100 Challenges in Echocardiography by Christophe Klimczak MD PhD, Petros Nihoyannopoulos MD FRCP

By Christophe Klimczak MD PhD, Petros Nihoyannopoulos MD FRCP FACC FESC

This publication deals either skilled cardiologists and trainees alike the chance to spot and handle the most typical pitfalls encountered with echocardiology in regimen scientific perform. The ebook covers a sequence of demanding situations starting from technical problems to issues of echocardiographic interpretation with each one part proposing a chain of simulations to check the reader's figuring out of the matter. The textual content is written in a hugely useful and didactic kind with a purpose to aid the busy health care professional by means of providing the knowledge in a succinct, 'essentials basically' demeanour. The heavy use of top of the range illustrations serves to make sure that the thoughts defined are supported via real-life examples and hence comfortably appropriate to the medical setting.Edited by way of a world expert.Abundant use of full-colour permits actual illustration of pictures to find the money for designated dialogue of the strategies involved.Didactic technique guarantees supply of key details in viable parts therefore saving time for the busy cardiologist.Includes the main common pitfalls linked to various concepts therefore making sure applicability to a number of scientific settings and gear availability.

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2 Segmentation of the mitral valve (MV) explored in multiplanar TEE: three segments of the large mitral valve (A1, A2, A3) and three segments of the small mitral valve (P1, P2, P3). The two mitral valve leaflets are separated by two commissures: the anterior commissure (AC) between A1 and P1, and the posterior commissure (PC) between A3 and P3. The TEE planes that can be used to study the different mitral segments are: 0°, A1 and P1; 45°, AC and PC; 90°, A3 and P3; 140°, A2 and P2. AO, aorta; LAR, left auricle.

Finally, post-extrasystolic complexes should be avoided when measuring the subaortic VTI, as they lead to a post-extrasystolic increase in the subaortic flow. Pitfalls when recording the stenotic flow The transvalvular stenotic flow (mitral or aortic) is recorded using continuous Doppler. 4). Poor alignment of the Doppler beam with the stenotic flow Poor alignment of the Doppler beam with the stenotic flow leads to an incomplete recording of the stenotic jet and a ‘hoarse’ and vibrant Doppler sound.

Study of the subvalvular apparatus is more difficult than that of the valves, probably because subvalvular lesions are more complex and are often not easily picked up by transthoracic echocardiography (TTE). Identification of such lesions is much more precise in TEE. Failure to diagnose a bicuspid aortic valve It is sometimes difficult to identify a bicuspid valve when using TTE, as the extent of calcification does not allow for good definition of the commissures or the number of semilunar cusps.

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