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Echo Research and Practice

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https://www.readbyqxmd.com/read/30099388/the-use-of-apixaban-for-the-treatment-of-an-lv-thrombus
#1
Sadie Bennett, Duwarakan Satchithananda, Garth Law
A 42 year old male was admitted with shortness of breath secondary to suspected heart failure and chest infection. An echocardiogram revealed a dilated and impaired left ventricle; ejection fraction 29%, with a large, mobile thrombus within the left ventricular apex. Due to the presence of liver dysfunction, vitamin K antagonists were deemed inappropriate, thus the decision was taken to use the novel anticoagulation agent Apixaban. After six days of receiving Apixaban, a cardiac magnetic resonance scan was preformed which showed complete resolution of the LV apical thrombus...
August 11, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/30099387/concomitant-acute-stroke-pulmonary-and-myocardial-infarction-due-to-in-transient-thrombus-across-a-patent-foramen-ovale
#2
Sergio Barros-Gomes, Abdullah El Sabbagh, Mackram F Eleid, Sunil V Mankad
Non-atherosclerotic myocardial infarction (MI) is an important but often misdiagnosed cause of acute MI. Furthermore, non-atherosclerotic MI with concomitant acute stroke and pulmonary embolism due to in-transit thrombus across a patent foramen ovale (PFO) is a rare but potentially fatal combination (1-3). Early detection of this clinical entity can facilitate delivery of targeted therapies and avoid poor outcome (1, 2). Here, we describe a 68-year-old female with hypertension, tobacco abuse, and chronic obstructive pulmonary disease presenting with facial droop, right arm weakness and aphasia...
August 11, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/30099386/trans-oesophageal-echocardiography-toe-contra-indications-complications-and-safety-of-perioperative-toe
#3
REVIEW
Neil David Hauser, Justiaan Swanevelder
Trans-oesophageal echocardiography (TOE) has become an almost universal intraoperative monitor and diagnostic tool. The use of TOE in most cardiac, aortic, major vascular and transplant operations is used to aid anaesthetic management as well as assist surgical decision-making. In addition to the perioperative environment it is increasingly being used in the Outpatient Department, Emergency Department and Intensive Care settings. In this review we consider the safety associated with the use of TOE, we review the suggested contra-indications and areas that we would consider to TOE to be a necessity...
August 11, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/30012852/educational-series-in-congenital-heart-disease-prenatal-diagnosis-of-congenital-heart-disease
#4
REVIEW
Lindsey E Hunter, Anna N Seale
This review article will guide the reader through the background of prenatal screening for congenital heart disease. The reader will be given insight into the normal screening views, common abnormalities, risk stratification of lesions and also recent advances in prenatal cardiology.
July 16, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29991480/a-physiologist-observing-and-reporting-supraphysiologic-dobutamine-stress-testing
#5
EDITORIAL
Thomas R Porter
In a study, published in this issue of Echo Research and Practice, Ntoskas et al. retrospectively analyzed the safety of a cardiac physiologist performing, and interpreting, DSEs in of 300 patients undergoing DSE for the detection of inducible reversible ischemia, myocardial viability, and valvular heart disease. While safety during the tests themselves did not appear to be compromised with this unsupervised approach, the interpretation of these DSEs causes concerns regarding broad patient safety relative to misread results...
July 10, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29976783/clinical-and-echocardiographic-follow-up-of-patients-following-surgical-heart-valve-repair-or-replacement-a-tertiary-centre-experience
#6
Bashir Alaour, Christina Menexi, Benoy Shah
International best practice guidelines recommend lifelong follow-up of patients that have undergone valve repair or replacement surgery and provide recommendations on the utilization of echocardiography during follow-up. However, such follow-up regimes can vary significantly between different centres and sometimes within the same centre. We undertook this study to determine the patterns of clinical follow-up and use of transthoracic echocardiography (TTE) amongst cardiologists in a large UK tertiary centre...
