Anatomic Basis of Echocardiographic Diagnosis (eBook)

Foreword 5
Preface 7
Contents 9
1: General Anatomy of the Heart in the Chest 15
Atrial Anatomy 16
Tricuspid Valve Anatomy 19
Right Ventricle Anatomy 20
Pulmonary Valve Anatomy 20
Mitral Valve Anatomy 20
Left Ventricle Anatomy 22
Aortic Valve Anatomy 22
Echocardiography Considerations 23
External Versus Internal Landmarks 28
Summary 40
References 40
2: Age-Related Cardiac Changes 41
Fenestrations 41
Lambl’s Excresences 41
Mitral Annular Calcification 43
Calcific Aortic Valve Changes 45
Age-Related Amyloidosis 47
Age-Related Cardiac Chamber Changes 48
Summary 50
References 50
3: Aortic Valve 52
Aortic Stenosis 52
Age-Related Calcific Valve Stenosis 54
Congenitally Bicuspid Aortic Valve 55
Post-inflammatory Rheumatic Aortic Stenosis 56
Sub-aortic Valve Stenosis 57
Dynamic Subaortic Obstruction 59
Supravalvular Aortic Stenosis 60
Echocardiographic Assessment of Aortic Valve Morphology 61
Assessment of Aortic Stenosis Severity 66
Left Ventricular Adaptation to Aortic Stenosis 70
Aortic Valve Regurgitation 72
Congenitally Bicuspid Valve 72
Post-inflammatory Changes 73
Other Valvular Causes of Aortic Regurgitation 74
Aortic Causes of Aortic Valve Regurgitation 77
Echocardiographic Consideration in Aortic Regurgitation 78
Assessment of Aortic Regurgitation Severity 81
Summary 82
References 86
4: Mitral Valve 88
Mitral Stenosis 91
Echocardiography Considerations 96
Assessment of Severity of Mitral Stenosis 98
Mitral Insufficiency 104
Anatomical Considerations 104
Leaflet Causes of Mitral Regurgitation 104
Myxomatous Valve Disease 105
Infective Endocarditis 107
Drug Related Causes of Mitral Regurgitation 107
Chordal Causes of Mitral Regurgitation 110
Ventricular Causes of Mitral Regurgitation 111
Mitral Annular Calcification 112
Papillary Muscle Causes of Mitral Regurgitation 113
Post-mitral Valve Repair 117
Assessment of Severity of Mitral Regurgitation 119
Quantitative Approach 119
Qualitative Approach 121
Summary 125
References 125
5: Tricuspid and Pulmonary Valve 127
Anatomical Considerations 127
Echocardiography Considerations 128
Tricuspid Valve Regurgitation 129
Ebstein’s Anomaly 131
Carcinoid Valve Disease 133
Severity of Tricuspid Regurgitation 135
Tricuspid Valve Stenotic Lesions 136
Pulmonary Stenosis 137
Pulmonary Regurgitation 139
Tricuspid and Pulmonary Valve Infective Endocarditis 140
Summary 140
References 154
6: Cardiomyopathies 156
Dilated Cardiomyopathy (DCM) 156
Noncompaction of the Ventricle 161
Hypertrophic Cardiomyopathy (HCM) 162
Restrictive Cardiomyopathy 170
Arrhythmogenic Right Ventricular Dysplasia – Arrhythmogenic Cardiomyopathy 173
Summary 181
References 181
7: Ischemic Heart Disease 184
Acute Ischemia 184
Global and Regional Function 185
Chest Pain Assessment 189
Myocardial Infarction 191
Papillary Muscle Rupture 193
Ventricular Septal Rupture 195
Dynamic Subaortic Stenosis 196
Free Wall Rupture 197
Takotsubo Cardiomyopathy 199
Right Ventricular Infarction 199
Chronic Complications of Myocardial Infarction 199
Left Ventricular True and False Aneurysm 201
Left Ventricular Thrombus 205
Atrial Infarction 208
Viability 208
Summary 211
References 215
8: Right Ventricular Diseases 217
Echocardiographic Assessment of Right Ventricle 219
Right Ventricular Areas and Fractional Area Change 221
Right Ventricular Volumes and Ejection Fraction 222
Eccentricity Index 222
Tricuspid Annular Plane Systolic Excursion 222
Myocardial Performance Index 223
Tissue Doppler Imaging 223
Strain and Strain Rate 224
Right Ventricular Failure and Pulmonary Hypertension 224
Trauma 229
Lines, Catheters, and Iatrogenic Disorders 230
Summary 231
References 235
9: Diseases of the Aorta 237
Acute Aortic Syndrome 239
Aortic Dissection 239
Intramural Hematoma 243
Aortic Rupture and Aortic Tear 245
Iatrogenic Aortic Dissection or Intramural Hematoma 246
Penetrating Aortic Ulcer 246
Traumatic Aortic Injury 247
Chronic Aortic Diseases 250
Aortic Dissection Post-Repair 250
Chronic Aortic Aneurysm 250
