Cardiac Ultrasound

2021 ◽  
Author(s):  
Leonard M Shapiro ◽  
Antoinette Kenny
Keyword(s):  
Cardiac Ultrasound

scholarly journals Training: improving antenatal detection and outcomes of congenital heart disease

2018 ◽  
Vol 7 (4) ◽  
pp. e000276 ◽  
Author(s):  
Orhan Uzun ◽  
Julia Kennedy ◽  
Colin Davies ◽  
Anthony Goodwin ◽  
Nerys Thomas ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Detection Rate ◽  
Congenital Heart ◽  
Training Programme ◽  
Referral Rate ◽  
Cardiac Anomaly ◽  
Cardiac Ultrasound ◽  
Detection Rates ◽  
Antenatal Detection ◽  
The Uk

ObjectivesThis study describes the design, delivery and efficacy of a regional fetal cardiac ultrasound training programme. This programme aimed to improve the antenatal detection of congenital heart disease (CHD) and its effect on fetal and postnatal outcomes.Design setting and participantsThis was a prospective study that compared antenatal CHD detection rates by professionals from 13 hospitals in Wales before and after engaging in our ‘skills development programme’. Existing fetal cardiac practice and perinatal outcomes were continuously audited and progressive targets were set. The work was undertaken by the Welsh Fetal Cardiovascular Network, Antenatal Screening Wales (ASW), a superintendent sonographer and a fetal cardiologist.InterventionsA core professional network was established, engaging all stakeholders (including patients, health boards, specialist commissioners, ASW, ultrasonographers, radiologists, obstetricians, midwives and paediatricians). A cardiac educational lead (midwife, superintendent sonographer, radiologist, obstetrician, or a fetal medicine specialist) was established in each hospital. A new cardiac anomaly screening protocol (‘outflow tract view’) was created and training on the new protocol was systematically delivered at each centre. Data were prospectively collected and outcomes were continuously audited: locally by the lead fetal cardiologist; regionally by the Congenital Anomaly Register and Information Service in Wales; and nationally by the National Institute for Cardiac Outcomes and Research (NICOR) in the UK.Main outcome measuresPatient satisfaction; improvements in individual sonographer skills, confidence and competency; true positive referral rate; local hospital detection rate; national detection rate of CHD; clinical outcomes of selected cardiac abnormalities; reduction of geographical health inequality; cost efficacy.ResultsHigh levels of patient satisfaction were demonstrated and the professional skill mix in each centre was improved. The confidence and competency of sonographers was enhanced. Each centre demonstrated a reduction in the false-positive referral rate and a significant increase in cardiac anomaly detection rate. According to the latest NICOR data, since implementing the new training programme Wales has sustained its status as UK lead for CHD detection. Health outcomes of children with CHD have improved, especially in cases of transposition of the great arteries (for which no perinatal mortality has been reported since 2008). Standardised care led to reduction of geographical health inequalities with substantial cost saving to the National Health Service due to reduced false-positive referral rates. Our successful model has been adopted by other fetal anomaly screening programmes in the UK.ConclusionsAntenatal cardiac ultrasound mass training programmes can be delivered effectively with minimal impact on finite healthcare resources. Sustainably high CHD detection rates can only be achieved by empowering the regional screening workforce through continuous investment in lifelong learning activities. These should be underpinned by high quality service standards, effective care pathways, and robust clinical governance and audit practices.

scholarly journals One clot after another in COVID-19 patient: diagnostic utility of handheld echocardiogram

2021 ◽  
Vol 2021 (2) ◽  
Author(s):  
Gini Priyadharshini Jeyashanmugaraja ◽  
Evgeny Shloknik ◽  
Deborah Tosin Akanya ◽  
Kristin Stawiarski ◽  
Christopher Winterbottom ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Care Setting ◽  
Pressure Overload ◽  
Massive Pulmonary Embolism ◽  
Cardiac Ultrasound ◽  
Ventricular Dilation ◽  
Severe Respiratory Distress ◽  
Systemic Thrombolysis ◽  
Focused Cardiac Ultrasound ◽  
Right Ventricular Dilation

