Textbook of Echocardiography

An echocardiogram uses sound waves to produce images of the heart. This common test allows a doctor to see the heart beating and pumping blood, and subsequently identify heart disease.

This book is a complete guide to performing and interpreting an echocardiogram. 56 chapters describe both basic and advanced techniques for diagnosing different heart disorders.

The second edition has been fully revised to provide clinicians with the latest developments and techniques in the field.

Seven new chapters have been added to this edition covering echocardiography and artificial intelligence, hypertension, arrhythmogenic right ventricular dysplasia, Kawasaki disease, cardio-oncology, diabetes mellitus, and foetal echo.

Dedicated chapters emphasise the role of echo in surgical procedures, and explore its use with electrophysiology – in patients with pacemakers and those undergoing cardiac resynchronisation therapy.

The book is highly illustrated with many 2D and 3D echo images helping explain the descriptive text for each topic.

CONTENTS
1. Basics of Ultrasound 1
Ashwin Venkateshvaran, Srikanth Sola
• Basic Principles 1; • Selecting a Transducer 2; • Understanding Image Resolution 3;
• Understanding Tissue Harmonic Imaging 5; • Understanding Artifacts 8
2. Introduction to Doppler Echocardiography 14
Madhu Mary Minz, Mansi Kaushik, Manish Bansal, Ravi R Kasliwal
• Doppler Equation 14; • Doppler Display 15; • Modes of Doppler Echocardiography 16;
• Doppler Ultrasound Equipment Control Panel 21; • Applications of Doppler Echocardiography in
Cardiology 22; • Doppler Artifacts 26
3. How to do Basic Transthoracic Echocardiography? 29
Vivek Tandon
• Preliminaries 29; • Basic Echocardiographic Examination 31; • Reporting 41
4. Performance of Transesophageal Echocardiography:
Basic Principles and Views 43
Nitin J Burkule, Manish Bansal
• Transesophageal Echocardiography Probe Hardware 43; • Patient Selection 43;
• Patient Set-up, Anesthesia, Intraprocedure Monitoring Considerations 44; • Technique of
Transesophageal Echocardiography Probe Insertion 46; • Technical Aspects of Transesophageal
Echocardiography Probe Manipulation and Image Display 47; • Transesophageal Echocardiography
Windows 49; • General Principles of Transesophageal Echocardiography Imaging 50;
• General Workflow of Comprehensive Transesophageal Echocardiography Imaging and Main Views 50
5. Chamber Quantification: Left Ventricle 65
Satish K Parashar, Rohit Tandon, Ankush Sachdeva, Sameer Shrivastava
• Measurement of Left Ventricular Linear Dimensions 66; • Left Ventricular Mass 67; • Evaluation of Left
Ventricular Volumes and Global Left Ventricular Systolic Functions 68; • Other Parameters for Estimating
Global Left Ventricular Functions 72; • Live Three-dimensional Echocardiography in Left Ventricular
Quantitation 75; • Global Longitudinal Strain 75 • Learning Points 77
6. Chamber Quantification: Right Ventricle 79
Rahul Mehrotra
• Problems with Right Ventricular Assessment 79; • Echocardiographic Views 79; • Measurement of
Right Ventricular Linear Dimensions 79; • Measurement of Right Ventricle Wall Thickness 82;
• Volumetric Assessment of Right Ventricle 82; • Measurement of Right Ventricle Systolic
Function 82; • Measurement of Right Ventricular Diastolic Function 84
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7. Chamber Quantification: Left Atrium and Right Atrium 88
Rajan Joseph Manjuran
• Left Atrial Volume Assessment 88; • Right Atrial Volume Assessment 92
8. Echocardiography in Pulmonary Hypertension 95
R Alagesan, Satish C Govind
• Evolution of Criteria of Pulmonary Hypertension 95; • Definition and Classification 96;
• Echocardiography in Pulmonary Hypertension 96
9. Echocardiographic Evaluation of Diastolic Functions 111
Anirudddha De, Satish K Parashar
• What is Diastolic Dysfunction and Why LV Filling Pressure is Increased? 112; • Pathophysiology of
Diastolic Dysfunction 112; • Hemodynamic Concepts of Diastole 113; • Echocardiographic
Assessment of Diastolic Function 114; • Mitral Annular Tissue Doppler 115; • Additional Useful
Parameters 118; • Newer Diagnostic Parameters 122; • Grading of Diastolic Dysfunction 124;
• Assessment of Diastolic Dysfunction in Four Common Clinical Conditions 125; • Diastolic Stress Test 128
10. Echocardiographic Evaluation of Mitral Valve 132
Satish K Parashar, Rakesh Gupta, Nandita Chakrabarti, Sangeeta Porwal
• Anatomy of Mitral Valve 132; • Echocardiographic Evaluation of Mitral Valve 133
11. Echocardiographic Evaluation of Mitral Stenosis 137
Satish K Parashar, S Balasubramanian, I Balaji, V Amuthan, Rakesh Gupta
• Pathophysiology of Mitral Stenosis 137; • Etiology 138; • Diagnosis 140; • Stages of Mitral
Stenosis 141; • Assessment of Severity 141; • Grading of Severity 147; • Key Points in Valve
Morphology 148; • Intracardiac Thrombi in Mitral Stenosis 148; • Mimickers of Mitral Stenosis 150
12. Step-by-Step Evaluation of Mitral Regurgitation Using Echocardiography 154
Rohit Tandon, Satish K Parashar, Shibba Takkar, Gurpreet Singh Mahal
• Main Goals of Imaging 154; • Mitral Valve Anatomy 154; • Hemodynamic Effects of Chronic
Mitral Regurgitation 154; • Etiology of Mitral Regurgitation 154; • Mechanisms of Mitral
Regurgitation 156; • Advanced Echocardiography Techniques Used in Mitral Regurgitation 163;
• Role of Exercise Stress Echocardiography in Mitral Regurgitation Evaluation 164;
• Role of Echocardiography Imaging in Guiding Management Decisions 166
13. Examination of Valves: Aortic Valve 170
R Alagesan, Satish C Govind
• Anatomy of Aortic Valve 170; • Echocardiographic Examination 172
14. Echocardiography in Aortic Stenosis 179
R Alagesan, Satish C Govind
• Assessment of Aortic Stenosis 180; • Quantitative Doppler Echocardiography 184;
• Other Indices of Severity of Aortic Stenosis 195; • Correlation of Peak Gradient, Mean Gradient and
Effective Orifice Area 196; • Special Considerations in Aortic Stenosis 200
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Author information

V Amuthan MD DM FACC FEACVI FASE FESC FCSI FIAE
Emeritus Professor of Cardiology, The Tamil Nadu Dr MGR Medical University; Director, 4D Echocardiography Lab, Jeyalakshmi Heart Centre; Senior Interventional Cardiologist, Vadamalayan Hospital, Madurai, Tamil Nadu, India

Satish K Parashar MD FACC FCSI FIAE
Senior Consultant, Non-Invasive Cardiac Laboratory at Metro Group of Hospitals & Heart Institute, New Delhi, India