ECHOCARDIOGRAPHY

Visualizes heart in real time with ultrasound; Doppler recordings noninvasively assess hemodynamics and abnormal flow patterns (Table 114-1 and Fig. 114-1). Imaging may be compromised in pts with chronic obstructive lung disease, thick chest wall, or narrow intercostal spaces. Transesophageal echocardiography (TEE) is performed when higher resolution images of cardiac structures is required.
TABLE 114-1: Clinical Uses of Echocardiography
2-D Echo
Cardiac chambers: size, hypertrophy, wall motion abnormalities
Valves: morphology and motion
Pericardium: effusion, tamponade
Aorta: aneurysm, dissection
Assess intracardiac masses
Doppler Echocardiography
Valvular stenosis and regurgitation
Intracardiac shunts
Diastolic filling/dysfunction
Approximate intracardiac pressures
Transesophageal Echocardiography
Superior to 2-D echo to identify:
 Infective endocarditis
 Cardiac source of embolism
 Prosthetic valve dysfunction
 Aortic dissection
Stress Echocardiography
Assess myocardial ischemia and viability
FIGURE 114-1
hmom20_ch114_f001.png
Two-dimensional echocardiographic still-frame images of a normal heart. Upper: Parasternal long axis view during systole and diastole (left) and systole (right). During systole, there is thickening of the myocardium and reduction in the size of the left ventricle (LV). The valve leaflets are thin and open widely. Lower: Parasternal short axis view during diastole (left) and systole (right) demonstrating a decrease in the left ventricular cavity size during systole as well as an increase in wall thickness. Ao, aorta. (Reproduced from Myerburg RJ: Harrison’s Principles of Internal Medicine, 12th ed, 1991.)

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