treatment and assessment of obstructive hypertrophic cardiomyopathy Pharmacologic therapy Surgical myectomy Alcohol septal ablation Dual-chamber pacing References Hypertrophic Cardiomyopathy: Screening of Relatives Genetics of hypertrophic cardiomyopathy Genetic testing in hypertrophic cardiomyopathy Recommendations for clinical screening Clinical and Electrocardiographic Assessment Echocardiographic Assessment Assessment by Cardiac Magnetic Resonance Imaging Findings in hypertrophic cardiomyopathy gene carriers Echocardiographic Studies Other Morphologic Abnormalities in Hypertrophic Cardiomyopathy Gene Carriers References Apical Hypertrophic Cardiomyopathy Morphology and Echocardiographic Features Subtypes Apical Aneurysms References Echocardiography in Athletic Preparticipation Screening Sports medicine physicians The athletic heart Transthoracic echocardiography Benefits of echocardiographic preparticipation screening Chapter application Conclusions References Dilated Cardiomyopathy: Etiology, Diagnostic Criteria, and Echocardiographic Features Etiology Echocardiographic assessment of dilated cardiomyopathy Morphological Assessment Assessment of Chamber Dimensions and Function Secondary Findings References Imaging in Familial Dilated Cardiomyopathy Etiology Epidemiology Case reports XIV Cardiomyopathies Imaging in Familial Dilated Cardiomyopathy Value of imaging in familial dilated cardiomyopathy References Echocardiographic Predictors of Outcome in Patients with Dilated Cardiomyopathy Left ventricular dimensions and ejection fraction Left ventricular diastolic dysfunction Left atrial size Other variables: myocardial viability, ischemia, and dyssynchrony References Right Ventricle in Dilated Cardiomyopathy Pathophysiology of right ventricular dysfunction Echocardiographic methods for evaluating right ventricular size and function Studies evaluating right ventricular function Fractional Area Change Right Ventricular Index of Myocardial Performance Tricuspid Annular Plane Systolic Excursion Doppler S Two-Dimensional Strain Imaging Multiple Parameters Pulmonary hemodynamics Conclusion and Recommendations References Restrictive Cardiomyopathy: Classification References Cardiac Amyloidosis: Echocardiographic Features Pathology Classification Diagnostic imaging modalities for the evaluation of cardiac amyloidosis Echocardiography Doppler Echocardiography Prognosis Treatment References Hereditary and Acquired Infiltrative Cardiomyopathy Clinical spectrum Diagnosis Echocardiography Speckle Tracking Cardiac Magnetic Resonance Endomyocardial Biopsy Infiltrative cardiomyopathy with thick walls Fabry Disease Danon Disease Oxalosis Mucopolysaccharidoses Glycogen Storage Disease Infiltrative cardiomyopathy with the dilated phenotype Hemochromatosis Conclusions References Endomyocardial Fibrosis Etiology Epidemiology Pathophysiology Physical examination Diagnostic testing References Restriction versus Constriction Etiology and physiopathology Constrictive Pericarditis Restrictive Cardiomyopathy Echocardiography Other investigations References Echocardiography in Arrhythmogenic Right Ventricular Cardiomyopathy Echocardiographic findings in arrhythmogenic right ventricular cardiomyopathy Right Ventricular Structure Right Ventricular Function Newer Echocardiographic Techniques in Arrhythmogenic Right Ventricular Cardiomyopathy Echocardiography versus other modalities for arrhythmogenic right ventricular cardiomyopathy Summary References Echocardiographic Analysis of Left Ventricular Noncompaction Echocardiographic features Available diagnostic criteria Echocardiography tricks and tips References Takotsubo-like Transient Left Ventricular Dysfunction: Takotsubo Cardiomyopathy References A Systematic Echocardiographic Approach to Left Ventricular Assist Device Therapy Echocardiographic analysis The left ventricular assist device Post-Left Ventricular Assist Device Implantation Evaluation Left ventricular assist device malfunction considerations Postoperative Troubleshooting Summary References Posttransplantation Echocardiographic Evaluation Screening Recipient Evaluation Donor Evaluation Perioperative monitoring Ventricular Structure and Function Valve Function Pericardial Effusion Posttransplantation surveillance Early Surveillance Late Surveillance References Familial Cardiomyopathies Friedreich ataxia Cardiac Manifestations Imaging Management Myotonic dystrophy Cardiac Manifestations Imaging Management Duchenne muscular dystrophy Cardiac Manifestations Imaging Management Summary References Echocardiography in Cor Pulmonale and/or