July 5, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29973344/left-ventricular-diastolic-dysfunction-identifying-presence-by-left-atrial-function
#7
Emily Worley, Bushra Rana, Lynne Williams, Shaun Robinson
OBJECTIVE: The left atrium (LA) is exposed to left ventricular pressure during diastole. Applying the 2016 American Society of Echocardiography left ventricular diastolic function (LVDF) guidelines; this study aims to investigate whether: left atrial ejection fraction (LAEF) and left atrial active emptying fraction (LAAEF) are markers of diastolic dysfunction (LVDD). METHODS: Retrospective cohort of consecutive patients (n=124) who underwent trans-thoracic echocardiography were studied...
July 4, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29973343/safety-and-efficacy-of-physiologist-led-dobutamine-stress-echocardiography-experience-from-a-tertiary-cardiac-centre
#8
Theodoros Ntoskas, Farhanda Ahmad, Paul Woodmansey
BACKGROUND: Dobutamine stress echocardiography (DSE) services have traditionally been medically led. In some UK institutions DSE lists are led by physiologists with medical support. In our tertiary cardiac centre at New Cross Hospital (NCH), the DSE service was established by a consultant echocardiographer. Following intensive training and assessment, the Trust approved drug administration by named senior cardiac physiologists. We believe this is the first report of a cardiac physiologist-managed DSE service, including physiologist drug administration...
July 4, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29895628/a-man-with-multiple-cardiac-masses
#9
Manasawee Indrabhinduwat, Maria C Arciniegas Calle, Joseph P Colgan, Benoy N Villarraga
A 37-year-old male presented with cough, dyspnea, significant weight loss (45 pounds) and subacute fever for the past two months. Physical examination revealed inspiratory and expiratory wheezing bilaterally. A normal S1, S2 and a 3/6 systolic ejection murmur at the left upper parasternal border with respiratory variation were found during cardiac auscultation. Kidney and bone marrow biopsy reported a high grade B cell lymphoma. Echocardiography and cardiac CT findings consisted of multiple intracardiac masses affecting the right ventricular (RV) outflow track, RV apex, medial portion of the right atrium and posterior left atrium, as well as mild impairment of the RV systolic function...
June 12, 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/30078786/a-physiologist-observing-and-reporting-supra-pharmacologic-dobutamine-stress-testing-can-we-trust-them-and-can-we-trust-the-results
#10
EDITORIAL
Thomas R Porter
In a study, published in this issue of Echo Research and Practice , Ntoskas et al retrospectively analyzed the safety of a cardiac physiologist performing, and interpreting, Dobutamine stress echocardiography (DSE) in of 300 patients undergoing DSE for the detection of inducible reversible ischemia, myocardial viability and valvular heart disease. While safety during the tests themselves did not appear to be compromised with this unsupervised approach, the interpretation of these DSEs causes concerns regarding broad patient safety relative to misread results...
September 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/30012832/echocardiographic-assessment-of-pulmonary-hypertension-a-guideline-protocol-from-the-british-society-of-echocardiography
#11
Daniel X Augustine, Lindsay D Coates-Bradshaw, James Willis, Allan Harkness, Liam Ring, Julia Grapsa, Gerry Coghlan, Nikki Kaye, David Oxborough, Shaun Robinson, Julie Sandoval, Bushra S Rana, Anjana Siva, Petros Nihoyannopoulos, Luke S Howard, Kevin Fox, Sanjeev Bhattacharyya, Vishal Sharma, Richard P Steeds, Thomas Mathew
Pulmonary hypertension is defined as a mean arterial pressure of ≥25 mmHg as confirmed on right heart catheterisation. Traditionally, the pulmonary arterial systolic pressure has been estimated on echo by utilising the simplified Bernoulli equation from the peak tricuspid regurgitant velocity and adding this to an estimate of right atrial pressure. Previous studies have demonstrated a correlation between this estimate of pulmonary arterial systolic pressure and that obtained from invasive measurement across a cohort of patients...
