Basic Principles of Echocardiography in Adults with Congenital Heart Disease
Anita Sadeghpour
6.1.Basic Principles of Echocardiography in Adults with Congenital Heart Disease
Patients with adult congenital heart disease (ACHD) have a range of heart conditions, varying from simple "holes in the heart" to complex single-ventricle anatomy. Some patients have undergone palliation or complete surgical repair, whereas others remain with their native heart condition. In all of these situations, echocardiography remains the mainstay of diagnosis for patients with CHD.
The following basic principles should be borne in mind in the imaging of patients with suspected CHD:
1. In all probability, the presence of one congenital abnormality denotes the existence of more. Whether we seek to diagnose the most basic of communications between the atria or we endeavor to detect the most complex of malformations, the objective of the sequential segmental modality is to prove normality. That is why we subject a patient with an isolated atrial septal defect in the setting of a normally constructed heart to the same painstaking analysis as a patient with congenitally corrected transposition of the great arteries allied to multiple intracardiac defects.
2. A patient’s history and/or written surgical report are to be meticulously perused even prior to meeting the patient. The echocardiographer's thorough understanding of the particulars of the patient's earlier repairs affords a more clear-cut and efficient imaging investigation.
3. Inspection of the patient’s color, fingers, and chest would be helpful. Is the patient cyanotic with clubbed fingers? After all, a cyanotic patient is more likely to have complex malformations. The presence of the s...
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...advantages of three-dimensional echocardiography (transthoracic and transesophageal) over two-dimensional echocardiography have been suggested in the following situations:
1. Assessment of the left ventricular volumes and ejection fraction; three-dimensional echocardiography has been clearly demonstrated to yield more accurate and reproducible measurements.
2. Assessment of the mitral valve pathology should be integrated into routine clinical practice in that three-dimensional echocardiography affords the best physiological and morphological information regarding the mitral valve (Figure 6.16).
3. Guidance of interventional mitral valve procedures (three-dimensional transesophageal echocardiography).
It is worthy of note, however, that the three-dimensional evaluation of the tricuspid valve, pulmonic valve, and prosthetic valves has yet to be fully investigated.
When a muscle contracts and relaxes without receiving signals from nerves it is known as myogenic. In the human body, the cardiac muscle is myogenic as this configuration of contractions controls the heartbeat. Within the wall of the right atrium is the sino-atrial node (SAN), which is where the process of the heartbeat begins. It directs consistent waves of electrical activity to the atrial walls, instigating the right and the left atria to contract at the same time. During this stage, the non conducting collagen tissue within the heart prevents the waves of electrical activity from being passed directly from the atria to the ventricles because if this were to happen, it would cause a backflow. Due to this barrier, The waves of electrical energy are directed from the SAN to the atrioventricular node (AVN) which is responsible for transferring the energy to the purkyne fibres in the right and left ventricle walls. Following this, there is a pause before the wave is passed on in order to assure the atria has emptied. After this delay, the walls of the right and left ventricles contract
Nishimura, R. A., & McGoon, M. D. (1999). Editorial: Perspectives on mitral-valve prolapse. The New England Journal of Medicine, 341(1), 48-50. Retrieved from http://search.proquest.com/docview/223939414?accountid=158514
Cardiomyopathy, by definition, means the weakening of the heart muscle. The heart is operated by a striated muscle that relies on the autonomic nervous system to function. Cardiomyopathy is diagnosed in four different ways based on what caused the illness and exactly what part of the heart is weakened. The four main types of cardiomyopathy are dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular dysplasia. One other category of cardiomyopathy that is diagnosed is “unclassified cardiomyopathy.” Unclassified cardiomyopathy is the weakening of the heart that does not fit into the main four categories.
of the heart: one chamber is on the top and one chamber is on the
..., Welsh R, Feindel C, Lichtenstein S. Transcatheter aortic valve implantation: a Canadian Cardiovascular Society position statement. Can J Cardiol. 2012;28:520-8.
Furthermore, Aristotle and Galen’s theories contributed to the Renaissance revival of heart anatomy. This reawakening made it possible for physicians to indicate the basic arrangement of the heart. It became commonly accepted that the heart was divided into four parts: two ventricles (lower chambers that pump blood out) and two auricles (upper chamber that r...