Pulmonary Heart Disease Structural abnormalities in pulmonary arterial hypertension Doppler findings in pulmonary arterial hypertension Echocardiographic findings and prognosis in cor pulmonale Echocardiography to predict and monitor response to therapy in pulmonary arterial hypertension Summary References Echocardiographic Evaluation of Functional Tricuspid Regurgitation Pathophysiology of secondary tricuspid regurgitation Tricuspid annulus dilation and dysfunction Right ventricular remodeling and tricuspid valve tethering Pulmonary hypertension Natural history of secondary tricuspid regurgitation Management References Echocardiographic Evaluation of the Right Heart: Limitations and Technical Considerations Limitations Technical considerations Summary References XV Aortic Stenosis Aortic Stenosis Morphology Congenital aortic stenosis Bicuspid Aortic Valve Natural History of Bicuspid Aortic Valves Echocardiographic Features of Bicuspid Aortic Valves Coarctation Infective Endocarditis Aortic Complications Surveillance (Serial Assessment of Patients with Bicuspid Aortic Valve) Family Screening of Patients with BAV Unicuspid Aortic Valve Quadricuspid Aortic Valve Calcific (degenerative) aortic stenosis Rheumatic aortic stenosis References Quantification of Aortic Stenosis Severity Normal aortic valve Two-Dimensional Echocardiography M-Mode Echocardiography Quantitative diagnosis of aortic stenosis Quantitative doppler assessment of severity of aortic stenosis Transaortic Velocities Pressure Gradients Aortic Valve Area by Continuity Equation Limitations and pitfalls in the echo-doppler quantitation of aortic stenosis Planimetry of aortic valve orifice Three-dimensional assessment of the aortic valve area Other methods of measuring aortic stenosis severity Serial evaluation of aortic stenosis Physiologic consequences of aortic stenosis Left Ventricular Systolic Dysfunction Left Ventricular Diastolic Dysfunction Pulmonary Hypertension Aortic valve sclerosis References Asymptomatic Aortic Stenosis Arguments for surgery in asymptomatic aortic stenosis Risk of Sudden Cardiac Death Risk of Irreversible Myocardial Damage Surgical Considerations Duration of the Asymptomatic Phase Studies Reporting Better Outcome with Early Surgery in Asymptomatic Severe Aortic Stenosis Predictors of outcome and risk stratification in asymptomatic severe aortic stenosis Echocardiography at rest Exercise testing Incremental value of exercise hemodynamics assessed by doppler echocardiography Biomarkers Summary References Risk Stratification—Timing of Surgery Risk stratification in asymptomatic aortic stenosis Importance of the predicted postinterventional survival on decision-making Assessing the risk of an intervention References Low-Flow, Low-Gradient Aortic Stenosis with Reduced Left Ventricular Ejection Fraction Usefulness of dobutamine stress echocardiography for assessing left ventricular flow reserve and stenosis severity Assessing left ventricular flow reserve Assessing stenosis severity Therapeutic management Conclusions References Low-Flow, Low-Gradient Aortic Stenosis with Preserved Left Ventricular Ejection Fraction Clinical presentation and pathophysiology of paradoxical low-flow, low-gradient aortic stenosis Assessment of flow and stenosis severity Therapeutic management Conclusion References Stress (Exercise) Echocardiography in Asymptomatic Aortic Stenosis Exercise testing protocol Exercise echocardiography protocol Clinical and prognostic value Exercise Electrocardiographic Parameters Echocardiographic Parameters Valve Compliance and Pressure Gradients Left Ventricular Function and Contractile Reserve Pulmonary Arterial Pressure Left Ventricular Diastolic Parameters and Mitral Regurgitation Impact on clinical decision-making Conclusion References Subaortic Stenosis Epidemiology Morphology Etiology and/or pathophysiology Diagnosis Treatment Acknowledgments References XVI Aortic Regurgitation Introduction to Aortic Regurgitation References Aortic Regurgitation: Etiologies and Left Ventricular Responses Etiology Left ventricular responses to aortic regurgitation Prognosis and guideline-based management of aortic regurgitation References Aortic Regurgitation: Pathophysiology Aortic regurgitation pathophysiology Acute aortic regurgitation Chronic aortic regurgitation References Quantitation of Aortic Regurgitation Quantitation of aortic regurgitation Semiquantitative Methods Quantitative Methods Left ventricular measurements Role of transesophageal echocardiography Role of three-dimensional echocardiography Conclusions References Risk