September 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/30006443/a-male-with-multiple-cardiac-masses
#12
Manasawee Indrabhinduwat, Maria C Arciniegas Calle, Joseph P Colgan, Hector R Villarraga
SummaryThirty-seven-year-old male presented with cough, dyspnea, significant weight loss (20 kg) and subacute fever for the past 2 months. Physical examination revealed inspiratory and expiratory wheezing bilaterally. A normal S1, S2 and a 3/6 systolic ejection murmur at the left upper parasternal border with respiratory variation were found during cardiac auscultation. Kidney and bone marrow biopsy reported a high-grade B-cell lymphoma. Echocardiography and cardiac CT findings consisted of multiple intracardiac masses affecting the right ventricular (RV) outflow track, RV apex, medial portion of the right atrium and posterior left atrium, as well as mild impairment of the RV systolic function...
September 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29895627/sub-acute-leaflet-thrombosis-a-reversible-cause-of-aortic-stenosis
#13
Athina Chasapi, Adam Hobbs, Theodore Velissaris, Benoy N Shah
No abstract text is available yet for this article.
September 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29743180/comparison-of-transesophageal-and-transthoracic-echocardiography-under-moderate-sedation-for-guiding-transcatheter-aortic-valve-replacement
#14
Ines Sherifi, Alaa Mabrouk Salem Omar, Mithun Varghese, Menachem Weiner, Ani Anyanwu, Jason C Kovacic, Samin Sharma, Annapoorna Kini, Partho P Sengupta
The optimal periprocedural imaging strategy during transcathether aortic valve replacement (TAVR) performed under moderate sedation is debated. Transthoracic echocardiography (TTE) provides suboptimal views due to poorer resolution and patient positioning, whereas use of transesophageal echocardiography (TEE) under moderate sedation is not widely utilized. The aim of our study was to compare the value of TTE in comparison with TEE guidance under moderate sedation during TAVR. The study population included 144 consecutive patients (mean age 83 ± 11 years, 78 (54%) females) who had TAVR under moderate sedation using either a TTE ( n  = 96) or TEE ( n  = 48)...
June 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29691224/echo-and-heart-failure-when-do-people-need-an-echo-and-when-do-they-need-natriuretic-peptides
#15
REVIEW
Daniel Modin, Ditte Madsen Andersen, Tor Biering-Sørensen
Heart failure (HF) is a threat to public health. Heterogeneities in aetiology and phenotype complicate the diagnosis and management of HF. This is especially true when considering HF with preserved ejection fraction (HFpEF), which makes up 50% of HF cases. Natriuretic peptides may aid in establishing a working diagnosis in patients suspected of HF, but echocardiography remains the optimal choice for diagnosing HF. Echocardiography provides important prognostic information in both HF with reduced ejection fraction (HFrEF) and HFpEF...
June 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29685924/the-clot-thickens-an-incompletely-ligated-left-atrial-appendage
#16
Merrill Thomas, Anna Grodzinsky, Martin Zink
SummaryOur patient presented with known mechanical mitral valve endocarditis documented by 2D transesophageal echocardiogram (TOE) from a recent hospitalization at an outside facility. On admission to our center, there was no prior knowledge of an incompletely ligated left atrial appendage (LAA) according to patient- or family-reported history, review of outside records or the outside facility's 2D TOE report. A 3D TOE performed at our center to assess her pathology, since a month had passed from her prior hospitalization, revealed a LAA ligation with evidence of communication to the left atrium and with clot present in the appendage...
June 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29681546/educational-series-in-congenital-heart-disease-congenital-left-sided-heart-obstruction
#17
REVIEW
Michelle Carr, Stephanie Curtis, Jan Marek
Congenital obstruction of the left ventricular outflow tract remains a significant problem and multilevel obstruction can often coexist. Obstruction can take several morphological forms and may involve the subvalvar, valvar or supravalvar portion of the aortic valve complex. Congenital valvar stenosis presenting in the neonatal period represents a spectrum of disorders ranging from the hypoplastic left heart syndrome to almost normal hearts. