Feigenbaum's Echocardiography

by Feigenbaum, Harvey; Armstrong, William F.; Ryan, Thomas

• ISBN13: 9780781731980
• ISBN10: 0781731984
• Edition: 6th
• Format: Hardcover
• Copyright: 2004-12-16
• Publisher: LWW

Summary

The thoroughly revised Sixth Edition of Feigenbaum's Echocardiography reflects recent changes in the technology and clinical use of echocardiography. Included are detailed discussions of tissue Doppler imaging, harmonic imaging and its impact on tissue and contrast visualization, new applications of myocardial perfusion and three-dimensional echocardiography. Emphasizing the clinical importance of various echocardiography applications, this edition has chapters on systolic and diastolic left ventricular function, infective endocarditis, prosthetic valves, contrast echocardiography, stress echocardiography, systemic diseases, and operative and perioperative echocardiography. More than 1,200 illustrations complement the text. An accompanying DVD-ROM contains more than 900 moving cine loops with corresponding still images from the book.

Table of Contents

History of Echocardiography	1	(10)
Harvey Feigenbaum
Development of Various Echocardiographic Technologies	3	(3)
Recording Echocardiograms	6	(1)
Cardiac Sonographers	7	(2)
Echocardiographic Education and Organizations	9	(1)
References	9	(2)
Physics and Instrumentation	11	(35)
Physical Principles	11	(2)
Interaction Between Ultrasound and Tissue	13	(2)
The Transducer	15	(2)
Manipulating the Ultrasound Beam	17	(2)
Resolution	19	(2)
Creating the Image	21	(2)
Transmitting Ultrasound Energy	23	(1)
Display Options	24	(2)
Tradeoffs in Image Creation	26	(1)
Signal Processing	27	(1)
Tissue Harmonic Imaging	28	(1)
Artifacts	29	(3)
Doppler Echocardiography	32	(10)
Principles of Doppler Ultrasound	32	(2)
Doppler Formats	34	(4)
Color Flow Imaging	38	(1)
Technical Limitations of Color Doppler Imaging	39	(2)
Doppler Artifacts	41	(1)
Tissue Doppler Imaging	42	(1)
Biologic Effects of Ultrasound	42	(2)
Suggested Readings	44	(2)
Specialized Echocardiographic Techniques and Methods	46	(30)
Imaging Devices and Methods	46	(1)
M-Mode Echocardiography	46	(1)
Two-Dimensional Echocardiography	47	(1)
Color B-mode Scanning	47	(1)
Doppler Interrogation	47	(5)
Color Flow Doppler Imaging	51	(1)
Color Doppler M-Mode Imaging	51	(1)
Doppler Tissue Imaging	52	(3)
Tissue Characterization	55	(1)
Acquisition of Cardiac Ultrasound Information	56	(14)
Transthoracic Echocardiography	57	(1)
Hand-Carried Ultrasound	58	(1)
Dedicated Single-Line Interrogation Transducers	58	(1)
Transesophageal Echocardiography	59	(2)
Three-Dimensional Echocardiography	61	(3)
Epicardial Imaging	64	(3)
Intracardiac Echocardiography	67	(1)
Intravascular Ultrasound (IVUS)	67	(3)
The Digital Echo Laboratory	70	(4)
Suggested Readings	74	(2)
Contrast Echocardiography	76	(29)
Source of Ultrasound Contrast	76	(1)
Contrast Agents	76	(2)
Clinical Use	78	(1)
Ultrasound Interaction with Contrast Agents	79	(1)
Detection Methods	80	(4)
Intermittent Imaging	80	(1)
Low Mechanical Index Imaging	81	(1)
Other Mechanical Factors Affecting Contrast Detection	82	(1)
Doppler Imaging	82	(2)
Contrast Artifacts	84	(2)
Detection and Utilization of Intracavitary Contrast	86	(8)
Spectral Doppler Enhancement	90	(1)