Stratification: Timing of Surgery for Aortic Regurgitation Introduction Medical therapy Acute Aortic Regurgitation Chronic Aortic Regurgitation Percutaneous interventional therapy Percutaneous Aortic Valves Intra-aortic Balloon Pump Surgical therapy Severity of Aortic Regurgitation Acute Versus Chronic Aortic Regurgitation Symptoms LV Systolic Function Need for Other Cardiac Surgery Decision algorithms for surgical treatment of aortic regurgitation Level of Evidence Strength of Recommendations Severe acute aortic regurgitation Severe chronic aortic regurgitation Class I Indications: AV Surgery Should Be Performed Class IIa Indications: AV Surgery Is a Reasonable Option Class IIb Indication: AV Surgery May Be Considered References XVII Mitral Stenosis Mitral Stenosis: Introduction References Rheumatic Mitral Stenosis Etiology of mitral stenosis Epidemiology Pathophysiology Physical examination Electrocardiography Chest radiography Transthoracic echocardiography Transesophageal echocardiography Therapy Medical Therapy Percutaneous Mitral Balloon Valvuloplasty Mitral Valve Surgery References Quantification of Mitral Stenosis Mean pressure gradient measurements Mitral valve area measurements Pressure Half-Time Method Mitral Deceleration Time Method Mitral Valve Area by Planimetry Mitral Valve Area by Doppler Techniques Mitral Valve Area by Continuity-Equation Method Mitral Valve Area by Proximal Isovelocity Surface Area Method Semiquantitative Mitral Valve Area Assessment by M-Mode Echocardiography Secondary changes due to mitral stenosis Summary References Other (Nonrheumatic) Etiologies of Mitral Stenosis; Situations That Mimic Mitral Stenosis Mitral annular calcification Other nonrheumatic forms of acquired mitral stenosis Cor Triatriatum Other Congenital Etiologies of Mitral Stenosis References Role of Hemodynamic Stress Testing in Mitral Stenosis Role of exercise hemodynamics: when and how according to current guidelines? Evaluation of right heart pressure Change in mitral valve area with exercise Stress echocardiography and timing of intervention Conclusions References Consequences of Mitral Stenosis Pulmonary edema Pulmonary hypertension Right heart failure Atrial arrythmias Atrial thrombus Low cardiac output Other valve involvement Pregnancy Complications from percutaneous mitral valvotomy Summary References XVIII Mitral Regurgitation Introduction to Mitral Regurgitation References Etiologies and Mechanisms of Mitral Valve Dysfunction Mitral valve etiologies Mitral valve lesions Mitral valve dysfunction References Mitral Valve Prolapse Etiology Diagnosis Mitral Valve Repair Summary References Quantification of Mitral Regurgitation Definition of severe mitral regurgitation Hemodynamics underlying the assessment of mitral regurgitation Anatomy Two-dimensional color doppler Two-Dimensional Color Doppler Jet Area Two Dimensional Vena Contracta Width Two-Dimensional Proximal Isovelocity Surface Area Method Two-Dimensional Volumetric Methods Three-dimensional echocardiography Three-Dimensional Vena Contracta Area Three-Dimensional Proximal Isovelocity Surface Area Three-Dimensional Anatomic Regurgitant Orifice Area Three-Dimensional Mitral Inflow and Left Ventricular Outflow Tract Stroke Volume Limitations of Three-Dimensionally-Derived Quantitative Measurements for Mitral Rergurgitation Supportive finding of severe mitral regurgitation Summary References Asymptomatic Severe Mitral Regurgitation Indications for surgery in mitral regurgitation Symptomatic Patients Asymptomatic Patients The question of surgery for truly asymptomatic patients Likelihood of mitral valve repair References Role of Exercise Stress Testing Exercise Echocardiography and Protocols Primary Mitral Regurgitation Indications Clinical and Prognostic Value Dynamic MR and Pulmonary Hypertension LV Function and Contractile Reserve Impact on Clinical Decision Making Secondary (Ischemic) Mitral Regurgitation Pathophysiology Indications Clinical and Prognostic Value Impact on Clinical Decision-Making References Ischemic Mitral Regurgitation Introduction and definition Mechanisms Chronic Mitral Regurgitation Due to Geometric Changes (Remodeling) of the Left Ventricle Papillary Muscle Rupture Echocardiographic Assessment of Ischemic Mitral Regurgitation Prognosis Management of ischemic mitral regurgitation Conclusion Acknowledgments References XIX Tricuspid Regurgitation Epidemiology, Etiology, and Natural History of Tricuspid Regurgitation Epidemiology Etiology and mechanisms of tricuspid regurgitation Natural history References Quantification of Tricuspid