ASE s Comprehensive Echocardiography 3rd Edition by Roberto M Lang, Steven A Goldstein, Itzhak Kronzon, Bijoy K Khandheria, Muhamed Saric, Victor Mor Avi ISBN 9780323698306 0323698301

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ISBN 10: 0323698301
ISBN 13: 9780323698306
Author: Roberto M Lang, Steven A Goldstein, Itzhak Kronzon, Bijoy K Khandheria, Muhamed Saric, Victor Mor Avi

Edited by a team of leading echocardiography experts and endorsed by the American Society of Echocardiography, ASE’S Comprehensive Echocardiography, 3rd Edition, covers the full spectrum of sonography of the heart in one succinct, authoritative resource. This highly regarded text provides must-know information on everything from basic foundations and principles to clinical application, written and edited by ASE members with expertise in each specific area. Case studies, numerous tables, high-quality images and videos highlight the latest uses of echocardiography, including the most recent 2D and 3D advances.

• Discusses all the latest methods to assess cardiac chamber size and function, valvular stenosis/regurgitation, cardiomyopathies, coronary artery disease, complications of myocardial infarction, and other cardiac pathologies. 

• Covers recent advances in critical care echocardiography, cardio-oncology, structural heart disease, interventional/intraoperative echocardiography, strain imaging of left and right heart chambers, multimodality imaging in systemic diseases, and novel 3D techniques. 

• Contains more than 1,200 updated images: echocardiograms (including 2D, 3D, and Doppler), diagrams, anatomic drawings, algorithmic drawings, and more. 

• Provides access to nearly 600 full-motion echocardiography video clips. 

• Keeps you up to date with the latest echocardiography practice guidelines and advanced technologies.

ASE s Comprehensive Echocardiography 3rd Edition Table of contents:

Section I. Physics and Instrumentation

1. General Principles of Echocardiography

Ultrasound

Transducer

Instrument

Artifacts

Virtual Beamforming

2. Three-Dimensional Echocardiography

Comparison Between Two- and Three-Dimensional Echocardiography Ultrasound Transducers

3. Doppler Principles

Doppler Effect

Color Doppler Displays

Spectral-Doppler Displays

Aliasing

Virtual-Beamforming

4. Tissue Doppler, Myocardial Work: Physics and Techniques

Tissue Doppler Imaging

Global Longitudinal Strain

Myocardial Work

Future Directions

5. Speckle-Tracking and Strain Measurements: Principles, Techniques, and Limitations

General Concepts

A Glance at the History: Tissue Doppler–Derived Strain

From the Present to the Future: Two- And Three-Dimensional Speckle-Tracking Echocardiography