Shunt Detection	91	(3)
Detection of Miscellaneous Conditions	94	(1)
Myocardial Perfusion Contrast	95	(8)
Suggested Readings	103	(2)
The Echocardiographic Examination	105	(33)
Selecting the Transducers	106	(1)
Patient Position	107	(1)
Placement of the Transducer	108	(2)
An Approach to the Transthoracic Examination	110	(1)
Parasternal Long-Axis Views	110	(3)
Parasternal Short-Axis Views	113	(2)
Apical Views	115	(5)
The Subcostal Examination	120	(2)
Suprasternal Views	122	(3)
Orientation of Two-Dimensional Images	125	(1)
Two-Dimensional Echocardiographic Measurements	126	(1)
Left Ventricular Wall Segments	126	(1)
M-Mode Examination	127	(2)
Transesophageal Echocardiography	129	(2)
Transesophageal Echocardiographic Views	131	(3)
Echocardiography as a Screening Test	134	(2)
Training in Echocardiography	136	(1)
Suggested Readings	137	(1)
Evaluation of Systolic and Diastolic Function of the Left Ventricle	138	(43)
General Principles	138	(1)
Linear Measurements	138	(3)
Indirect M-Mode Markers of Left Ventricular Function	140	(1)
Two-Dimensional Measurements	141	(8)
Determination of Left Ventricular Mass	146	(2)
Physiologic Versus Pathologic Hypertrophy	148	(1)
Regional Left Ventricular Function	149	(10)
Nonischemic Wall Motion Abnormalities	154	(2)
Paced Rhythms	156	(1)
Ventricular Preexcitation	157	(1)
Postoperative Cardiac Motion	157	(1)
Pericardial Constriction	158	(1)
Premature Ventricular Contractions	159	(1)
Doppler Evaluation of Global Left Ventricular Function	159	(10)
Other Techniques for Determination of Left Ventricular Systolic Function	161	(2)
Determination of Left Ventricular dP/dt	163	(1)
Doppler Tissue Velocity	164	(2)
Strain Rate Imaging and Other Derived Doppler Tissue Parameters	166	(3)
Evaluation of Diastolic Function	169	(10)
Methods for Evaluating Diastolic Function	170	(1)
M-Mode Echocardiography	170	(1)
Two-Dimensional Echocardiography	171	(1)
Doppler Evaluation of Diastolic Function	171	(1)
Evaluation of Mitral Inflow	171	(3)
Determination of Isovolumic Relaxation Time	174	(1)
Evaluation of Pulmonary Vein Flow	175	(1)
Doppler Tissue Imaging	176	(1)
Color Doppler M-Mode Imaging	177	(1)
Mitral Flow Dispersion	178	(1)
Left Atrial Volume/Size	178	(1)
Overall Evaluation of Diastolic Function	179	(1)
Suggested Readings	179	(2)
Left Atrium, Right Atrium, and Right Ventricle	181	(33)
Left Atrium	181	(13)
Left Atrial Dimensions and Volume	181	(4)
Left Atrial Function	185	(6)
Pulmonary Veins	191	(3)
Right Atrium	194	(8)
Right Atrial Thrombi	197	(2)
Right Atrial Blood Flow	199	(3)
Right Ventricle	202	(10)
Right Ventricular Dimensions and Volumes	203	(3)
Right Ventricular Overload	206	(4)
Right Ventricular Dysplasia	210	(2)
Suggested Readings	212	(2)
Hemodynamics	214	(33)
Use of M-Mode and Two-Dimensional Echocardiography	214	(2)
Quantifying Blood Flow	216	(2)
Clinical Application of Blood Flow Measurement	218	(5)
Measuring Pressure Gradients	223	(5)
Applications of the Bernoulli Equation	228	(6)
Determining Pressure Half-Time	234	(1)
The Continuity Equation	235	(2)
Proximal Isovelocity Surface Area	237	(2)
Myocardial Performance Index	239	(1)
Estimation of Left Ventricular Filling Pressure	239	(6)
Suggested Readings	245	(2)
Pericardial Diseases	247	(24)
Echocardiographic Evaluation of the Pericardium	248	(7)
