Echocardiography and thoracic ultrasound

2021 ◽  
pp. 201-217
Author(s):  
Frank A Flachskampf ◽  
Pavlos Myrianthefs ◽  
Ruxandra Beyer
Keyword(s):  
Intensive Care ◽  
Imaging Techniques ◽  
Aortic Disease ◽  
Thoracic Ultrasound ◽  
Coronary Syndrome ◽  
Systematic Training ◽  
Ideal Tool ◽  
Left And Right ◽  
Cardiovascular Intensive Care

For the emergency management of cardiovascular disorders, echocardiography and thoracic ultrasound are indispensable imaging techniques at the bedside. In the intensive care environment, crucial questions, such as left and right ventricular function, valvular heart disease, volume status, aortic disease, cardiac infection, pleural effusion, pulmonary oedema, pneumothorax, and many others, can be sufficiently and reliably answered by using these techniques; in fact, it is almost impossible to manage patients with acute severe haemodynamic impairment reasonably well without prompt and repeated access to echocardiography. This is confirmed by the prominent place that echocardiography has in the guideline-based diagnosis and treatment of all major cardiovascular emergencies, from acute heart failure to acute coronary syndrome to pulmonary embolism, etc. Moreover, it is the ideal tool to follow up the patient, since repeat examinations pose no risk to the patient and demand relatively little logistics and resources. To benefit from the wealth of information that echocardiography and thoracic ultrasound can provide, modern equipment (including a transoesophageal probe) and systematic training of echocardiographers must be ensured. The availability of prompt and experienced echocardiography and thoracic ultrasound services at all times is fundamental for sound contemporary cardiovascular intensive care.

Echocardiography and thoracic ultrasound

2015 ◽  
Author(s):  
Frank A Flachskampf ◽  
Pavlos Myrianthefs ◽  
Ruxandra Beyer ◽  
Pavlos M. Myrianthefs
Keyword(s):  
Intensive Care ◽  
Imaging Techniques ◽  
Aortic Disease ◽  
Care Environment ◽  
Thoracic Ultrasound ◽  
Coronary Syndrome ◽  
Systematic Training ◽  
Ideal Tool ◽  
Left And Right ◽  
Cardiovascular Intensive Care

For the emergency management of cardiovascular disorders, echocardiography and thoracic ultrasound are indispensable imaging techniques at the bedside. In the intensive care environment, crucial questions, such as left and right ventricular function, valvular heart disease, volume status, aortic disease, cardiac infection, pleural effusion, pulmonary oedema, pneumothorax, and many others, can be sufficiently and reliably answered by using these techniques; in fact, it is almost impossible to manage patients with acute severe haemodynamic impairment reasonably well without a prompt and repeated access to echocardiography. This is confirmed by the prominent place that echocardiography has in the guideline-based diagnosis and treatment of all major cardiovascular emergencies, from acute heart failure to the acute coronary syndrome to pulmonary embolism, etc. Moreover, it is the ideal tool to follow the patient, since repeat examinations pose no risk to the patient and demand relatively little logistics and resources. To benefit from the wealth of information that echocardiography and thoracic ultrasound can provide, modern equipment (including a transoesophageal probe) and systematic training of echocardiographers must be ensured. The availability of prompt and experienced echocardiography and thoracic ultrasound services at all times is fundamental for sound contemporary cardiovascular intensive care.

Echocardiography and thoracic ultrasound

2017 ◽  
Author(s):  
Frank A Flachskampf ◽  
Pavlos Myrianthefs ◽  
Ruxandra Beyer ◽  
Pavlos M. Myrianthefs
Keyword(s):  
Intensive Care ◽  
Imaging Techniques ◽  
Aortic Disease ◽  
Care Environment ◽  
Thoracic Ultrasound ◽  
Coronary Syndrome ◽  
Systematic Training ◽  
Ideal Tool ◽  
Left And Right ◽  
Cardiovascular Intensive Care