6. Clinical Utility of Global Longitudinal Strain

Evaluation of Left Ventricular Systolic Function

Evaluation of the Right Ventricle

Evaluation of left Atrial Function

Section II. Transthoracic Echocardiography

7. Transthoracic Echocardiography: Nomenclature and Standard Views

Imaging Planes

Image Acquisition Windows

Scanning Maneuvers: Transducer Movement Descriptions

Transducer Orientation

Standard Views: Two-Dimensional Imaging

8. Technical Quality and Tips

Optimizing Two-Dimensional Images

Avoiding Apical Foreshortening

Optimizing Spectral Doppler Traces

Optimizing Color Doppler Images

Alternate Windows

Summary

9. Transthoracic Echocardiography Tomographic Views

Parasternal Window

Transthoracic Apical Window

Subcostal Window

Transthoracic Suprasternal Window

Off-Axis Views

10. M-Mode Echocardiography

Left Ventricle

Mitral Valve

Aortic Valve

Pulmonic Valve

Pericardial Disease

Cardiac Tamponade

Constrictive Pericarditis

11. Doppler Echocardiography: Normal Antegrade Flow Patterns

Basic Concepts

Technical Considerations For Optimal Doppler Recordings

Individual Flow Profiles

Emerging Applications Of Doppler: Intracardiac Flow Analysis

Section III. Transesophageal Echocardiography

12. Introduction to Transesophageal Echocardiography: Indications, Risks, Complications, and Protocol

Preprocedural Assessment

Anesthesia and Sedation

Movements of TEE Transducer

Transducer Insertion and Manipulation

Sample Protocol

13. Transesophageal Echocardiography Tomographic Views

Midesophageal Five-Chamber View

Midesophageal Four-Chamber View

Midesophageal Mitral Commissural View

Midesophageal Two-Chamber View

Midesophageal Long-Axis View

Midesophageal Aortic Valve Long-Axis View

Midesophageal Ascending Aorta Lax View

Midesophageal Ascending Aorta Short-Axis View

Midesophageal Right Pulmonary Vein View

Midesophageal Aortic Valve Short-Axis View

Midesophageal Right Ventricle Inflow–Outflow View

Midesophageal Modified Bicaval Tricuspid Valve View

Midesophageal Bicaval View

Midesophageal Right And Left Pulmonary Veins View

Midesophageal Left Atrial Appendage View

Transgastric Basal Short-Axis View

Transgastric Midpapillary Short-Axis View

Transgastric Apical Short-Axis View

Transgastric Right Ventricular Basal View

Transgastric Right Ventricular Inflow–Outflow View

Deep Transgastric Five-Chamber View

Transgastric Two-Chamber View

Transgastric Right Ventricle Inflow View

Transgastric Long-Axis View

Descending Aorta Short-Axis And Descending Long-Axis Views

Upper Esophageal Aortic Arch Long-Axis View

Upper Esophageal Aortic Arch Short-Axis View

14. Applications of Transesophageal Echocardiography

Diagnostic Applications

Intracardiac Thrombus And Mass Evaluation

Patent Foramen Ovale And Septal Defects

Endocarditis

Aortic Disease

Critical Care Applications Of Transesophageal Echocardiography

Intraoperative Applications Of Transesophageal Echocardiography

Intraprocedural And Structural Applications Of Transesophageal Echocardiography

Conclusions

15. Pitfalls and Artifacts in Transesophageal Echocardiography

Pitfalls Of Transesophageal Echocardiography

Transesophageal Echocardiography Artifacts

Conclusions

Section IV. Handheld Echocardiography

16. Cardiac Point-of-Care Ultrasound: Background, Instrumentation, and Technique

When a Stat Echo is Not Fast Enough

Pocus: Intents and Purposes

Instrumentation: Form Fits Function

Pocus: diversity in practice and outcomes

Pocus can Affect Referral for Echocardiography

Incidental findings: the achilles heel of pocus?

The Value of Lung Pocus Data in Echocardiography

Discrepancies Between Pocus and Echocardiographic Results

Conclusion

17. Focused Cardiac Ultrasound in Emergency Clinical Settings

Chest Pain

Hypotension

Dyspnea

Cardiac Arrest (Advanced Cardiac Life Support)

Section V. Contrast Echocardiography

18. Ultrasound-Enhancing Agents

Currently Available Second-Generation Ultrasound Contrast Agents

Ultrasound Contrast Agent Composition

Technical Considerations to Optimize Contrast Enhancement

Role of Health Care Professionals in Maintaining Ultrasound-Enhancing Agent Quality

Role of Sonographer/Nurse

Safety of Ultrasound Contrast Agents

19. Physical Properties of Microbubble Ultrasound Contrast Agents

Microbubble Contrast Agents

Contrast-Specific Imaging Techniques

Clinical Perspective

20. Applications of Ultrasound Contrast Agents

Clinical Applications

Summary

21. Use of Contrast in the Intensive Care Unit and Emergency Department

Contrast Use in the Intensive Care Unit

Contrast Use in the Emergency Department

Summary

22. Technical Aspects of Contrast Echocardiography

Indications

Available Types of Contrast Agents

Step-by-Step Protocol

Complications of Ultrasound-Enhancing Agents

Section VI. Left Ventricular Systolic Function

23. Left Ventricular Systolic Function: Basic Principles

Functional Anatomy of the Left Ventricle

Left Ventricular Volume and its Dynamic Geometry

Generating Left Ventricular Ejection from Contraction of Myofibrills

Cardiac Cycle

Determinants of Left Ventricular Performance

Response to Exercise

24. Global Left Ventricular Systolic Function: Ejection Fraction Versus Strain

Indications for Systolic Function Evaluation

Limitations of Ejection Fraction

The Role of Global Longitudinal Strain

Choice for Assessment Tool of Left Ventricular Systolic Function in Multimodality Era