Detection and Quantitation of Pericardial Fluid	249	(3)
Direct Visualization of the Pericardium	252	(2)
Differentiation of Pericardial from Pleural Effusion	254	(1)
Cardiac Tamponade	255	(5)
Echocardiographic Findings in Cardiac Tamponade	256	(1)
Doppler Findings in Tamponade	257	(3)
Pericardial Constriction	260	(6)
Echocardiographic Diagnosis	261	(1)
Doppler Echocardiographic Findings in Constriction	262	(1)
Effusive Constrictive Pericarditis	263	(2)
Constrictive Pericarditis Versus Restrictive Cardiomyopathy	265	(1)
Miscellaneous Pericardial Disorders and Observations	266	(3)
Postoperative Effusions	266	(1)
Echocardiography-Guided Pericardiocentesis	267	(1)
Pericardial Cysts	268	(1)
Suggested Readings	269	(2)
Aortic Valve Disease	271	(35)
Aortic Stenosis	271	(17)
Doppler Assessment of Aortic Stenosis	274	(10)
Other Approaches to Quantifying Stenosis	284	(1)
Dobutamine Echocardiography in the Evaluation of Aortic Stenosis	285	(1)
Natural History of Aortic Stenosis	285	(2)
Clinical Decision Making	287	(1)
Aortic Regurgitation	288	(15)
M-Mode and Two-Dimensional Imaging	289	(2)
Establishing a Diagnosis	291	(5)
Evaluating the Severity of Aortic Regurgitation	296	(5)
Acute Versus Chronic Aortic Regurgitation	301	(1)
Assessing the Left Ventricle	302	(1)
Miscellaneous Abnormalities of the Aortic Valve	303	(1)
Suggested Readings	304	(2)
Mitral Valve Disease	306	(46)
Anatomy of the Mitral Valve	306	(3)
Physiology of Mitral Valve Disease	309	(3)
Mitral Stenosis	312	(11)
Two-Dimensional Echocardiography in Rheumatic Mitral Stenosis	312	(1)
Congenital Mitral Stenosis	313	(1)
M-Mode Echocardiographic Appearance	314	(1)
Transesophageal Echocardiography	314	(1)
Three-Dimensional Echocardiography	315	(1)
Anatomic Determination of Severity	316	(1)
Doppler Echocardiographic Determination of Severity	317	(3)
Exercise Gradients	320	(1)
Secondary Features of Mitral Stenosis	320	(2)
Atrial Fibrillation	322	(1)
Secondary Pulmonary Hypertension	323	(1)
Decision Making Regarding Intervention	323	(1)
Mitral Regurgitation	323	(14)
Doppler Evaluation of Mitral Regurgitation	324	(5)
Determination of Mitral Regurgitation Severity	329	(6)
Other Considerations in Assessing Mitral Regurgitation	335	(2)
Mitral Valve Prolapse	337	(5)
Flail Leaflets	342	(4)
Miscellaneous Mitral Valve Abnormalities	346	(4)
Calcification of the Mitral Anulus	346	(1)
Tumors of the Mitral Valve	347	(1)
Aneurysms of the Mitral Valve	347	(1)
Mitral Valve Perforation	348	(1)
Anular Abscess	349	(1)
Anular Dehiscence	349	(1)
Radiation Damage	349	(1)
Carcinoid and Diet Drug Valvulopathy	349	(1)
Suggested Readings	350	(2)
Tricuspid and Pulmonary Valves	352	(23)
Clinical Overview	352	(1)
Pulmonary Valve	352	(9)
Pulmonary Valve Stenosis	356	(1)
Pulmonary Valve Regurgitation	357	(3)
Evaluation of the Right Ventricular Outflow Tract	360	(1)
Miscellaneous Abnormalities of the Pulmonary Valve	360	(1)
Tricuspid Valve	361	(9)
Doppler Evaluation of the Tricuspid Valve	362	(2)
Tricuspid Stenosis	364	(1)
Tricuspid Regurgitation	364	(3)
Determination of Right Ventricular Systolic Pressure	367	(3)
Miscellaneous Conditions	370	(3)
Carcinoid Heart Disease	370	(1)
Endocardial Fibroelastosis	370	(1)
Ebstein Anomaly	371	(1)
Pacemakers and Catheters	372	(1)
