Transthoracic examination

This chapter covers all aspects of transthoracic examination, including patient information, preparing machine and probe, probe handling and image quality, 2D image acquisition, 3D image acquisition, multiplane image acquisition, data acquisition, parasternal long axis view, parasternal right ventricle inflow view, parasternal right ventricle outflow view, parasternal short axis (aortic) view, parasternal short axis (mitral) view, parasternal short axis (ventricle) views, parasternal 3D views, apical 4-chamber view, apical 5-chamber view, apical 2-chamber view, apical 3-chamber view, apical 3D views, subcostal views, inferior vena cava view, abdominal aorta view, suprasternal view, right parasternal view, and standard examination.

Transoesophageal: Chambers and vessels

This chapter covers the chambers and vessels in transoesophageal echocardiography. It includes the left and right ventricles (size, mass, and function); the left and right atria, including the left atrial appendage; the pulmonary veins; the coronary sinus; the interatrial and interventricular septa; the pericardium and pericardial effusion; cardiac tamponade; the aorta (size, atherosclerosis, and dissection); intramural haematoma; aortic transection; thoracic aortic aneurysm; masses; pleural space and lungs; and implanted devices.

Acute and critical care echocardiography

This chapter covers the role of echocardiography in acute and critical care. This includes ‘front door’ echocardiography, the safeguarding of patient care, cardiopulmonary resuscitation, and acute diagnostics. The chapter then examines the circulating volume, fluid responsiveness, advanced haemodynamics, and special circumstances in the critically ill patient.

Quality assurance, reporting, and normal ranges

As discussed in this chapter, any echocardiography laboratory should have a quality assurance (QA) system in place. This allows for continuous monitoring and evaluation of the quality of echocardiographic studies and of the unit’s functioning. The chapter also gives an overview of accreditation and how to adopt a standard approach to reporting. It then gives the normal ranges for all aspects of the heart that are examined in echocardiography.

Transoesophageal: Valves

This chapter deals with the valves in transoesophageal echocardiography. It covers the mitral valve (stenosis, regurgitation, and prolapse), the aortic valve (stenosis and low-flow stenosis and regurgitation), the tricuspid valve, the pulmonary valve (stenosis, regurgitation, and prolapse), infective endocarditis (diagnosis, echocardiographic features, and differential diagnoses).

Transthoracic anatomy and pathology: Chambers and vessels

This chapter deals with the anatomy and pathology of the chambers and vessels in transthoracic echocardiography. It covers the left ventricle, global systolic function, regional systolic function, diastolic function and dysfunction, heart failure, the right ventricle, pulmonary hypertension, the left and right atria, the interatrial septum and interventricular septum, pericardium, pericardial effusion, cardiac tamponade, pericarditis, constrictive pericarditis, the aorta, primary cardiac tumours and other masses, extra-cardiac tumours, cardiomyopathies, and athlete’s heart.

Ultrasound

After a brief introduction to echocardiography, sound waves, and ultrasound, this chapter covers the following topics: the behaviour of ultrasound in tissue; reflection, attenuation, and depth compensation; reverberation artefacts; transthoracic, transoesophageal, and other transducers; echocardiography modes; transmit power; gain; grey scale and compression; image resolution; fundamental and second harmonic imaging; Doppler echocardiography; spectral trace analysis; continuous wave and pulsed wave Doppler; colour flow mapping; tissue Doppler imaging; second harmonic Doppler for contrast imaging; power Doppler (amplitude) imaging; 3D echocardiography, artefacts, image display, and image rendering; speckle tracking echocardiography; basic fluid dynamics; and the bioeffects of ultrasound.

Interventional echocardiography

The topic of this chapter is interventional cardiology. It covers pericardiocentesis, mitral valve balloon valvotomy, MitraClip, the MitraClip procedure, TAVI, assessment during TAVI, paravalvular leak closure, left atrial appendage occlusion, atrial septal defect closure, imaging during atrial septal device closure, ICE for atrial septal interventions, ICE imaging planes, ICE guided atrial septal device closure, electrophysiological interventions, cardiopulmonary bypass and coronary artery surgery, haemodynamic instability, and mechanical cardiac support

Contrast echocardiography

This chapter concerns contrast in echocardiography. It discusses specific contrast agent preparation, administration of contrast agents, and contrast safety. It then covers contrast studies for atrial septal defects, pulmonary shunts, persistent left superior vena cava, myocardial perfusion, non-compaction cardiomyopathy, LV aneurysms and pseudoaneurysms, apical hypertrophic cardiomyopathy, LV thrombi, LAA thrombi, and aortic disease. It also deals with contrast studies in the case of Doppler enhancement, imaging techniques for LV opacification, applications of left-heart contrast studies, and the use of contrast in dobutamine stress echocardiography,

Transoesophageal examination

This chapter deals with transoesophageal examination. It covers indications; contraindications and complications; information for the patient; preparing for the study; preparing and cleaning the probe; probe movements; anaesthesia, sedation, and analgesia; sedation complications; intubation; image acquisition; 4-chamber view; 5-chamber view; short axis (aortic valve) view; short axis (right ventricle) view; long axis (aortic valve) view; long axis (mitral valve) view; atrial septum (bicaval) view; 2-chamber (atrial appendage) view; pulmonary vein views; coronary sinus view; transgastric short axis views; transgastric long axis view; transgastric long axis (aortic) view; transgastric right ventricular view; deep transgastric view; pulmonary artery view; aortic views; 3D oesophageal views; 3D mitral valve; 3D aortic valve; 3D tricuspid valve; 3D pulmonary valve; 3D left ventricle; 3D interatrial septum; and the X-plane.