Conclusions

25. Regional Left Ventricular Systolic Function

Assessment of Regional LV Systolic Dysfunction

Clinical Applications

26. Myocardial Strain in Valvular Heart Disease

Strain As An Additive To Ejection Fraction In Valvular Heart Disease

Strain In Mitral Regurgitation

Strain In Aortic Stenosis

Strain In Aortic Regurgitation

Section VII. Right Heart

27. Right Ventricular Anatomy

Coronary Flow To The Right Ventricle

Echocardiographic Assessment Of Right Ventricular Anatomy

Reference Values For Right Ventricular Structure

28. The Physiologic Basis of Right Ventricular Echocardiography

Structure And Anatomy Of The Right Ventricle

Right Ventricular Hemodynamics

Quantitative Assessment Of Right Ventricular Function

Coronary Blood Flow Of The Right Ventricle

Interventricular Dependence

Right Ventricular Diastolic Function

Rhythm Disturbances Originating From The Right Ventricle

Conclusion

29. Imaging the Right Heart: Limitations and Technical Considerations

Core Limitations Of Imaging

Challenges In Evaluating Rv Size And Structure

Pitfalls In Assessment Of Rv Function

Overcoming Technical Challenges Of Two-Dimensional Transthoracic Echocardiography With Advanced Imaging

Right Atrium

30. Assessment of Right Ventricular Systolic and Diastolic Function

Anatomy And Physiology

Quantitative Evaluation By Echocardiography

Right Ventricular Diastolic Function

Clinical Impact Of Right Ventricular Size And Function: Prognosis

Summary And Recommendations

31. Right Ventricular Hemodynamics

Flow

Pressure

Resistance

Right Heart Hemodynamic Measures

Secondary Indices Of Right Atrial Pressure

Summary

32. The Right Atrium

Anatomy

Physiology

Echocardiographic Views

Anatomic Variants

Right Atrial Size And Function

Clinical Implications Of Right Atrial Enlargement And Dysfunction

Right Atrium Pressure And Performance

Conclusions

33. Pulmonary Embolism

Diagnosis

Transthoracic Echocardiography

Transesophageal Echocardiography

Prognosis

Summary

Section VIII. Diastolic Function

34. Physiology of Diastole

Left Ventricular Relaxation

Left Ventricular Stiffness

Ventricular–Arterial Coupling

Diagnosis of Heart Failure with Preserved Ejection Fraction

35. Echo Doppler Parameters of Diastolic Function

Doppler Mitral Flow Velocity Patterns

Valsalva Maneuver

Pulmonary Venous Flow

Color M-Mode Flow Propagation Velocity

Tissue Doppler Annular Velocity

Myocardial Performance Index

Pulmonary Artery Systolic Pressures

Integration of Doppler Echocardiography Parameters

Conclusion

36. Clinical Recommendations for Echocardiography Laboratories for Assessment of Left Ventricular Diastolic Function and Filling Pressures

Estimation of Left Ventricular Filling Pressure and Left Ventricular Diastolic Function Grading

Stress Testing for Assessment of 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 American Society of Echocardiography/European Association of Cardiovascular Imaging Diastolic Function Grade

37. Causes of Diastolic Dysfunction

Definitions

Diastolic Heart Failure Versus Heart Failure with Preserved Ejection Fraction

Comorbidities Associated with Heart Failure with Preserved Ejection Fraction

Diastolic Dysfunction in Restrictive Cardiomyopathy

Physiologic Changes Associated with Heart Failure with Preserved Ejection Fraction

Phenotyping Heart Failure with Preserved Ejection Fraction

Impact on Survival

Section IX. Left Atrium

38. Assessment of Left Atrial Size

Prognostic Value of Left Atrial Size

Conclusions

39. 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

Section X. Ischemic Heart Disease

40. Ischemic Heart Disease: Which Test to Use?

Patient Selection for Noninvasive Testing

Selecting the Optimal Noninvasive Test for Ischemic Heart Disease Diagnosis: A Proposed Approach

General Approach: Functional Testing Strategies

Diagnostic Accuracy of Functional Testing Strategies

General Approach: Anatomical Strategies Using Coronary Computed Tomography Angiography