Regurgitation References Indications for Tricuspid Valve Surgery Severity of tricuspid regurgitation Right ventricular function Tricuspid annular dilatation Late development of tricuspid regurgitation following mitral valve surgery References Tricuspid Valve Procedures Annuloplasty band Annuloplasty Suture Bicuspidization Edge-to-Edge Suture Tricuspid valve replacement Echocardiographic evaluation of prosthetic function Conclusion References XX Pulmonic Regurgitation Introduction and Etiology of Pulmonic Regurgitation Epidemiology and etiology Two-dimensional echocardiographic evaluation Transthoracic Echocardiography Transesophageal Echocardiography Three-dimensional echocardiographic evaluation Doppler echocardiographic evaluation Color Flow Doppler Continuous Wave Doppler Pulsed Wave Doppler Grading pulmonic regurgitation severity Direct Evaluation Indirect Evaluation Surgical treatment of severe pulmonic regurgitation References Pulmonic Regurgitation: Semiquantification Introduction Pulmonic regurgitation evaluation overview Mechanism of pulmonic regurgitation Semiquantitative assessment of pulmonic regurgitation severity Color Doppler Jet Length Jet Area Turbulent versus Laminar Regurgitant Jet Vena Contracta Continuous Wave Spectral Doppler Jet Density Deceleration Slope Premature Cessation of Retrograde Flow To-and-Fro Flow Low Peak Pulmonic Regurgitation Velocity Premature Tricuspid and Pulmonic Valve Events Pulsed Wave (PW) Spectral Doppler Regurgitant Fraction by Pulmonic Valve Pulsed Wave Regurgitant Volume and Fraction by Comparing Pulmonic to Systemic Flow Holodiastolic Flow Reversal in Pulmonary Artery M-Mode Echocardiography Impact of pulmonic regurgitation on cardiac chambers References XXI Prosthetic Valves Prosthetic Valves: Introduction General overview and approach General considerations for evaluation of prosthetic valve function Complications of prosthetic valves Imaging in the catheterization laboratory: prosthetic valve implantation and repair Summary References Classification of Prosthetic Valve Types and Fluid Dynamics Different types of prosthetic valves Surgical prosthetic valves Mechanical Valves Ball-Cage Valves Monoleaflet Valves Bileaflet Valves Tissue Valves Stented Bioprostheses Stentless Bioprostheses Sutureless Bioprostheses Aortic Homografts Pulmonary Autografts (Ross Procedure) Transcatheter bioprosthetic valves Balloon-Expandable Valves Self-expanding Valves Pressure recovery Localized high gradient in bileaflet mechanical valves Prosthesis-patient mismatch Conclusion References Aortic Prosthetic Valves Standard transthoracic echocardiographic assessment of aortic prosthetic valve function Two-Dimensional Imaging Doppler Parameters Used to Assess Aortic Prosthetic Valve Function Doppler Velocity Index Effective Orifice Area and Indexed Effective Orifice Area Measurement of Left Ventricular Outflow Tract Parameters after Transcatheter Aortic Valve Implantation Normal Doppler Values Diagnosis of aortic prosthetic valve dysfunction Interpretation of Elevated Valve Gradients Prosthetic Valve Obstruction Prosthesis-Patient Mismatch Rapid Pressure Recovery Aortic prosthetic valve regurgitation Physiologic or "Normal" Regurgitation Pathologic Regurgitation Limitations of Transesophageal Echocardiography in Aortic Prostheses Summary References Mitral Prosthetic Valves Standard transthoracic echocardiographic assessment of mitral prosthetic valve function Two-Dimensional Imaging Doppler Parameters Used to Assess Mitral Prosthetic Valve Function Effective Orifice Area and Pressure Half-Time Doppler Velocity Index Normal Doppler Values Diagnosis of mitral prosthetic valve dysfunction Interpretation of Elevated Valve Gradients Prosthetic Valve Obstruction Prosthesis-Patient Mismatch Doppler detection and quantitation of mitral prosthetic valve regurgitation ``Normal´´ Regurgitation Pathologic Regurgitation Optimal use of transesophageal echocardiography Etiology of Obstruction Confirmation of Regurgitation Infective Endocarditis Summary References Periprosthetic Leaks Prevalence Clinical presentation Diagnosis Other imaging modalities Treatment References Tricuspid Prosthetic Valves Tricuspid valve prosthesis dysfunction Echocardiographic assessment of prosthetic tricuspid valve function Two-Dimensional Echocardiography Color Flow Imaging Doppler Echocardiography Mean Gradient Pressure Half-Time Velocity Time Interval Ratio for Tricuspid Valve Prostheses Effective Orifice Area Prosthetic valve regurgitation Two-Dimensional Echocardiography Color Flow Imaging Spectral Doppler Transesophageal