Emergency echocardiography

275 Pages·2017·54.689 MB·English

by  Flachskampf, Frank A., Neskovic, Aleksandar N., Picard, Michael H

Emergency
Echocardiography
SE CO ND E DITION

Emergency
Echocardiography
S E C O N D E D I T I O N
edited by
Aleksandar N. Neskovic
Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade,
Belgrade, Serbia
Frank A. Flachskampf
Uppsala University Hospital, University of Uppsala, Uppsala, Sweden
Michael H. Picard
Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Contents
Preface to Second Edition vii 7. Echocardiography in acute
Preface to First Edition ix pulmonary embolism 93
Contributors xi Piotr Pruszczyk and Adam Torbicki
Image and Video Contributors xv
Important Technical Note xix 8. Echocardiography in cardiac
Abbreviations xxi tamponade 107
Mauro Pepi, Gloria Tamborini,
1. Emergency echocardiography: and Manuela Muratori
General considerations 1
9. Echocardiography in acute
Ivan Stankovic, Andreas Hagendorff,
aortic insufficiency 119
and Aleksandar N. Neskovic
Asaad A. Khan and Michael H. Picard
2. Echocardiography in acute
10. Echocardiography in acute mitral
myocardial infarction 11
regurgitation 125
Aleksandar N. Neskovic, Leonardo
Tomasz Baron and Frank A. Flachskampf
Bolognese, and Michael H. Picard
11. Echocardiography in obstruction
3. Echocardiography in complications of native valves 135
of acute myocardial infarction 35 Dmitriy Kireyev and Michael H. Picard
Aleksandar N. Neskovic, Predrag M.
12. Emergency echocardiography in
Milicevic, and Michael H. Picard
patients with prosthetic valves 141
Mauro Pepi and Frank A. Flachskampf
4. Echocardiography in acute heart
failure and cardiogenic shock 53
13. Echocardiography in detecting
Mohammed T. Ali and Michael H. Picard
cardiac sources of embolism 151
Satoshi Nakatani, Maria Joao
5. Echocardiography in cardiac arrest 67
Andrade, and Justiaan Swanevelder
Gregory M. Scalia and Julie A. Humphries
14. Emergency intraoperative
6. Echocardiography in acute aortic echocardiography 165
dissection 81 Patrick Collier, Zoran B. Popovic,
Tomasz Baron and Frank A. Flachskampf and Brian P. Griffin
vi Contents
15. Echocardiography in mechanical 18. Pocket-size imaging devices in
circulatory assistance 187 the emergency setting 221
David G. Platts and Gregory M. Scalia Ivan Stankovic and Satoshi Nakatani
16. Echocardiography in chest trauma 199 19. Focused cardiac ultrasound (FoCUS) 233
Gregory M. Scalia and Agatha Y. Kwon Gabriele Via, Guido Tavazzi,
and Silvia Mongodi
17. Stress echocardiography in
the emergency department 213 Index 247
Quirino Ciampi and Eugenio Picano
Preface to Second Edition
The use of echocardiography in cardiovascular emergency to imaging reality than still-frame illustrations can. New
situations continues to expand. Since the first edition of chapters, like that on mechanical circulatory assist devices
this book, cardiac ultrasound has become more widely and the FoCUS routine, have been also added, and all
available by introducing truly mobile, often pocket-sized chapters have been rewritten and updated.
devices that offer surprisingly good image quality. It has The editors are proud of this much-enhanced second
become more sophisticated by improving image quality edition and thank the authors and numerous colleagues
and adding tissue Doppler, strain imaging, and real-time who contributed their experience and material. The
3D imaging, as well as many electronic post-processing authors continue to be a truly international and intercon-
capabilities. Finally, its versatility and easy logistics are tinental band of friends that make this book much better
now harnessed by more medical specialties than ever, for than any single author could.
example, anesthesiologists, intensive care and emergency We hope it will again be found useful by the readers.
physicians.
Most of these aspects are represented in this book. The Aleksandar N. Neskovic, MD
authors have added an enormous wealth of often stun- Frank A. Flachskampf, MD
ning video examples that brings the book much nearer Michael H. Picard, MD

Preface to First Edition
A unique feature of current echocardiography machines is specific clinical situations are also discussed. Additionally,
their mobility, which allows examinations to be carried out the role and potential advantages of special echocardio-
wherever necessary – from echocardiographic l aboratories graphic techniques, such as transesophageal echocardiog-
to emergency departments, wards, catheterization labs, raphy, are discussed whenever appropriate.
electrophysiology labs and operating theatres. Information The book is illustrated by carefully selected echocar-
about the structure and function of the heart and its hemo- diographic images and schematics. At times some of the
dynamics can be obtained relatively rapidly and such infor- images may appear to be of relatively poor technical qual-
mation is of incomparable value for decision making in ity; however, we included them in the book because they
cardiovascular emergencies and the critically ill. represent images that are obtained under challenging con-
This book is intended to outline specific echocardio- ditions. Some of these are real rarities and contain exciting
graphic features and procedures pertinent to emergency information.
situations, in particular cardiologic severe acute ill- While we aimed to focus this book toward all members
nesses. Thus, it is not an introduction into echocardiog- of the health care team, it should be noted that echocardio-
raphy in general, and assumes a basic knowledge of the graphic examination in unstable patients in the emergency
technique. It should serve as a guide to rapid, up-to-date setting is a highly demanding procedure that requires
echocardiographic evaluation of life-threatening clinical both excellent technical skills to obtain adequate images
situations. in a stressful environment and the ability to interpret
Emergency Echocardiography consists of state-of-the- findings quickly and accurately. Therefore, despite efforts
art reviews on the role of cardiac ultrasound in emergency made to give complete overview of the field to the readers,
clinical settings. International experts discuss the use of the importance of appropriate echocardiographic training
echocardiography in acute coronary syndromes, acute and personal experience in the evaluation of emergency
native and prosthetic valve disease, cardiac tamponade, patients should not be neglected.
acute diseases of the great vessels, cardiac-related embo- Finally, we express our gratitude to all contributors who
lism, cardiac arrest, chest trauma and cardiogenic shock. generously and enthusiastically linked their talent and
Specific problems related to intraoperative echocardiog- experience with this project.
raphy, echocardiography in the emergency room and the The authors sincerely hope that this book will be found
use of portable echo machines in the emergency setting useful in everyday clinical practice and encourage feed-
were also addressed. Since echocardiography is already back, criticism and suggestions.
incorporated into patient management algorithms for the
majority of cardiac emergencies, special efforts were made Aleksandar N. Neskovic, MD
by the contributors to underline its diagnostic power. Frank A. Flachskampf, MD
Importantly, the limitations of echocardiography in Michael H. Picard, MD