Diagnostic Accuracy of Coronary Computed Tomography Angiography

Integrating Functional and Anatomical Strategies

Summary

41. Ischemic Heart Disease: Basic Principles

Acute Effects Of Myocardial Ischemia

Echocardiographic Detection Of Myocardial Ischemia And Infarction

Myocardial Deformation During Cardiac Ischemia

Patterns Of Ischemia Based On Coronary Artery Involvement

False Indications Of Ischemia On Echocardiography

42. Acute Chest Pain Syndromes: Differential Diagnosis

Left Ventricle

43. 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

44. Echocardiography in Stable Coronary Artery Disease

Diagnosis

Prognosis

Stress Echocardiography

Image Interpretation

Prognostic Value Of Stress Echocardiography

Speckle Tracking With Stress Echocardiography

Conclusion

45. Old Myocardial Infarction

Timing of Imaging

Risk Factors for Chronic Remodeling

Chronic Remodeling

Viability

Summary

46. End-Stage Cardiomyopathy Due to Coronary Artery Disease

Determining The Cause of Ventricular Dysfunction

Characterization of Left Ventricular Size and Function

Right Ventricle

Left Ventricular Aneurysm

Functional Mitral Regurgitation

47. Coronary Artery Anomalies

Classification of Coronary Artery Anomalies

Multimodality Imaging for Identification of Congenital Coronary Artery Anomalies

Imaging Protocol for Transthoracic Echocardiography

Incidence of Coronary Anomalies Diagnosed by Echocardiography

Perioperative Transesophageal Echocardiography

Conclusions

48. Coronary Artery Imaging

Instructions For Cfv Recording

Diagnostic Value Of Coronary Flow Velocity At Rest

Clinical Utility Of Coronary Flow Velocity Reserve

Conclusions

Section XI. Stress Echocardiography

49. Effects of Exercise, Pharmacologic Stress, and Pacing on the Cardiovascular System

Hemodynamic Effects

Mechanisms Of Ischemia

Left Ventricular Response To Stress

Comparisons Of Stressors

Hypertensive Response To Stress

Stress Echocardiography For Noncoronary Indications

Conclusions

50. Diagnostic Criteria and Accuracy

The Main Sign Of Ischemia: Regional Wall Motion Abnormalities

Stress Echocardiography In Four Equations

Diagnostic Results And Accuracy

False-Negative Results

False-Positive Results

Beyond Regional Wall Motion: The Abcde Protocol Of Stress Echocardiography

Toward Quantitative Stress Echocardiography

Conclusions

51. Stress Echocardiography: Methodology

General Test Protocol

Specific Test Protocols

Exercise

Dobutamine

Dipyridamole

Adenosine

Pacing

The Role of Contrast

52. Stress Echocardiography: Image Acquisition

53. Stress Echocardiography: Prognosis

Evaluation for Obstructive Coronary Artery Disease

Prognostic Implications of the Diastolic Stress Test

Stress Echocardiography In Hypertrophic Cardiomyopathy

Stress Echocardiography to Guide Risk Evaluation Before Major Noncardiac Surgery

Prognostic Role of Stress Echocardiography In Valvular Heart Disease

54. Echocardiography for the Assessment of Myocardial Viability in Ischemic Cardiomyopathy

Introduction and General Concepts

Assessment of Myocardial Viability by Echocardiography

Comparison of Methods Used for Viability Testing

Clinical Implications

55. Ultrasound-Enhanced Stress Echocardiography

Ultrasound-Enhancing Agents for Stress Echocardiography

Optimizing Ultrasound Enhancement During Stress Echocardiography

Physiologic Basis for Examining Myocardial Perfusion with UEAs

Technical Considerations and Components

Role of the Physician

Role of the Imaging Team

Advantages and Disadvantages of Real-Time Perfusion Echocardiography Versus Other Imaging Techniques

Acquisition of Real-Time Perfusion Echocardiography Images

Specific Stress Protocols

Dobutamine Stress Real-Time Perfusion and Left Ventricular Opacification Protocols

Vasodilator Stress Myocardial Perfusion Imaging

Pitfalls and Clinical Tips for all Real-Time Perfusion Echocardiography Stress Acquisitions and Interpretations

Future Directions

56. Stress Echocardiography for Valve Disease: Aortic Regurgitation and Mitral Stenosis

Stress Echocardiography Protocol

Aortic Regurgitation

Prognostic Value of Stress Echocardiography in Aortic Regurgitation

Mitral Stenosis

Prognostic Value of Changes in Transmitral Pressure Gradient and Systolic Pulmonary Artery Pressure