echocardiography in patients with prosthetic tricuspid valves Three-dimensional echocardiography Transcatheter valve-in-valve implantation References Mitral Valve Repair Pre-cardiopulmonary bypass transesophageal echocardiographic examination Post-cardiopulmonary bypass transesophageal echocardiographic examination Three-dimensional echocardiography for mitral valve surgery References XXII Infective Endocarditis Introduction and Echocardiographic Features of Infective Endocarditis Vegetations Other features References Infective Endocarditis: Role of Transthoracic versus Transesophageal Echocardiography Epidemiology of infective endocarditis Types of infective endocarditis Pathophysiology Diagnosis Types of echocardiography: indications and diagnosis Echocardiography: detection of complications Therapy Acknowledgment References Echocardiography for Prediction of Cardioembolic Risk Introduction Spectrum of cardioembolism Stroke Cardioembolic Stroke: Clinical Caveats Cryptogenic Stroke Echocardiographic evaluation Specific cardioembolic clinical situations Atrial Fibrillation Thrombus Left Atrial Thrombus Masses Endocarditis Aortic Pathology Conduits Prosthetic Valves Conditions that are low/uncertain risk for cardioembolism Conclusion Acknowledgments References Echocardiography and Decision Making for Surgery Transthoracic versus transesophageal echocardiography in infective endocarditis Echocardiography and surgical decision making in infective endocarditis Conclusion References Intraoperative Echocardiography in Infective Endocarditis Conclusion References Limitations and Technical Considerations References XXIII Pericardial Diseases Introduction to Pericardial Diseases References Normal Pericardial Anatomy Phylogeny and embryology Basic anatomy Pericardial thickness Pericardial fluid Intrapericardial pressure Intrapericardial versus extrapericardial heart structures Pericardial fat Pericardial extensions References Pericarditis Definition Epidemiology Etiology Diagnostic evaluation Clinical features Symptoms Signs Electrocardiography Chest X-ray Labs Echocardiography Magnetic resonance imaging Computed tomographic imaging Treatment References Pericardial Effusion and Cardiac Tamponade Normal anatomy of pericardium Pericardial effusion Echocardiography in pericardial effusion Cardiac tamponade Acute Tamponade Subacute Tamponade Echocardiography in Cardiac Tamponade Chamber Collapse Inferior Vena Cava Plethora Echocardiographic or Doppler Signs of Increased Ventricular Interdependence Caveats Echo-guided pericardiocentesis Acknowledgments References Constrictive Pericarditis Demographics and presenting symptoms Pathophysiology Diagnostics Echocardiography Pulsed Doppler Studies Tissue Doppler Treatment References Effusive Constrictive Pericarditis Epidemiology Etiology Pathophysiology Diagnostic tests Echocardiography Other Techniques Treatment References Pericardial Cysts and Congenital Absence of the Pericardium Pericardial cysts Clinical Presentation Imaging Modalities Differential Diagnosis Treatment Absence of the pericardium Epidemiology Pathogenesis Associated Anomalies Clinical Presentation Diagnostic Modalities Echocardiography Treatment Cardiac Magnetic Resonance and Cardiac Computed Tomography References XXIV Tumors and Masses Introduction to Echocardiographic Assessmentof Cardiac Tumors and Masses References Primary Benign, Malignant, and Metastatic Tumors in the Heart Tumor classification and frequency Primary benign tumors Primary malignant tumors Metastatic tumors Summary Acknowledgment References Left Ventricular Thrombus Left ventricular thrombus with impaired left ventricular function Left ventricular thrombus with preserved left ventricular function Diagnostic tests and the role of echocardiography Prognosis and treatment Summary References Left Atrial Thrombus Pathogenesis of left atrial thrombus formation Transesophageal echocardiographic diagnosis of left atrial thrombus Additional diagnostic techniques Transthoracic Echocardiography and Contrast Echocardiography Cardiac Computed Tomography and Magnetic Resonance Imaging Clinical implications of the diagnosis of left atrial thrombus by transesophageal echocardiography Cardiac Source of Embolism Cardioversion of Atrial Fibrillation References Right Heart Thrombi Incidence Risk factors associated with right heart thrombi Special at-risk clinical populations Atrial Fibrillation Inflammatory Bowel Diseases Children Right heart thrombus imaging by echocardiography Right heart thrombi morphology and outcomes Specific echocardiographic imaging for