Aortic Pseudoaneurysm 251
Aortitis 252
Aortic Plaques 254
Aortic Neoplasm 258
Summary 258
References 267
10: Pericardial Diseases 269
Pericarditis and Pericardial Effusion 271
Pericardial Tamponade 274
Constrictive Pericarditis 278
Constrictive Pericarditis Versus Restrictive Cardiomyopathy 281
Pericardial Tumors 282
Absence of the Pericardium 285
Pericardial Cysts 285
Echo-Guided Pericardiocentesis 285
Summary 287
References 287
11: Prosthetic Heart Valves 289
Types of Prostheses 289
Morphologic Assessment of Prosthetic Valves 293
Hemodynamic Assessment of Prosthetic Valves 300
Prosthetic–Patient Mismatch 303
High Transprosthetic Gradient and Prosthetic Dysfunction 303
Prosthetic Valvular Regurgitation 309
Stress Echocardiography 310
Prosthesis-Related Complications 311
Summary 316
References 324
12: Infective Endocarditis and Related Conditions 327
Predisposing Factors 327
Diagnostic Approach 328
Complications 330
Local 331
Echocardiographic Correlates 335
Paravalvular Complications 338
Echocardiographic Correlates 342
Right-Sided Endocarditis 344
Prosthetic Valve Endocarditis 345
Culture Negative Endocarditis 350
Fungal Endocarditis 351
Nonbacterial Thrombotic Endocarditis 352
Rheumatic Fever Verrucous Endocarditis 353
Libman Sacks Endocarditis, Antiphospholipid, and Anticardiolipin Antibody Syndrome 353
Summary 354
References 355
13: Neoplasm, Cardiac Tumor 358
Echocardiographic Approach 359
Primary Benign Cardiac Tumors 363
Cardiac Myxoma 363
Cardiac Rhabdomyoma 368
Papillary Fibroelastoma 371
Other Benign Neoplasms 372
Primary Malignant Cardiac Tumors 374
Sarcoma 374
Metastatic Secondary Tumors 378
Summary 381
References 381
14: Congenital Heart Disease 383
Segmental Approach 383
Unrepaired Lesions 385
Atrial Septal Defect 385
Ventricular Septal Defects 388
Atrioventricular Septal Defect 390
Patent Ductus Arteriosus 391
Coarctation 391
Left Superior Vena Cava 395
Congenital Sinus of Valsalva Aneurysm 396
Postsurgical Conditions 396
Tetralogy of Fallot Postrepair 397
Complete Transposition of the Great Arteries Post Repair 398
Fontan Operation 399
Summary 399
References 408
15: Cardiac Source of Embolism 410
Diagnostic Difficulties 410
Diagnostic Approach 410
Diagnostic Yield versus Therapeutic Yield 412
Echocardiographic Findings 412
High-Risk Findings 412
Atrial Fibrillation 413
Mitral Stenosis 413
Aortic Plaque 414
Moderate-Risk Findings 416
Myocardial Infarction and Left Ventricular Dysfunction 416
Prosthetic Valves 416
Spontaneous Echo Contrast 417
Uncertain, Likely Low-Risk Findings 418
Chronic Left Ventricular Aneurysm 418
Patent Foramen Ovale 418
Atrial Septal Aneurysm 419
Intrapulmonary Shunt 420
Valvular Strands, Lambl’s Excrescences, Fibroelastoma 420
Valve Diseases 421
Summary 422
References 425
16: Assessment of Diastolic Function 427
Echo-Doppler Measures of Diastolic Function 428
Normal Diastolic Function 430
Mild Diastolic Dysfunction 431
Moderate Diastolic Dysfunction 431
Severe Diastolic Dysfunction 431
Summary 443
References 443
17: Cardiac Involvement by Systemic Diseases 445
Pathognomonic Findings Are Generally Uncommon but Can Be Key to the Diagnosis of the Underlying Disease 445
Nonspecific Findings Are More Common 446
Any Part of the Cardiovascular System May Be Affected 446
The Cardiac Involvement Can Be Focal or Diffuse 448
Myocardial Involvement is Common in Neuromuscular Diseases 448
Systemic Disease Can Be a Cause of Cardiomyopathy 449
Suspect Congenital Syndromes or Chromosomal Diseases in the Setting of Cardiac Malformations 450
Conclusion 459
References 459
18: Interventional Procedures 461
Permanent Pacemaker and Internal Defibrillator Leads 461
Cardiac Resynchronization 463
Device Closure of Intracardiac Defects 467
Atrial Septal Defect 467
Patent Foramen Ovale 468
Ventricular Septal Defect 470
Perivalvular Regurgitation 470
Percutaneous Aortic Valve Implantation 471
Percutaneous Mitral Valve Repair 473
Left Ventricular Assist Device 473
Summary 482
References 482
Index 485