Impact on Clinical Decision Making

57. Stress Echocardiography: Comparison With Other Techniques

Aims of Noninvasive Coronary Imaging

Anatomy Versus Physiology

Coronary Artery Calcium Scoring

Computed Tomography Coronary Angiographyβ

Computed Fractional Flow Reserve Derived from Computed Tomography

Magnetic Resonance Coronary Angiography

Exercise Electrocardiography Stress Testing

Stress Echocardiography

Radionuclide Stress Myocardial Perfusion Imaging

Computed Tomography Perfusion

Cardiovascular Magnetic Resonance Perfusion

Conclusions

Section XII. Hypertrophic Cardiomyopathies

58. Pathophysiology and Variants of Hypertrophic Cardiomyopathy

Anatomic Variants

Pathophysiology

Physiologic Variants

End-Stage Hypertrophic Cardiomyopathy

59. 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

60. Differential of Hypertrophic Cardiomyopathy Versus Secondary Conditions That Mimic Hypertrophic Cardiomyopathy

Hypertensive Heart Disease

Athletes’ Hearts

Infiltrative Disorders of the Myocardium

Isolated Left Ventricular Non-Compaction Cardiomyopathy

Storage Diseases

Syndromic Hypertrophic Cardiomyopathy

61. Hypertrophic Cardiomyopathy: Assessment of Therapy

Pharmacotherapy

Surgical Myectomy

Alcohol Septal Ablation

62. Hypertrophic Cardiomyopathy: Screening of Relatives

Epidemiology of Hypertrophic Cardiomyopathy

Genetics of Hypertrophic Cardiomyopathy

Clinical Screening in Children and Adolescents

Clinical and Echocardiographic Screening in Adults

Findings in Hypertrophic Cardiomyopathy Gene Carriers

63. Apical Hypertrophic Cardiomyopathy

Morphology and Echocardiographic Features

Subtypes

Apical Aneurysms

Summary

64. The Role of Echocardiography in the Screening and Evaluation of Athletes

Exercise-Associated Cardiac Remodeling: the Left Ventricle

Exercise-Associated Cardiac Remodeling: Beyond the Left Ventricle

Detraining

Sudden Cardiac Death and Screening Strategies

Conclusions

65. Echocardiographic Assessment of Myocarditis

Cause of Myocarditis

Transthoracic Echocardiography

Electrocardiogram and Biomarkers

Cardiac Magnetic Resonance Imaging

Role of Endomyocardial Biopsy

Conclusion

Section XIII. Dilated and Other Cardiomyopathies

66. Dilated Cardiomyopathy: Etiology, Pathophysiology, and Echocardiographic Evaluation

Cause

Pathophysiology

Echocardiographic Features

Complementary Role of Alternative Modalities

Future Directions

Conclusion

Acknowledgment

67. Echocardiographic Predictors of Outcome in Patients With Dilated Cardiomyopathy

Left Ventricular Ejection Fraction and Dimensions

Left Ventricular Diastolic Dysfunction

Left Atrial Size

Secondary Mitral Regurgitation

Other Variables: Myocardial Viability, Ischemia, and Dyssynchrony

68. Right Ventricle in Dilated Cardiomyopathy

Pathophysiology of Right Ventricular Dysfunction

Echocardiographic Methods for Evaluating Right Ventricular Size and Function

Studies Evaluating Right Ventricular Function

Doppler S′

Conclusions and Recommendations

69. Restrictive Cardiomyopathy: Classification

70. Echocardiographic Diagnosis of Left Ventricular Noncompaction Cardiomyopathy

Clinical Spectrum Of Left Ventricular Noncompaction Cardiomyopathy

Diagnosis

Echocardiography

Conclusion

71. Hereditary and Acquired Infiltrative Cardiomyopathy

Clinical Spectrum

Diagnosis

Echocardiography

Speckle Tracking

Cardiac Magnetic Resonance

Endomyocardial Biopsy

Infiltrative Cardiomyopathy With The Dilated Phenotype

Conclusions

72. Endomyocardial Fibrosis

Cause

Epidemiology

Pathophysiology, Key Clinical Manifestations, And Disease Course

Physical Examination

73. Restriction Versus Constriction

Cause

Hemodynamics In Constriction And Restriction

Echocardiographic Differentiation Of Constriction And Restriction

74. Echocardiography in Arrhythmogenic Right Ventricular Cardiomyopathy

Two-Dimensional Echocardiography

Strain Quantification