right heart thrombi Tissue characterization and contrast perfusion of right heart thrombi Conventional management strategies Contemporary Management Strategies Conclusions References Normal Anatomic Variants and Artifacts Crista terminalis Eustachian valve Chiari network Lipomatous hypertrophy of the atrial septum Fat infiltration of the tricuspid annulus Pectinate muscles in the left atrial appendage Prominent ridge of tissue between the left atrial appendage and the left upper pulmonary vein Fluid in the transverse sinus Caseous calcification of the mitral annulus Artifacts of the thoracic aorta References Role of Contrast Echocardiography in the Assessment of Intracardiac Masses Traditional echocardiographic diagnosis Use of contrast to detect and define intracardiac masses Differential diagnosis of cardiac masses with contrast perfusion imaging Limitations Conclusion References Echocardiography-Guided Biopsy of Intracardiac Masses Differential diagnosis of intracardiac mass lesions Diagnostic evaluation Indications for endomyocardial biopsy Technique of endomyocardial biopsy Potential complications of endomyocardial biopsy References Cardiac Sources of Emboli References XXV Diseases of the Aorta Introduction Imaging techniques in aorta assessment Transthoracic Echocardiography Transesophageal Echocardiography Computed Tomography Magnetic Resonance Imaging Multimodality imaging in aortic diseases References Aortic Atherosclerosis and Embolic Events Transesophageal echocardiography and aortic plaque Other imaging modalities Clot embolization versus cholesterol embolization High-risk plaque Aortic plaque and embolic events in heart surgery and invasive intravascular procedures Management options References Aortic Aneurysm Etiology Morphology Diagnosis Natural history and complications Serial imaging Surgical indication References Clinical significance Diagnosis Treatment References Acute Aortic Syndrome History Classifications of aortic dissection Temporal Spatial Epidemiology Pathophysiology Basic Features Complications Long-Term Changes Diagnosis of aortic dissection Echocardiography in aortic dissection Therapy and prognosis Conclusions References Penetrating Atherosclerotic Ulcer and Intramural Hematoma Penetrating atherosclerotic ulcer Etiology Imaging Features Imaging modalities Computed Tomography Transesophageal Echocardiography Intravascular Ultrasound Magnetic Resonance Imaging Angiography Imaging Algorithm Serial follow-up of a penetrating atherosclerotic ulcer Treatment Outcomes and prognosis Intramural hematoma Acknowledgments References Aortic Trauma Pathophysiology Demographics and presenting symptoms Echocardiographic findings Diagnosis Initial management Conclusion References Intraoperative Echocardiography Intraoperative transesophageal echocardiography: the thoracic aorta Epiaortic scanning: a solution to the "blind spot" References Postoperative Echocardiography of the Aorta Postsurgical imaging of the aortic root and aorta What the Imager Needs to Know Common aortic surgical techniques Interposition Technique Inclusion Technique Composite Grafts Reduction Aortic Aortoplasty External Reinforcement (Wrapping) Aortic Arch Grafts Elephant Trunk Procedure Cabrol Shunt Procedure Technical Adjuncts Normal postoperative features Complications after aortic repair Pseudoaneurysm False Lumen Dilatation Involvement of Aortic Branches Infection Recommendations for serial imaging techniques and schedules References XXVI Adult Congenital Heart Disease Introduction References Systematic Approach to Adult Congenital Heart Disease History and natural history Location of the scar: "the scar is the clue" Segmental analysis Cardiac Position and Visceral Situs Visceral Situs Atrial Situs Ventricular Position and Morphologic Identification Blood Flow into the Heart Blood Flow through the Heart Blood Flow out of the Heart Coronary Artery Anatomy Special pediatric views and their significance Role of transesophageal echocardiography in an adult patient with congenital heart disease Summary References Common Congenital Heart Defects Associated with Left-to-Right Shunts References Obstructive Lesions Anatomy of the outflow tracts and thoracic aorta Clinical presentation Valvar aortic stenosis Aortic coarctation Subvalvar aortic stenosis Supravalvar aortic stenosis Valvar pulmonary stenosis Double-chambered right ventricle Supravalvar and peripheral pulmonic stenosis References The Adult with Unrepaired Complex Congenital Heart Defects Sequential, segmental approach to complex congenital heart disease Abdominal/Cardiac Situs