During a physical examination, a specialist may hear a heart murmur which will prompt a referral to a pediatric cardiologist for an analysis. Diagnostic testing will vary by the child’s age, clinical condition, and institutional preferences. Such test may incorporate a chest X-ray, electrocardiogram, echocardiography and cardiac catheterization. A chest X-ray uses unseen X-ray beams to cr...
Tetralogy of Fallot is a congenital heart disease which involves four different heart defects in one. The four different heart defects are a large ventricular septal defect (VSD), Pulmonary Stenosis, Right ventricular hypertrophy, and an overriding aorta. These congenital defects change the normal flow of blood thro...
These heart tests are known as echocardiograms. For example, these evaluate different aspects of the heart, such as chamber size, valve function, and blood flow. One may even do tests such as Holter monitoring and stress testing. This job requires you to be responsible for recording medical history, preparing the patients, maintaining the equipment, and performing the procedures. After you perform the procedure on the patient, you must then discuss the results with the doctor. Strong communication skills are a key characteristic that a physician should always possess in this field of duty.
Hypertrophic cardiomyopathy is an inherited disease that affects the cardiac muscle of the heart, causing the walls of the heart to thicken and become stiff. [1] On a cellular level, the sarcomere increase in size. As a result, the cardiac muscles become abnormally thick, making it difficult for the cells to contract and the heart to pump. A genetic mutation causes the myocytes to form chaotic intersecting bundles. A pathognomonic abnormality called myocardial fiber disarray. [2,12] How the hypertrophy is distributed throughout the heart is varied. Though, in most cases, the left ventricle is always affected. [3] The heart muscle can thicken in four different patterns. The most common being asymmetrical septal hypertrophy without obstruction. Here the intraventricular septum becomes thick, but the mitral valve is not affected. Asymmetrical septal hypertrophy with obstruction causes the mitral valve to touch the septal wall during contraction. (Left ventricle outflow tract obstruction.) The obstruction of the mitral valve allows for blood to slowly flow from the left ventricle back into the left atrium (Mitral regurgitation). Symmetrical hypertrophy is the thickening of the entire left ven...
(Slide 2) What is Cardiomyopathy? If we break down the word we can see “Cardio” which means of the heart, “myo” which means muscle, and “pathy” which means disease, therefore cardiomyopathies are diseases of the heart muscle. (Slide 3) There are 3 main types of cardiomyopathies; hypertrophic, dilated, and restrictive. I will only be discussing dilated cardiomyopathy, which is characterized by the enlargement of the hearts chambers with impaired systolic function. It is estimated that as many as 1 of 500 adults may have this condition. Dilated cardiomyopathy is more common in blacks than in whites and in males than in females. It is the most common form of cardiomyopathy in children and it can occur at any age (CDC).
...ts, electrocardiogram, sonogram and cardiac rehabilitation. As a clinical observer, I found an opportunity to create a solid foundation on patient diagnosis and treatment, and not to mention, long hours with charting and recording patients’ information.
[IMAGE] The four heart valves are: 1. the tricuspid valve, located between the right atrium and the right ventricle 2. the pulmonary (pulmonic) valve, between the right ventricle and the pulmonary artery 3. the mitral valve, between the left atrium and left ventricle 4.
The heart is a pump with four chambers made of their own special muscle called cardiac muscle. Its interwoven muscle fibers enable the heart to contract or squeeze together automatically (Colombo 7). It’s about the same size of a fist and weighs some where around two hundred fifty to three hundred fifty grams (Marieb 432). The size of the heart depends on a person’s height and size. The heart wall is enclosed in three layers: superficial epicardium, middle epicardium, and deep epicardium. It is then enclosed in a double-walled sac called the Pericardium. The terms Systole and Diastole refer respectively and literally to the contraction and relaxation periods of heart activity (Marieb 432). While the doctor is taking a patient’s blood pressure, he listens for the contractions and relaxations of the heart. He also listens for them to make sure that they are going in a single rhythm, to make sure that there are no arrhythmias or complications. The heart muscle does not depend on the nervous system. If the nervous s...
The commonest defect is a narrowing of the main artery from the heart aortic coarctation. A regular ultrasound examination of the heart ... ... middle of paper ... ... s are relatively limited. So far, researchers think it will be possible to increase the final height by 5-10 centimeters, depending on the duration of treatment.