Three-Dimensional Echocardiography

Other Imaging Modalities

Emerging Concepts Regarding Left Ventricular Involvement

Summary

75. Takotsubo Cardiomyopathy

76. Familial Cardiomyopathies

Friedreich Ataxia

Dystrophin Related Cardiomyopathies

Summary

77. Echocardiography in Cor Pulmonale and Pulmonary Heart Disease

Structural Abnormalities

Doppler Findings

Three-Dimensional Echocardiography

Myocardial Strain

Echocardiography And Prognosis

Echocardiography To Monitor Response To Therapy

Conclusion

Section XIV. Aortic Stenosis

78. Aortic Stenosis Morphology

Congenital Aortic Stenosis

Calcific (Degenerative) Aortic Stenosis

Rheumatic Aortic Stenosis

79. Quantification of Aortic Stenosis Severity

Normal Aortic Valve

Quantitative Diagnosis of Aortic Stenosis

Quantitative Doppler Assessment of Severity of Aortic Stenosis

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

New Classification Scheme For Aortic Stenosis

Serial Evaluation Of Aortic Stenosis

Physiologic Consequences Of Aortic Stenosis

Aortic Valve Sclerosis

80. Asymptomatic Aortic Stenosis

Natural History of Severe Aortic Stenosis

Risk of Deferring Intervention

Features that Predict Increased Risk

Evolving Understanding of the Risk of the Intervention

Future Directions

81. Aortic Stenosis: Risk Stratification and Timing of Surgery

Assessment of Left Ventricular Systolic Function

Unmasking Symptoms in “Asymptomatic” Patients

Other Elements of Echocardiography-Based Risk Stratification

Conclusion

82. Low-Flow, Low-Gradient Aortic Stenosis With Reduced Left Ventricular Ejection Fraction

Usefulness of Dobutamine Stress Echocardiography for Assessment of as Severity and Degree of Myocardial Impairment

Assessing Stenosis Severity

Assessing the Degree of LV Myocardial Impairment

Therapeutic Management of Low-LVEF Low-Flow, Low-Gradient Aortic Stenosis

Conclusions

83. Low-Flow, Low-Gradient Aortic Stenosis With Preserved Left Ventricular Ejection Fraction

Clinical Presentation and Pathophysiology of Paradoxical Low-Flow, Low-Gradient Aortic Stenosis

Conclusion

84. Asymptomatic Severe Aortic Stenosis

Natural History of Asymptomatic Severe Aortic Stenosis

Stress Testing

Outcomes and Future Research

85. Subaortic Stenosis

Epidemiology

Morphology

Cause and Pathophysiology

Diagnosis

Treatment

Acknowledgments

Section XV. Aortic Regurgitation

86. Aortic Regurgitation: Etiologies and Left Ventricular Responses

Anatomy of the Aortic Valve

Etiology of Aortic Regurgitation

Mechanism of Aortic Regurgitation

Left Ventricular Remodeling

87. Aortic Regurgitation: Pathophysiology

Aortic Regurgitation Pathophysiology

Acute Aortic Regurgitation

Chronic Aortic Regurgitation

88. Quantitation of Aortic Regurgitation

Quantitation of Aortic Regurgitation

Conclusions

89. Risk Stratification: Timing of Surgery and Percutaneous Interventions for Aortic Regurgitation

Medical Therapy

Percutaneous Interventional Therapy

Left Ventricular Assist Devices

Surgical Therapy

Decision Algorithms for Surgical Treatment of Aortic Regurgitation

Severe Acute Aortic Regurgitation

Severe Chronic Aortic Regurgitation

Section XVI. Mitral Stenosis

90. Rheumatic Mitral Stenosis

Cause of Mitral Stenosis

Epidemiology

Pathophysiology

Physical Examination

Electrocardiography

Chest Radiography

Transthoracic Echocardiography

Transesophageal Echocardiography

Therapy

91. Quantification of Mitral Stenosis

Mitral Valve Area Measurements

Invasive Method

Echocardiography Methods

Mean Pressure Gradient Measurements

Secondary Changes Caused by Mitral Stenosis

92. Nonrheumatic Etiologies of Mitral Stenosis: Situations That Mimic Mitral Stenosis

Mitral Annular Calcification

Other Nonrheumatic Forms of Acquired Mitral Stenosis

93. Role of Hemodynamic Stress Testing in Mitral Stenosis

Indications for hemodynamic stress testing in mitral stenosis according to the most recent guidelines:

Valvular Stress Echocardiography

Exercise Stress Echocardiography

Dobutamine Stress Echocardiography

Summary

94. Consequences of Mitral Stenosis

Pulmonary Edema

Pulmonary Hypertension

Right Heart Failure

Atrial Arrhythmias

Atrial Thrombus

Low Cardiac Output

Other Valve Involvement

Pregnancy

Complications From Percutaneous Mitral Valvotomy

Valve Repair Surgery

Summary

Section XVII. Mitral Regurgitation

95. Etiologies and Mechanisms of Mitral Valve Dysfunction

Causes of Mitral Valve Disease

Mitral Valve Lesions

Mitral Valve Dysfunction

96. Mitral Valve Prolapse

Etiology

Arrhythmogenic Mitral Valve Prolapse

Diagnosis

Risk Stratification For Surgery

Surgical Mitral Valve Repair

Percutaneous Mitral Valve Repair

Summary

97. Secondary Mitral Regurgitation

Mechanisms

Echocardiographic Assessment of Secondary Mitral Regurgitation

Prognosis

Management of Ischemic Mitral Regurgitation

98. Quantification of Mitral Regurgitation

Echocardiographic Assessment of Mr

Two-Dimensional Proximal Isovelocity Surface Area Method

Two-Dimensional Volumetric Method

Three-Dimensional Echocardiography

Supportive Findings

Cardiac Magnetic Resonance Imaging Role in Mitral Regurgitation Assessment

Summary

Acknowledgments

99. Asymptomatic Severe Mitral Regurgitation

Approach to Asymptomatic Severe Mitral Regurgitation

Surgical Indications in Asymptomatic Patients

Watchful Waiting Versus Early Surgery

Global Longitudinal Strain and Severe Mitral Regurgitation

100. Role of Exercise Stress Testing in Mitral Regurgitation

Exercise Stress Echocardiography Protocol

Primary Mitral Regurgitation

Secondary (Ischemic) Mitral Regurgitation

Other Exercise Testing in Mitral Regurgitation

Section XVIII. Tricuspid and Pulmonic Valve Disease

101. Tricuspid Valve Complex: Anatomy by Two-Dimensional and Three-Dimensional Echocardiography

Tricuspid Valve Anatomy

Imaging of Tricuspid Valve With Two-Dimensional Echocardiography

Imaging of Tricuspid Valve With Three-Dimensional Echocardiography

102. Epidemiology, Etiology, and Natural History of Tricuspid Regurgitation

Epidemiology

Cause and Mechanisms of Tricuspid Regurgitation

Natural History

103. Quantification of Tricuspid Regurgitation

Color Jet Area

Vena Contracta Width

Continuous-Wave Doppler Spectral Tracing

Pulsed-Wave Doppler Flow in the Hepatic Vein

Proximal Isovelocity Surface Area Analysis

104. Indications for Tricuspid Valve Intervention

Severity of Tricuspid Regurgitation

Right Ventricular Function

Late Development of Tricuspid Regurgitation after Mitral Valve Surgery

105. Imaging for Surgical and Percutaneous Tricuspid Valve Procedures

Current Guidelines: Indications for Surgical Intervention and Outcomes

Surgical Tricuspid Valve Intervention

Transcatheter Tricuspid Valve Interventions

Examples of Procedural Guidance for Specific Devices

Future Perspective

Conclusions

106. Device Lead–Associated Tricuspid Regurgitation

Cardiac Implantable Electronic Devices and Tricuspid Regurgitation

Natural History of Cardiac Implantable Electronic Device–Induced Tricuspid Regurgitaton

Mechanisms of Cardiac Implantable Electronic Device–Induced Tricuspid Regurgitaton

Echocardiography in the Diagnosis of Cardiac Implantable Electronic Device–Induced Tricuspid Regurgitaton

Future Directions

107. Pulmonic Regurgitation: Etiology and Quantification

Pulmonic Regurgitation Evaluation Overview

Cause and Mechanism of Pulmonic Regurgitation

Semiquantitative Assessment of the Severity of Pulmonic Regurgitation

Color Doppler

Continuous-Wave Spectral Doppler

Pulsed-Wave Spectral Doppler

M-Mode Echocardiography

Impact of Pulmonic Regurgitation on Cardiac Chambers

108. Tricuspid and Pulmonic Stenosis

Tricuspid Stenosis

Pathophysiology

Diagnosis

Management

Pulmonic Valve Stenosis

Management

Section XIX. Prosthetic Valves

109. Classification of Prosthetic Valve Types and Fluid Dynamics

Different Types of Prosthetic Valves

Tissue Valves

Transcatheter Bioprosthetic Valves

Pressure Recovery

Localized High Gradient in Bileaflet Mechanical Valves

Prosthesis–Patient Mismatch

Conclusion

110. Aortic Prosthetic Valves

Standard Transthoracic Echocardiography Assessment of Aortic Prosthetic Valve Function