Cardiac Position Definition of the Connection Ventricular Looping Associated Malformations Cyanotic complex congenital heart disease Tetralogy of Fallot Complete Transposition of the Great Arteries (TGA or D-TGA) Univentricular Heart Palliative Shunts Acyanotic complex congenital heart disease Ebstein Anomaly Physiologically "Corrected" Transposition of the Great Arteries (c-TGA) Limitations in echocardiographic assessment of complex congenital heart disease References Adult Congenital Heart Disease with Prior Surgical Repair Historical perspective and timeline Basic concepts of surgical repair Palliative Operations Anatomic Operations Nonanatomic Operations Important echocardiographic considerations in the postoperative patient Representative case examples Case1 Repair of Conotruncal Defects Postoperative Complications Postoperative Echocardiography Checklist Case2 Repair of D-Transposition of the Great Arteries Postoperative Complications Postoperative Echocardiography Checklist Case3 The Fontan-Type Operation for Single Ventricle Postoperative Complications Postoperative Echo Checklist References XXVII Systemic Diseases Hypertension Left ventricular size, chamber function, and mass Cardiac mechanics Arterial dynamics References Diabetes Pathophysiology Time course of diabetes mellitus: anatomic and echocardiographic overview Left ventricular systolic function Left ventricular diastolic function Right ventricular function Aortic valve and aortic elasticity Can echocardiography be used to determine efficacy of therapy? Novel measures of cardiac function in diabetes: twist and torsion References End-Stage Renal Disease Epidemiology Hypertension and/or Left Ventricular Hypertension Congestive Heart Failure Valvular Heart Disease Pericarditis Pulmonary Hypertension Mobile Calcific Calcinosis of the Heart Guidelines Kidney Disease Outcomes Quality Initiative Clinical Practice Guidelines for Cardiovascular Disease in Dialysis Patients 2012 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the Evaluation and Management of Chr... Cardiac Disease and Evaluation and Management among Kidney and Liver Transplantation Candidates References Obesity Pathophysiology Cardiac assessment by echocardiography Doppler echocardiography References Rheumatic Fever and Rheumatic Heart Disease Epidemiology Pathogenesis Acute rheumatic fever Diagnosis Recurrent Acute Rheumatic Fever Subclinical Carditis in Acute Rheumatic Fever Rheumatic heart disease Therapy Treatment of Acute Rheumatic Fever Conclusions References Systemic Lupus Erythematosus Etiology and pathophysiology Prevalence and outcome Diagnostic approach Cardiac manifestations References Antiphospholipid Antibody Syndrome Demographics and presenting symptoms Pathophysiology Outline placeholder Diagnostic approach Cardiac manifestations Management References Carcinoid Heart Disease Carcinoid heart disease Echocardiographic findings of tricuspid valve involvement Tricuspid valve replacement Outline placeholder Echocardiographic Findings of Pulmonic Valve Involvement Pulmonic balloon valvuloplasty References Amyloid Introduction Other amyloidogenic proteins Clinical presentation Echocardiographic features Structural Changes Functional Changes Mitral tissue doppler Mitral inflow pattern Pulmonary vein pattern Mitral flow propagation Left ventricular strain imaging References Sarcoidosis Echocardiographic findings of cardiac sarcoidosis Role of echocardiography in treatment, risk stratification, and surveillance of cardiac sarcoidosis Other echocardiographic techniques for the detection of cardiac sarcoidosis References Cardiac Involvement in Hypereosinophilic Syndrome Demographics and presenting symptoms Pathophysiology Diagnostics and therapeutics References Endocrine Disease Hypothyroidism Hyperthyroidism Acromegaly Hypercortisolism Hyperaldosteronism Conclusion References Chagas Cardiomyopathy Demographic and presenting symptoms Pathophysiology Diagnosis, doppler echocardiography, prognosis, and therapeutics References Sickle Cell Disease Left ventricular structure and systolic function Diastolic dysfunction Pulmonary hypertension Other cardiac findings Screening considerations Limitations References Human Immunodeficiency Virus Pericardial disease Myocardial disease and cardiomyopathy Pulmonary hypertension Cardiac tumors and valvular disease Atherosclerotic disease References Cardiotoxic Effects of Cancer Therapy Cancer therapeutics-related cardiac dysfunction Definition Classification by Mechanism of Toxicity Type 1 Cancer Therapeutics-Related Cardiac Dysfunction Type 2 