Emergency Medicine Echocardiography Ppt Powerpoint Presentation slides Richard Kendall,Paul Atkinson Medical Slideshow Pediatric Emergency Medicine Research | Emergency Medicine

Emergency Medicine Echocardiography

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Slide 1 :

Echocardiography Pál Soltész M.D., Ph.D.

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Echocardiography I. useful diagnostic method ensuring a complete morphologic and functional evaluation of patients with cardiovascular disease possible to obtain all diagnostic parameters: tomographic features of the heart and vessels, analysis of the motion and structure of heart valves and walls, tissue characteristics and blood flow studies

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Basic principles ultrasounds used in medicine have frequencies between 1-20 MHz transducers generate and receive ultrasound waves, have one or more piezoelectric crystals

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Echocardiography II. Imaging modalities: M-mode, Two-dimensional, Doppler, TEE, contrast Evaluation of ventricular function, valvular heart disease, prosthetic valves, coronary artery disease, congenital heart disease, endocardtitis, primary disease of the myocardium, pericardial disease, intracardiac masses and tumors

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M-mode echocardiography time-motion mode = M-mód record og echo motion, adding the dimension of time M-mode recording is like a diagram that shows how positions of the cardiac structures change during the course of the cardiac cycle chamber size and wall thickness, evaluate cardiac function, simultaneous imaging

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RV LV LA Aorta SW PW AWRV CW Aorta LV LA transducer Abbreviations AWRV - anterior wall, right ventricle PW - posterior wall CW - chest wall RV - right ventricle LA - left atrium SW - septal wall LV - left ventricle Echocardiography Heart

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M-mode echocardiography at the minor axis of the left ventricle. ED = end diastole, ES = end systole, S = septum or anterior wall; PW = posterior wall. Depth = 2 mm. Time = 1 sec. Time (sec) M-mode beam (depth) 1 second Echocardiographic image

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ESD EDD SWTh PWTh LV Cavity PW SW CW AWRV RV Cavity Time Abbreviations Calculations EDD - end diastolic dimension FS (fractional shortenting) = (EDD - ESD) / EDD ESD - end systolic dimension LV mass = 1.06 x [(EDD + PWTh + SWTh)3 – (EDD)3] PWTh - posterior wall thickness Th/r = (PWTH + SWTh) / EDD SWTh - septal wall thickness SV (stroke volume) = EDD3 - ESD3 HR = beats per min CO (cardiac output) = SV x HR Echocardiography: Measures and calculations

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Two-dimensional echocardiography parasternal long axis view, short axis view apical 4-chamber view subcostal 4-chamber view

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Doppler echocardiography evaluation of blood flow regurgitant flow stenotic lesions

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Invasive examination of the heart

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Cardiac catheterization the „gold-standard” of diagnostic tests for selected cardiovascular disorders nor only diagnostic method, but „upgraded” by using a catheter-based interventional procedure – like balloon angioplasty, stent implantation

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Clinical conditions coronary heart disease is known or suspected in asymptomatic/symptomatic patients atypical thoracic pain of unknown origin acute myocardial infarction valvular heart disease congenital heart disease other clinical conditions: LV or aortic disease, HCM, DCM, patients after thoracic trauma, patients after heart transplantation, patients with donated organs

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Techniques right heart catheterization: via the femoral or subclavian veins, intracardiac pressures and oxygen saturations may be measured left heart catheterization: through the brachial artery or percutaneous transfemoral approach, measurements of aortic and LV pressures – pressure gradients, selective coronary angiography is performed IVUS

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Complications myocardial infarction brady-or tachyarrhythmia vascular complications: occlusion, bleeding vaso-vagal reaction allergic response to contrast media injection death (> 1%)

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emergencyultrasound.org.uk. The ACES scan. Ultrasound in hypotension. Richard Kendall. Paul Atkinso more emergencyultrasound.org.uk. The ACES scan. Ultrasound in hypotension. Richard Kendall. Paul Atkinson. emergencyultrasound.org.uk. Abdominal ... less

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