For the emergency management of cardiovascular disorders, echocardiography and thoracic ultrasound are indispensable imaging techniques at the bedside. In the intensive care environment, crucial questions, such as left and right ventricular function, valvular heart disease, volume status, aortic disease, cardiac infection, pleural effusion, pulmonary oedema, pneumothorax, and many others, can be sufficiently and reliably answered by using these techniques; in fact, it is almost impossible to manage patients with acute severe haemodynamic impairment reasonably well without a prompt and repeated access to echocardiography. This is confirmed by the prominent place that echocardiography has in the guideline-based diagnosis and treatment of all major cardiovascular emergencies, from acute heart failure to the acute coronary syndrome to pulmonary embolism, etc. Moreover, it is the ideal tool to follow the patient, since repeat examinations pose no risk to the patient and demand relatively little logistics and resources. To benefit from the wealth of information that echocardiography and thoracic ultrasound can provide, modern equipment (including a transoesophageal probe) and systematic training of echocardiographers must be ensured. The availability of prompt and experienced echocardiography and thoracic ultrasound services at all times is fundamental for sound contemporary cardiovascular intensive care.

Prognostic Value of Troponin I with Echocardiography Assessment in Septic Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sherif Farouk Ibrahim ◽  
Ashraf Elsayed Elagmy ◽  
Abdelrhman Gamal Abdelsabour
Keyword(s):  
Septic Shock ◽  
Acute Coronary Syndrome ◽  
Intensive Care ◽  
Cardiac Troponin ◽  
Prognostic Value ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Coronary Syndrome ◽  
Sepsis And Septic Shock

Abstract Background Sepsis is heterogenous with regard to factors such as causal microorganism, patient predisposition, co-morbidity and response to therapy, a key element and unifying feature is the manifestation of cardiovascular dysfunction. Elevated concentrations of cardiac troponin I (cTnI) are frequently observed in patients with severe sepsis and septic shock even in the absence of an acute coronary syndrome (ACS). Objective To evaluate the prognostic value of (cTnI) with echocardiography assessment in septic patients. Patients and Methods This study was conducted at the intensive care units of Ain Shams university hospitals. 20 patients of both sexes with age ranging from 18 to 70 years diagnosed with sepsis admitted to Intensive care unit were included in prospective observational study. Results Baseline cTnI had a significant positive correlation with follow up troponine (p = 0.0016). Baseline EF had a significant negative correlation with follow up troponine (p = 0.036). Using ROC-curve analysis, troponin level at a cutoff point (>1.9) predicted patients with mortality, with good (87%) accuracy, sensitivity= 90% and specificity= 90% (p < 0.01). Conclusion Elevated concentrations of cardiac troponin I (cTnI) are frequently observed in patients with sepsis and septic shock even in the absence of an acute coronary syndrome.

Abstract P240: Clinical Outcomes in Patients With Takotsubo’s Cardiomyopathy Who Have Undergone Cardiac Catherterization at Presentation vs. Those Who Have Not: A Two Community Based Hospitals Experience

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Umama Gorsi ◽  
Muhammad Shafi ◽  
Mary Roberts ◽  
Chester Hedgepeth
Keyword(s):  
Ejection Fraction ◽  
Rhode Island ◽  
Medical Condition ◽  
Imaging Techniques ◽  
Shortness Of Breath ◽  
Community Based ◽  
Coronary Syndrome ◽  
Non Invasive ◽  
Chi Square Analysis

