Echocardiography : a practical guide for reporting and interpretation

246 Pages·2016·9.489 MB·English

by  Helen Rimington, John Boyd Chambers

T H I R D E D I T I O N
MEDICINE/CARDIOLOGY
Echocardiography
T H I R D E D I T I O N
Echocardiography
A Practical Guide for Reporting
A Practical Guide for Reporting
and Interpretation
and Interpretation
Echocardiography: A Practical Guide for Reporting and Interpretation is a
step-by-step guide to clinical echocardiography.
This new edition has been extensively revised and includes new interna-
tional guidelines, grading criteria and normal data. The book presents an
up-to-date discussion of echocardiography use in both acute and critical
care settings and provides increased guidance for clinical interpretation,
including how echocardiography can help inform surgical decisions. In
addition, the content has been extended, particularly in the consideration
of valve disease and cardiomyopathies.
Providing a pragmatic approach to clinical echocardiography, the book also
covers examples of conditions requiring urgent clinical advice. It contains
a summary of formulae as well as supporting online images and videos.
Helen Rimington
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ISBN: 978-1-4822-3192-2
90000
John B. Chambers
9 781482 231922
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Echocardiography
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Echocardiography
A Practical Guide for Reporting and
Interpretation
Third edition
Helen Rimington BSc, PhD
Consultant Cardiac Physiologist
Guy’s and St Thomas’ Hospitals, London
John B. Chambers MD, FESC, FACC
Professor of Clinical Cardiology
Guy’s and St Thomas’ Hospitals, London
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CRC Press
Taylor & Francis Group
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© 2016 by Taylor & Francis Group, LLC
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Version Date: 20150803
International Standard Book Number-13: 978-1-4822-3193-9 (eBook - PDF)
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Contents
Preface ix
Acknowledgements xi
Author biographies xiii
Icons and QR codes xiv
Abbreviations xv
1 Introduction 1
Minimum standard echocardiogram 1
Organisation of a report 2
Indications for urgent clinical advice 4
Interpretation for the non-echocardiographer 5
2 Left ventricular dimensions and function 7
LV size and wall thickness 7
LV systolic function 10
LV diastolic function 15
Diastolic heart failure 18
3 Acute coronary syndrome 21
4 Cardiomyopathies 27
The dilated left ventricle 27
The hypertrophied left ventricle 32
Restrictive cardiomyopathy 37
Noncompaction 39
Arrhythmogenic right ventricular cardiomyopathy/dysplasia 41
5 The right ventricle 47
6 Pulmonary pressure and hypertension 53
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Contents
7 Aortic valve disease 59
Aortic stenosis 59
Aortic regurgitation 67
8 Mitral valve disease 75
Mitral stenosis 75
Mitral regurgitation 80
Specialist pre- and postoperative assessment 88
9 Right-sided valve disease 95
Tricuspid regurgitation 95
Tricuspid stenosis 99
Pulmonary stenosis and regurgitation 101
10 Replacement heart valves 109
General 109
Replacement valves in the aortic position 113
Replacement valves in the mitral position 117
Replacement valves in the tricuspid position 120
Replacement valves in the pulmonary position 122
11 Endocarditis 125
12 The aorta and dissection 131
The aorta 131
Dissection 136
13 The atria and atrial septum 141
The left atrium 141
The right atrium 141
The atrial septum 142
14 Adult congenital disease 149
Simple defects 150
Systematic study 159
Post-procedure studies 162
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Contents
15 Pericardial disease 167
Pericardial effusion 167
Pericardial constriction 172
Pericarditis 176
16 Masses 179
17 Echocardiography in acute and critical
care medicine 191
18 General clinical requests 199
19 Indications and appropriateness
criteria for echocardiography 207
Appendices 213
Appendix 1 Left ventricle 213
Appendix 2 Critical care monitoring 216
Appendix 3 Valve disease 220
Appendix 4 Summary of formulae 227
Appendix 5 Figures 229
Index 233
vii
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Preface
This book provides a pragmatic approach to clinical echocardiography. It gives a
step-by-step guide to performing and reporting a study as an aide-memoire for the
experienced echocardiographer or interpreting physician and as a learning tool for the
beginner.
Since the second edition, the text has been extensively revised by the inclusion of
new international guidelines, grading criteria and normal data. On occasion these are
not in agreement and we have then offered a balanced clinical view.
The clinical interpretation of echocardiography has been extended including criteria
for surgery in valve disease, and the diagnosis of diastolic heart failure. The integration
of echocardiography with other imaging modalities has also been described.
Echocardiography is increasingly used in acute medicine and intensive care units,
and a systematic approach to devolved echocardiography has consolidated enough for
us to include focused studies in addition to standard echocardiograms. The chapter on
checklists in clinical presentations has been extended.
The text has also been reformatted to be more easily accessible, and numerous
diagrams have been added. Images and clips have been placed in a web-based
archive.
This book will be relevant to all echocardiographers including cardiac physiologists,
sonographers, clinical scientists, cardiologists, and clinicians in acute medicine, critical
care, and general and emergency medicine. It will also be useful to hospitals and
community physicians needing to interpret reports.
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Acknowledgements
We are grateful to colleagues who have provided valuable feedback: Stefanie
Bruemmer-Smith, Cathy Head, Ronak Rajani, David Sprigings and Kelly Victor.
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Author biographies
John Chambers is Professor of Clinical Cardiology and Consultant Cardiologist at
Guy’s and St Thomas’ Hospitals where he is Head of Noninvasive Cardiology. He has a
lifelong interest in teaching and training in echocardiography. He founded and ran the
London Echo Course for 10 years, is on the faculty of many national and international
teaching courses, and helped set up the British Society of Echocardiography
accreditation systems in transthoracic echocardiography. From 1995 to 1998 he was
British Society of Echocardiography examiner and he was its President between 2003
and 2005. He was President of the British Heart Valve Society from 2010 to 2013. His
research is mainly in the optimal timing of surgery in heart valve disease.
Helen Rimington is Consultant Cardiac Physiologist at Guy’s and St Thomas’
Hospitals. She has long been active within the British Society of Echocardiography,
helping to write standards for departmental accreditation and chairing the
departmental accreditation committee between 2008 and 2012. She was British
Society of Echocardiography Vice President from 2009 to 2011 and helped set up the
national quality assurance programme jointly with the British Heart Foundation. She
represents the society at the IQIPS standard committees and has been involved in
developing the specialist Clinical Scientist training programmes in cardiology. Since
2012 she has represented physiologists at the Academy of Healthcare Science. Her
research interests are in quality of life after heart valve surgery.
xiii
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