ABSTRACT A 63-year-old woman was admitted with severe respiratory distress requiring mechanical ventilation and shock requiring vasopressor support. She was found to have COVID-19 pneumonia. Focused cardiac ultrasound performed for evaluation of shock was significant for right ventricular dilation and dysfunction with signs of right ventricular pressure overload. Given worsening shock and hypoxemia systemic thrombolysis was administered for presumed massive pulmonary embolism with remarkable improvement of hemodynamics and respiratory failure. In next 24 h patient’s neurologic status deteriorated to the point of unresponsiveness. Emergent computed tomography showed multiple ischemic infarcts concerning for embolic etiology. Focused cardiac ultrasound with agitated saline showed large right to left shunt due to a patent foramen ovale. This was confirmed by transesophageal echocardiogram, 5 months later. This case highlights strengths of focused cardiac ultrasound in critical care setting and in patients with COVID-19 when access to other imaging modalities can be limited.

scholarly journals Cardiac ultrasound of the fetus.

1984 ◽  
Vol 59 (7) ◽  
pp. 603-604 ◽  
Author(s):  
L D Allan
Keyword(s):  
Cardiac Ultrasound

scholarly journals Reference values of electrographic and cardiac ultrasound parameters in Russian healthy children and adolescents

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Geraldine Landon ◽  
Isabelle Denjoy ◽  
Enora Clero ◽  
Aleksandr Silenok ◽  
Irina Kurnosova ◽  
...  
Keyword(s):  
Age Groups ◽  
Cross Sectional Study ◽  
Healthy Children ◽  
Cardiac Ultrasound ◽  
Relevant Feature ◽  
Sectional Study ◽  
Cross Sectional ◽  
Echocardiographic Parameters ◽  
Electrocardiographic Parameters ◽  
Ultrasound Parameters

AbstractBetween 2009 and 2013, a large cross-sectional study on the health consequences of the Chernobyl nuclear accident was performed in the contaminated and uncontaminated territories of the Bryansk Oblast (Russian Federation). The objective of this work was to confirm or refute a possible association between childhood cardiac arrhythmia and a chronic exposure to caesium-137. As part of this study, a large number of electrocardiographic and cardiac ultrasound parameters were collected from 18,152 children aged 2–18 years including 12,512 healthy ones not contaminated with caesium-137. It seemed therefore relevant for us to share in a second publication these medical data based on healthy and uncontaminated children with the scientific community because of the large quantities and the limited availability of such kind of data. In the present study, relating to electrocardiographic parameters, the measurements performed fully reflect the expected evolution of the paediatric electrocardiogram between 5 and 18 years of age. Thus, the median values were generally quite close to those available in the literature. In contrast, differences in the 2nd and 98th percentiles were notable and could be explained in particular by the type of equipment used, the number of subjects included in the study and racial disparities. As for echocardiographic parameters, the evolution of the measured values in age groups is consistent with what was expected considering factors such as growth. In comparison with other scientific studies that have investigated these echocardiographic parameters, some differences by age groups have been identified. The ethnic factor truly appears to be a relevant feature to consider. In view of the results, it appeared essential to the authors to approach the methodological conditions of the scientific studies already published on the topic to be truly comparable and thus to provide a reliable answer on a topic for which real expectations in terms of medical care are required.

scholarly journals Accuracy of focussed cardiac ultrasound screening for rheumatic heart disease by health workers with limited training

2015 ◽  
Vol 24 ◽  
pp. S423
Author(s):  
D. Engelman ◽  
J. Kado ◽  
B. Remenyi ◽  
S. Colquhoun ◽  
J. Carapetis ◽  
...  
Keyword(s):  
Heart Disease ◽  
Rheumatic Heart Disease ◽  
Health Workers ◽  
Ultrasound Screening ◽  
Cardiac Ultrasound ◽  
Rheumatic Heart

Abstract 12018: Cardiac Ultrasound Performed During Cardiac Arrest has Potential to Detect Pulmonary Embolism as a Reversible Cause of Cardiac Arrest when Compared to Hypoxia and Ventricular Fibrillation - A Randomized Porcine Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Rasmus Aagaard ◽  
Philip Caap ◽  
Nicolaj C Hansson ◽  
Morten T Bøtker ◽  
Asger Granfeldt ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Life Support ◽  
Advanced Life Support ◽  
Ultrasound Images ◽  
Cardiac Ultrasound ◽  
Pilot Studies ◽  
Hypoxia Group ◽  
Rhythm Analysis