Tricuspid Valve Resection	372	(1)
Cardiac Biopsy	372	(1)
Tumors and Other Masses	373	(1)
Ischemic Heart Disease	373	(1)
Suggested Readings	373	(2)
Infective Endocarditis	375	(24)
Clinical Perspective	375	(1)
Echocardiographic Characteristics of a Vegetation	375	(6)
Diagnostic Accuracy of Echocardiography	381	(1)
Evolution of the Diagnostic Criteria	382	(1)
Complications of Endocarditis	383	(5)
Prognosis and Predicting Risk	388	(1)
Prosthetic Valve Endocarditis	389	(1)
Infected Intracardiac Devices	390	(2)
Right-Sided Endocarditis	392	(1)
Approach to the Patient with Endocarditis	393	(4)
Suggested Readings	397	(2)
Prosthetic Valves	399	(38)
Types of Prosthetic Valves	399	(1)
Normal Prosthetic Valve Function	400	(7)
General Approach to Imaging	407	(3)
Prosthetic Aortic Valves	410	(4)
Prosthetic Mitral Valves	414	(3)
Specific Causes of Dysfunction	417	(11)
Obstruction	417	(8)
Infective Endocarditis	425	(3)
Mechanical Failure	428	(1)
Right-Sided Prosthetic Valves	428	(3)
Valved Conduits	431	(1)
Mitral Valve Repair	431	(4)
Suggested Readings	435	(2)
Coronary Artery Disease	437	(51)
Clinical Overview	437	(1)
Pathophysiology of Coronary Syndromes	438	(4)
Detection and Quantitation of Wall Motion Abnormalities	442	(8)
Myocardial Strain and Strain Rate Imaging	449	(1)
Other Methods for Evaluating Ischemic Myocardium	449	(1)
Echocardiographic Evaluation of Clinical Syndromes	450	(11)
Angina Pectoris	450	(1)
Acute Myocardial Infarction	450	(7)
Natural History of Wall Motion Abnormalities	457	(3)
Prognostic Implications	460	(1)
Doppler Evaluation of Systolic and Diastolic Function in Acute Myocardial Infarction	460	(1)
Complications of Acute Myocardial Infarction	461	(8)
Pericardial Effusion	462	(1)
Infarct Expansion	463	(1)
Free-Wall Rupture	463	(1)
Ventricular Thrombus	463	(2)
Right Ventricular Infarction	465	(1)
Acute Mitral Regurgitation	466	(1)
Ventricular Septal Rupture	467	(2)
Chronic Coronary Artery Disease	469	(11)
Left Ventricular Aneurysm	469	(4)
Pseudoaneurysm	473	(2)
Chronic Remodeling	475	(1)
Mural Thrombus	476	(2)
Mitral Regurgitation	478	(1)
Ischemic Cardiomyopathy	479	(1)
Direct Coronary Visualization	480	(6)
Kawasaki Disease	483	(1)
Direct Visualization of Atherosclerosis	484	(2)
Suggested Readings	486	(2)
Stress Echocardiography	488	(35)
Physiologic Basis	488	(2)
Methodology	490	(5)
Treadmill	490	(2)
Bicycle Ergometry	492	(1)
Dobutamine Stress Echocardiography	493	(1)
Dipyridamole and Adenosine	494	(1)
Choosing Among the Different Stress Modalities	495	(1)
Interpretation of Stress Echocardiography	496	(6)
Categorization of Wall Motion	499	(1)
Wall Motion Response to Stress	500	(1)
Localization of Coronary Artery Lesions	500	(1)
Correlation with Symptoms and Electrocardiographic Changes	501	(1)
Detection of Coronary Artery Disease	502	(4)
Comparison with Nuclear Techniques	505	(1)
Applications of Stress Echocardiography	506	(9)
Prognostic Value of Stress Echocardiography	507	(1)
Stress Echocardiography After Myocardial Infarction	507	(4)
Stress Echocardiography After Revascularization	511	(1)
Preoperative Risk Assessment	512	(1)
Stress Echocardiography in Women	513	(1)
Assessment of Myocardial Viability	513	(2)
Use of Myocardial Contrast Techniques in Stress Echocardiography	515	(2)