Cancer Therapeutics-Related Cardiac Dysfunction Combined Chemotherapy Echocardiographic evaluation of the patient receiving cancer therapy Two-Dimensional Echocardiography Contrast-Enhanced Echocardiography Three-Dimensional Echocardiography Contrast-Enhanced Three-Dimensional Echocardiography Stress Echocardiography and Cardiotoxicity Strain Imaging Diastolic Function and Cardiotoxicity Conclusions References Pregnancy and the Heart Physiologic changes with pregnancy Echocardiographic findings during normal pregnancy Cardiac Chamber Dimensions Left Ventricular Contractility and Ejection Fraction Right Ventricular Systolic Function Cardiac Output Diastolic Function Valve Function Pericardium References Cocaine Pathophysiology Clinical assessment Echocardiography Cocaine use in pregnancy Treatment References XXVIII Echocardiography in the Emergency Department Echocardiography in Emergency Clinical Presentation Diagnosis and prognosis in acute coronary syndrome Diagnostic Algorithms for Acute Coronary Syndrome Evaluation for Wall Motion Abnormalities Myocardial Contrast Echocardiography for Left Ventricular Opacification Myocardial Contrast Echocardiography Perfusion Imaging Hypotension and dyspnea Acute Complications of Myocardial Infarction The Hypotensive Patient References XXIX Interventional Echocardiography Introduction References Transcatheter Aortic Valve Replacement Transcatheter heart valve characteristics Patient selection Preprocedural imaging Procedural imaging Postimplantation follow-up References MitraClip Procedure Studies on effectiveness of mitraclip procedure Indications and patient selection Two-dimensional echocardiography Transesophageal echocardiography Three-dimensional transesophageal echocardiography Mitraclip procedure guidance Transseptal Puncture Steerable Guide Catheter Introduction into the Left Atrium Advancement of the Clip Delivery System into the Left Atrium Steering and Positioning of the MitraClip above the Mitral Valve Advancement of the MitraClip into the Left Ventricle Grasping of the Leaflets and Assessment of Proper Leaflet Insertion Assessment of Result and MitraClip Release Additional MitraClip Implantation Acknowledgments References Mitral Balloon Valvuloplasty Etiology of mitral stenosis Patient selection for balloon mitral commissurotomy Role of three-dimensional transesophageal echocardiography in balloon mitral commissurotomy Technique for balloon mitral commissurotomy Complications of balloon mitral commissurotomy Long-term results of balloon mitral commissurotomy Summary References Transcatheter Valve-in-Valve Implantation Valve in valve Imaging The procedure Complications Conclusion References Atrial and Ventricular Septal Defect Closure Atrial septal defect closure Surgical Atrial Septal Defect Closure Percutaneous Atrial Septal Defect Closure Role of Echocardiography in Percutaneous Atrial Septal Defect Closure Before Atrial Septal Defect Closure During Atrial Septal Defect Closure After Atrial Septal Defect Closure Ventricular septal defect closure Surgical Ventricular Septal Defect Closure Percutaneous Ventricular Septal Defect Closure Role of Echocardiography in Percutaneous Ventricular Septal Defect Closure References Transcatheter Cardiac Pseudoaneurysm Closure Left ventricular pseudoaneurysm Echocardiographic imaging Other imaging modalities Clinical course and treatment options Conclusions References Patent Foramen Ovale Prevalence Anatomy and embryology Pathophysiology Clinical presentations Cryptogenic stroke Migraine Decompression sickness in divers Platypnea-orthodeoxia syndrome Diagnosis Medical management Interventional closure Conclusion Acknowledgments References Fusion of Three-Dimensional Echocardiography with Fluoroscopy for Interventional Guidance Conclusion and future directions References XXX Miscellaneous Topics in Echocardiography Appropriate Use Criteria What are appropriate use criteria? What led to the development of appropriate use criteria? What do the appropriate use criteria for echocardiography tell us about current clinical practice? What can we learn from "inappropriate" (now termed "rarely appropriate") studies? How will the appropriate use criteria be implemented into clinical practice? References Carotid Ultrasound to Evaluate Cardiovascular Disease Risk: Carotid Intima-Media Thickness and Plaque Detection References Coronary Artery Imaging System settings for coronary flow imaging How to record coronary flow Detection of total occlusion of the coronary arteries Detection of proximal lad stenosis Summary References Inside Back Cover