Introduction: Survival from non-shockable cardiac arrest is unlikely unless a reversible cause is identified and treated. Guidelines state that ultrasound has the potential to identify reversible causes. Currently, ultrasonographic findings from patients with spontaneous circulation are extrapolated to patients in cardiac arrest. While right ventricular (RV) dilation is a finding normally associated with pulmonary embolism (PE), porcine studies have shown that RV dilation is also seen in ventricular fibrillation (VF) and severe hypoxia. No studies have investigated how causes of cardiac arrest affect RV size during resuscitation. Hypothesis: The RV diameter is larger during resuscitation of cardiac arrest caused by PE when compared to hypoxia and VF. Methods: Pigs were anesthetized and randomized to cardiac arrest induced by VF, hypoxia, or PE. Advanced life support (ALS) was preceded by 7 minutes of untreated cardiac arrest. Cardiac ultrasound images of the RV from a subcostal 5-chamber view were obtained during induction of cardiac arrest and ALS. The RV diameter was measured two centimeters from the aortic valve at end diastole. RV diameter at 3rd rhythm analysis was the primary endpoint. Based on pilot studies a sample size of 8 animals in each group was needed. Results: Eight animals were included in each group. RV diameter was not statistically different at baseline (mean (95%CI)) in VF: 19.8 (18.0-21.5) mm, hypoxia: 19.8 (16.6-22.9) mm, and PE: 21.8 (19.2-24.3) mm. During induction of cardiac arrest the RV diameter increased to 29.6 (27.3-31.9) mm in the hypoxia group and 38.0 (33.4-42.6) mm in the PE group (difference to baseline and between groups, both p<0.01). Induction of VF caused an immediate increase in the RV diameter to 25.0 (21.2-28.8) mm (difference to baseline p<0.01). At 3rd rhythm analysis, RV diameter was 32.4 (28.6-36.2) mm in the PE group, which was significantly larger than both the hypoxia group at 23.3 (19.5-27.0) mm and the VF group at 24.9 (22.2-27.5) mm (difference between groups p<0.01). Conclusions: Cardiac arrest due to VF, hypoxia, and PE all caused an increase in RV diameter. During resuscitation the RV was larger in PE compared to VF and hypoxia. Cardiac ultrasound thus has the potential to detect PE during resuscitation.

Interobserver agreement and image quality of functional cardiac ultrasound measures used in a randomised trial of delayed cord clamping in preterm infants

2017 ◽  
Vol 103 (3) ◽  
pp. F257-F263 ◽  
Author(s):  
Himanshu Popat ◽  
Kristy P Robledo ◽  
Lucille Sebastian ◽  
Nicholas Evans ◽  
Andrew Gill ◽  
...  
Keyword(s):  
Image Quality ◽  
Preterm Infants ◽  
Interobserver Agreement ◽  
Ductus Arteriosus ◽  
Randomised Trial ◽  
Vena Cava ◽  
Mean Difference ◽  
Cardiac Ultrasound ◽  
Delayed Cord Clamping ◽  
Cord Clamping

ObjectiveFunctional cardiac ultrasound measures are used clinically and in trials for assessing the haemodynamic status of newborn infants. Superior vena cava (SVC) flow and right ventricular output (RVO) are established measures of systemic blood flow on the first postnatal day. The objective was to assess image quality and interobserver agreement of these measures in preterm infants enrolled in a randomised trial of immediate versus delayed cord clamping.Design and settingImage quality and interobserver agreement for SVC flow, RVO and ductus arteriosus (DA) size were assessed on measurements taken at 3–6, 6–12 and 20–28 hours for the first 10 infants enrolled at each of four sites (total 40). Bland-Altman plots were constructed; mean difference (bias) and limits of agreement (LOA) were calculated. Potential sources of variation were explored.ResultsQuality was judged satisfactory for >97% of images. The mean difference and LOA between the observers were 5.4 mL/kg/min and −49.0 to 59.8 mL/kg/min for SVC flow, −26.6 mL/kg/min and −131.4 to 78.2 mL/kg/min for RVO, and 0 mm and −0.8 to 0.8 mm for DA diameter, respectively. The principal source of measurement error for SVC flow was diameter, and for RVO, diameter and velocity time integral. The difference between observers for both SVC and RVO was significantly associated with site.ConclusionInterobserver variability for SVC flow is consistent with that previously reported, but higher for RVO. The findings should be incorporated into clinical practice, training, accreditation and trial design.

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