Diagnosis of Aortic Prosthetic Valve Dysfunction

Aortic Prosthetic Valve Regurgitation

Summary

111. Mitral Prosthetic Valves

Standard Tte Assessment of Mitral Prosthetic Valve Function

Diagnosis of Mitral Prosthetic Valve Dysfunction

Doppler Detection and Quantitation of Mitral Prosthetic Valve Regurgitation

Optimal Use of Transesophageal Echocardiography

Summary

112. Mitral Valve Repair

Pre–Cardiopulmonary Bypass Transesophageal Echocardiographicexamination

Post–Cardiopulmonary Bypass Transesophageal Echocardiographic Examination

Three-Dimensional Echocardiography for Mitral Valve Surgery

113. Tricuspid and Pulmonic Prosthetic Valves

Tricuspid Valve Prosthesis Dysfunction

Echocardiographic Assessment of Prosthetic Tricuspid Valve Function

Prosthetic Valve Regurgitation

Transesophageal Echocardiography in Patients with Prosthetic Tricuspid Valves

Three-Dimensional Echocardiography

Transcatheter Valve-In-Valve Implantation

Prosthetic Pulmonic Valves

Prosthetic Pulmonary Valve Regurgitation

Section XX. Infective Endocarditis

114. Infective Endocarditis: Role of Transthoracic Versus Transesophageal Echocardiography

Role of echocardiography: transthoracic versus transesophageal echocardiography

Complications of infective endocarditis

115. Echocardiography for Prediction of Cardioembolic Risk

Spectrum of Cardioembolism

Echocardiographic Evaluation

Specific Cardioembolic Clinical Situations

Conditions That Are Low or Uncertain Risk For Cardioembolism

Conclusion

116. Limitations and Technical Considerations in Infective Endocarditis

Echocardiography in Diagnosis of Native Valve Infective Endocarditis

Echocardiography in The Diagnosis of Prosthetic Valve Endocarditis

Echocardiography in Diagnosis of Infective Endocarditis Complications or Perivalvular Extension

117. Echocardiography and Decision Making for Surgery

Transthoracic Echocardiography Versus Transesophageal Echocardiography In Infective Endocarditis

Echocardiography and Surgical Decision Making In Infective Endocarditis

Conclusion

118. Intraoperative Echocardiography in Infective Endocarditis

Section XXI. Pericardial Disease

119. Normal Pericardial Anatomy

Phylogeny and Embryology

Basic Anatomy

Pericardial Thickness

Pericardial Fluid

Intrapericardial Pressure

Intrapericardial Versus Extrapericardial Heart Structures

Pericardial Fat

Pericardial Extensions

120. Pericarditis

Definition

Epidemiology

Etiology

Diagnostic Evaluation

Clinical Features

Electrocardiography

Chest Radiography

Laboratory Studies

Echocardiography

Magnetic Resonance Imaging

Computed Tomographic Imaging

Treatment

121. Pericardial Effusion and Cardiac Tamponade

Normal Anatomy of The Pericardium

Pericardial Effusion

Cardiac Tamponade

Echocardiography-Guided Pericardiocentesis

Summary

122. Constrictive Pericarditis

Demographics and Presenting Symptoms

Pathophysiology

Diagnostics

Echocardiography

Pulsed Doppler Studies

Tissue Doppler

Treatment

123. Effusive Constrictive Pericarditis

Epidemiology

Cause

Pathophysiology

Diagnostic Tests

Other Techniques

Treatment

124. Pericardial Cysts and Congenital Absence of the Pericardium

Pericardial Cysts

Absence of the Pericardium

Section XXII. Tumors and Masses

125. Primary Benign, Malignant, and Metastatic Tumors of the Heart

Tumor Classification and Frequency

Primary Benign Tumors

Primary Malignant Tumors

Metastatic Tumors

Summary

126. 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

127. Left Atrial Appendage Thrombus

Pathogenesis of Left Atrial Appendage Thrombus Formation

Transesophageal Echocardiographic Diagnosis of Left Atrial Thrombus

Additional Diagnostic Techniques

Cardiac Computed Tomography and Magnetic Resonance Imaging

Clinical Implications of the Diagnosis of Left Atrial Thrombus by Transesophageal Echocardiography

128. Right Heart Thrombi

Incidence

Risk Factors

Echocardiographic Imaging of Right Heart Thrombi

Right Heart Thrombi Morphology

Specific Echocardiography Imaging Strategies for Right Heart Thrombi

Tissue Characterization and Contrast Perfusion

Conventional Management Strategies

Contemporary Management Strategies

Conclusion

129. Normal Anatomic Variants and Artifacts

Crista Terminalis

Eustachian Valve

Chiari Network

Thebesian Valve

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

Section XXIII. Diseases of the Aorta

130. 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

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Tags: Roberto M Lang, Steven A Goldstein, Itzhak Kronzon, Bijoy K Khandheria, Muhamed Saric, Victor Mor Avi, ASE s Comprehensive Echocardiography