Background: Diagnosis of Takotsubo’s Cardiomyopathy (TC) remains a challenge due to similar presentation to acute coronary syndrome. Coronary catheterization (CC) proven clean coronaries is important to diagnose TC. However, it is not uncommon that CC is occasionally delayed due to unstable medical condition and/or high risk for CC. We hypothesized that patients with TC had similar outcomes whether they underwent CC at presentation or were diagnosed using non-invasive imaging techniques. Methods: Retrospective chart review of data from Memorial Hospital of Rhode Island and Kent Hospital, two community based hospitals, from June 2008 to March 2016 was done. Thirty nine adult patients > 18 years of age admitted to the intensive care unit or medical floor with chest pain, shortness of breath, elevated troponin, EKG changes, and new non-regional wall motion abnormalities or reduce ejection fraction, with suspected TC were enrolled. Patients were divided into 2 groups based on diagnostic approach of TC: Baseline echo findings suggestive of TC with EF improvement at follow up (non-CC) vs. clean coronaries by CC. Outcomes of the two groups were compared using Chi-square analysis, analysis of variance (ANOVA) and Mann-Whitney Test appropriately. Results: Out of 39 patients, 20 underwent CC while 19 did not. Mean age was not different between the 2 groups (69.1±11.8 vs. 62.4±14.0, p= NS) but CC group had more females (95 %, 19 of 20 vs 68.4%, 13 of 19; p=0.031). Most common chief complaint at the time of admission in both groups was shortness of breath (60.0%, 12 of 20 vs 68.4%, 13 of 19; p=0.548). Admission heart rate was significantly higher in non-CC vs. CC patients (102.3± 19.3 vs 85.4±85.4; p=0.007). Third troponin was higher in non-CC group (1.926 ± 2.667 vs 0.775± 1.378, p=0.017). All other admission and in-hospital findings and drug management in both groups were similar. Both CC and non-CC groups had comparable outcomes: intubation (15%, 3 of 20 vs 21.1%, 4 of 19) , heart failure (21.2 %, 4 of 20 vs 15.8%, 3 of 19), shock (0 %, 0 of 20 vs 5.3% 1 of 19 ), stroke (5 %, 1 of 20 vs 0%, 0 of 19), death (5.3 % 1 of 20 vs 5.3% 1 of 19 ), recovery (65%,13 of 20 vs 52.9 % 10 of 19) p=NS for all. ICU admission (42.1%, 8 of 20 vs 52.6%, 10 of 19; p=NS) and length of stay (8.21±7.82 days vs 5.75±5.67 days; p=NS) was not significantly different between the 2 groups. Both groups showed analogous improvement in ejection fraction (21.92 ± 13.96 vs 20.63 ± 13.21; p= 0.835) on a follow up Echo done within 2 weeks to 6 months. Conclusion: This study shows no difference in outcomes between TC patients diagnosed with CC or TTE on admission. However, CC should still be done on admission for diagnosis of TC until large non-invasive diagnostic imaging modalities (such as myocardial perfusion echocardiogram) trials show high specificity for diagnosis of TC.

scholarly journals An unusual case of cardiac syncope and acute coronary syndrome – a case report

2014 ◽  
Vol 60 (6) ◽  
pp. 285-287
Author(s):  
Monica Chitu ◽  
Theodora Benedek ◽  
S. Condrea ◽  
C. Blendea ◽  
I. Benedek
Keyword(s):  
Acute Coronary Syndrome ◽  
Structural Damage ◽  
Imaging Techniques ◽  
Ventricular Myocardium ◽  
Left Ventricular ◽  
Diabetic Woman ◽  
Left Ventricular Myocardium ◽  
Coronary Syndrome ◽  
Cardiac Syncope

Abstract Introduction: We aimed to present a case of acute coronary syndrome with unexpected etiology complicated by syncope and arrhythmias, confirmed by imagistic examinations as cardiac parasitosis. Cardiac parasitic diseases are rare diseases, whose diagnosis and therapy should be adapted to each case. Imaging techniques allow precise diagnosis of cardiac echinococcosis, providing essential structural details on the damage degree of heart structures, allowing optimization of complex treatment in these cases. Case presentation: A 67-year old, obese and diabetic woman presented with cardiac syncope, arrhythmias and acute chest pain. Imagistic examinations excluded intracoronary thrombosis and confirmed a severe structural damage of myocardial tissue, consisting in replacement of the myocardial structure by many cysts caused by parasitic infestation with echinococcus multilocularis and echinoccocus granulosus originating from the liver. CT scan confirmed severe distruction of the left ventricular myocardium by policysts, that led to thinning of inferior and apical left ventricle wall without any possibility of surgical excision. Therefore a specific chemotherapy with albendazole was initiated. Follow up at 2 months indicated a favorable evolution, with serological decrease of echinococcal antibodies and reduction of cysts volume. Conclusion: In cases of angina and arrhythmias with non-atherosclerotic etiology, imaging techniques can diagnose the anatomopathological substrate of the disease and represent a valuable tool for the follow up.

Sign in / Sign up

Export Citation Format

Share Document