Stress Echocardiography in Valvular Heart Disease	517	(3)
Suggested Readings	520	(3)
Cardiomyopathies	523	(36)
Clinical and Echocardiographic Overview	523	(1)
Dilated Cardiomyopathy	523	(4)
Doppler Evaluation of Systolic and Diastolic Function	527	(4)
Assessment of Diastolic Function	528	(3)
Myocardial Performance Index	531	(1)
Secondary Findings in Dilated Cardiomyopathy	531	(2)
Etiology of Dilated Cardiomyopathy	533	(3)
Determination of Prognosis in Dilated Cardiomyopathy	536	(1)
Therapeutic Decisions	537	(4)
Biventricular Pacing for Congestive Heart Failure	538	(1)
Cardiac Transplantation	538	(2)
Ventricular Assist Devices	540	(1)
Infiltrative and Restrictive Cardiomyopathy	541	(4)
Echocardiographic Evaluation of Restrictive Cardiomyopathy	542	(2)
Constrictive Versus Restrictive Heart Disease	544	(1)
Hypertrophic Cardiomyopathy	545	(10)
Echocardiographic Evaluation of Hypertrophic Cardiomyopathy	545	(4)
Assessment of the Left Ventricular Outflow Tract in Obstructive Cardiomyopathy	549	(2)
Mitral Regurgitation in Hypertrophic Cardiomyopathy	551	(1)
Other Variants of Hypertrophic Cardiomyopathy	552	(1)
Mid-Cavitary Obstruction	552	(1)
Conditions Mimicking Hypertrophic Cardiomyopathy	553	(2)
End-Stage Hypertrophic Cardiomyopathy	555	(1)
Therapeutic Decision Making and Monitoring in Hypertrophic Cardiomyopathy	555	(1)
Myocarditis	555	(2)
Postpartum Cardiomyopathy	557	(1)
Chagas Myocarditis	557	(1)
Endocardial Fibroelastosis and Hypereosinophilic Syndrome	557	(1)
Suggested Readings	558	(1)
Congenital Heart Diseases	559	(78)
The Echocardiographic Examination: A Segmental Approach to Anatomy	559	(4)
Cardiac Situs	560	(1)
Ventricular Morphology	561	(2)
Great Artery Connections	563	(1)
Abnormalities of Right Ventricular Inflow	563	(2)
Abnormalities of Left Ventricular Inflow	565	(6)
Pulmonary Veins	565	(2)
Left Atrium	567	(4)
Mitral Valve	571	(1)
Abnormalities of Right Ventricular Outflow	571	(5)
Right Ventricle	571	(3)
Pulmonary Valve	574	(2)
Pulmonary Artery	576	(1)
Abnormalities of Left Ventricular Outflow	576	(5)
Subvalvular Obstruction	577	(1)
Valvular Aortic Stenosis	578	(2)
Supravalvular Aortic Stenosis	580	(1)
Coarctation of the Aorta	581	(2)
Abnormalities of Cardiac Septation	583	(23)
Atrial Septal Defect	584	(9)
Ventricular Septal Defect	593	(11)
Endocardial Cushion Defect	604	(2)
Abnormal Vascular Connections and Structures	606	(8)
Patent Ductus Arteriosus	606	(2)
Abnormal Systemic Venous Connections	608	(2)
Abnormal Pulmonary Venous Connections	610	(2)
Abnormalities of the Coronary Circulation	612	(2)
Conotruncal Abnormalities	614	(10)
Tetralogy of Fallot	614	(1)
Transposition of the Great Arteries	615	(7)
Double-Outlet Right Ventricle	622	(1)
Persistent Truncus Arteriosus and Aortopulmonary Window	623	(1)
Abnormalities of Ventricular Development	624	(5)
Hypoplastic Left Heart Syndrome	624	(3)
Single Ventricle	627	(1)
Tricuspid Atresia	628	(1)
Echocardiographic Evaluation During and After Surgery	629	(3)
Systemic Artery to Pulmonary Artery Shunts	629	(1)
Pulmonary Artery Bands	630	(1)
The Fontan Procedure	630	(2)
Right Ventricle to Pulmonary Artery Conduits	632	(1)
Fetal Echocardiography	632	(2)
Suggested Readings	634	(3)
ICU and Operative/Perioperative Applications	637	(35)
