Practical Manual of Echocardiography in the Urgent Setting In the acute care setting, medicine happens at full speed and with little margin for error. As echocardiography plays an ever more important role in the diagnosis of patients who present with symptoms that suggest a cardiovascular emergency, clinicians must learn to collect, process and act on echocardiographic information as quickly and effectively as possible. Practical Manual of Echocardiography in the Urgent Setting covers the essentials of echocardiography in the acute setting, from ultrasound basics to descriptions of all pertinent echocardiographic views to clear, stepwise advice on basic calculations and normal/abnormal ranges. This compact new reference: Provides step-by-step guidance to acquiring the correct views and making the necessary calculations to accurately diagnose cardiac conditions commonly encountered in urgent settings. Presents information organized by complaint/initial presentation so that readers can work from this first knowledge of the patient through the steps required to pinpoint a diagnosis. Covers echo basics, from sound wave characteristics/properties to common device settings to basic ultrasound formulas Includes diagnostic algorithms fitted to address the differential diagnosis in the most commonlyencountered clinical scenarios. Designed and written by frontline clinicians with extensive experience treating patients, Practical Manual of Echocardiography in the Urgent Setting is the perfect pocket-sized guide for residents in cardiology, emergency medicine, and hospital medicine; trainees in echocardiography; medical students on cardiology or emergency medicine rotations; technicians, nurses, attending physicians—anyone who practices in the urgent setting and who needs reliable guidance on echocardiographic views, data and normal/abnormal ranges to aid rapid diagnosis and decision-making at the point of care. RELATED TITLES: Kacharava, et al: Pocket Guide to Echocardiography; ISBN: 978-0-470-67444-4 Sun, et al: Practical Handbook of Echocardiography: 101 Case Studies; ISBN: 978-1-4051-9556-0

Table of Contents:
Contributors, x Preface, xiv 1 Ultrasound physics, 1 Vladimir Fridman Ultrasound generation, 7 Image formation, 9 Doppler ultrasound, 15 Summary and key points, 22 References, 22 2 The transthoracic examination, 23 Vladimir Fridman and Dennis Finkielstein Performing the echocardiogram, 33 Using the transducer, 35 Steps involved in a comprehensive transthoracic echocardiogram, 37 References, 40 3 Transesophageal echocardiography, 41 Salim Baghdadi and Balendu C. Vasavada Preparation of the patient, 42 Acoustic windows and standard views, 45 Clean-up and maintenance, 54 References, 56 4 Ventricles, 57 Deepika Misra and Dayana Eslava Left ventricle, 57 Right ventricle, 66 Atria, 72 Contrast echocardiography, 74 References, 77 5 Left-sided heart valves, 79 Muhammad M. Chaudhry, Ravi Diwan, Yili Huang, and Furqan H. Tejani Aortic valve, 79 Mitral valve, 94 References, 111 6 Right-sided heart valves, 113 Michael J. Levine and Vladimir Fridman Tricuspid valve, 113 Pulmonic valve, 122 Qp/Qs: Pulmonary to systemic flow ratio, 127 References, 127 7 Prosthetic heart valves, 129 Karthik Gujja and Vladimir Fridman Echocardiographic approach to prosthetic heart valves, 132 Approach to suspected valve dysfunction, 134 References, 140 8 The great vessels, 141 Vladimir Fridman and Hejmadi Prabhu Aorta, 141 Pulmonary artery, 147 D-septal shift, 151 References, 152 9 Evaluation of the pericardium, 153 Chirag R. Barbhaiya Pericardial effusions, 153 Cardiac tamponade, 154 Echo-guided pericardiocentesis, 159 Constrictive pericarditis, 161 Differentiation of constrictive pericarditis and restrictive cardiomyopathy, 163 Effusive–constrictive pericarditis, 165 References, 165 10 Specialty echocardiographic examinations, 167 Cesare Saponieri TTE in a VAD patient, 167 Intracardiac echocardiography, 169 TEE in the operating room, 171 Echocardiography to guide percutaneous closure devices placement, 172 References, 173 11 Common artifacts, 174 Padmakshi Singh, Moinakhtar Lala, and Sapan Talati References, 182 12 Hypotension and shock, 183 Sheila Gupta Nadiminti Determination of central venous pressure, stroke volume, cardiac output, and vascular resistance, 183 Hypovolemia, 184 Septic shock, 188 Cardiogenic shock due to left ventricular failure, 189 Cardiogenic shock due to right ventricular failure, 189 Cardiogenic shock due to acute valvular insufficiency or shunt, 190 Acute pulmonary hypertension/pulmonary embolism, 190 References, 193 13 Chest pain syndrome, 195 Sandeep Dhillon and Jagdeep Singh Myocardial Infarction, 195 Aortic dissection, 198 Pulmonary embolus, 199 Other causes, 201 References, 202 14 Cardiac causes of syncope and acute neurological events, 204 Erika R. Gehrie Hypovolemia, 205 Arrhythmias, 205 Aortic stenosis, 207 Cardiac tamponade, 207 Pacemaker malfunction, 207 Endocarditis, 207 Pulmonary embolism, 208 Stroke and transient ischemic attacks, 208 Cardiac masses, 212 References, 215 15 Acute dyspnea and heart failure, 216 Mariusz W. Wysoczanski Echocardiogram in “heart failure”, 216 Intracardiac pressures, 217 Echocardiographic approach to dyspnea with hypoxemia, 222 Differential diagnosis for cardiac induced dyspnea, 223 Algorithm for treatment, 223 References, 225 16 Evaluation of a new heart murmur, 226 Vinay Manoranjan Pai Acute valvular regurgitation, 226 Intracardiac shunts, 231 Pericardial effusion, 232 Post myocardial infarction, 232 References, 233 17 Infective endocarditis, 234 Luis Aybar Diagnosis and diagnostic accuracy, 234 Guidelines for use of echocardiography to diagnose endocarditis, 236 Appearance on echocardiography, 236 Complications and risk stratification, 238 Prosthetic valve endocarditis, 239 Cardiac device-related infective endocarditis, 240 References, 241 18 Post-procedural complications, 244 Vladimir Fridman Noncardiac procedures, 244 Cardiac procedures, 245 References, 247 19 “Quick echo in the emergency department”: What the EM physician needs to know and do, 248 Dimitry Bosoy and Alexander Tsukerman Goal of FOCUS, 248 Clinical use of FOCUS, 250 References, 252 Index, 253