Evaluation of Patients in an Intensive Care Unit	637	(5)
Hypotension and Shock	637	(3)
Evaluation of Hypoxia	640	(2)
Echocardiography in the Emergency Department	642	(1)
Pre-, Intra-, and Perioperative Echocardiography	642	(21)
Role of Echocardiography in Mitral Valve Surgery	644	(7)
Aortic Valve Procedures	651	(5)
Miscellaneous Applications	656	(1)
Intraoperative Complications of Cardiac Surgery	657	(3)
Operative Monitoring for Noncardiac Procedures	660	(1)
Delayed Cardiac Surgery Complications	661	(2)
Monitoring of Nonoperative and Other Interventional Procedures	663	(5)
Cardiac Interventional Procedures	664	(4)
Other Applications in the Catheterization Laboratory	668	(1)
Evaluation of Patients After Cardiac Transplantation	668	(2)
Suggested Readings	670	(2)
Diseases of the Aorta	672	(29)
Normal Aortic Anatomy	672	(1)
Echocardiographic Evaluation	673	(4)
Aortic Dilation and Aneurysm	677	(1)
Marfan Syndrome	678	(1)
Valsalva Sinus Aneurysm	679	(4)
Aortic Dissection	683	(11)
Echocardiographic Diagnosis	685	(9)
Aortic Atheroma	694	(1)
Miscellaneous Conditions	695	(4)
Aortic Pseudoaneurysm	695	(1)
Aortic Trauma	695	(3)
Infections of the Aorta	698	(1)
Aortic Thrombus	698	(1)
Takayasu Arteritis	699	(1)
Suggested Readings	699	(2)
Masses, Tumors, and Source of Embolus	701	(34)
Normal Variants and Artifacts: Sources of False-Positive Findings	701	(1)
Cardiac Tumors	702	(8)
Primary Tumors	702	(6)
Metastatic Tumors to the Heart	708	(2)
Intracardiac Thrombi	710	(15)
Left Ventricular Thrombi	710	(8)
Left Atrial Thrombi	718	(3)
Right Atrial Thrombi	721	(1)
Spontaneous Echo Contrast	721	(4)
Role of Echocardiography in Atrial Fibrillation and Cardioversion	725	(1)
Role of Echocardiography in Systemic Embolus	726	(3)
Pseudotumors and Other Cardiac Masses	729	(4)
Suggested Readings	733	(2)
Echocardiography in Systemic Disease and Clinical Problem Solving	735	(40)
Echocardiography and Systemic Disease	735	(4)
Hypertension	735	(2)
Diabetes Mellitus	737	(1)
Thyroid Disease	737	(1)
Chronic Renal Insufficiency	738	(1)
Connective Tissue/Autoimmune Disease	739	(4)
Systemic Lupus Erythematosus	739	(1)
Scleroderma/Raynaud Phenomena	740	(1)
Marfan Syndrome	740	(3)
Chronic Liver Disease and Cirrhosis	743	(3)
Chronic Obstructive Pulmonary Disease	746	(1)
Pulmonary Hypertension	746	(4)
Miscellaneous Diseases	750	(4)
Sarcoidosis	750	(1)
Hemochromatosis	751	(1)
Muscular Dystrophy	752	(1)
Hypereosinophilia	752	(1)
Carcinoid Syndrome	752	(1)
Sickle Cell Anemia	752	(1)
Human Immunodeficiency Virus	752	(1)
Diet Drug Valvulopathy	753	(1)
Obesity	754	(1)
Clinical Presentations and Problems	754	(5)
Peripheral Vascular Disease	754	(1)
Congestive Heart Failure	754	(2)
Evaluation of Dyspnea	756	(1)
Acute Pulmonary Embolus	757	(1)
Echocardiographic Findings	757	(2)
Atrial Fibrillation and Cardioversion	759	(2)
Neurologic Events and Cardiac Source of Embolus	761	(4)
Neurogenic Myocardial Stunning	765	(1)
Syncope	765	(1)
Evaluation of Cardiac Arrhythmias	766	(1)
Evaluation of Patients Before and During Chemotherapy	766	(1)
Radiation-Induced Cardiac Disease	766	(1)
Screening for Athletic Competition and the Athlete's Heart	767	(1)
The Heart in Pregnancy	768	(2)
Effects of Advanced Age	770	(2)
Suggested Readings	772	(3)
Index	775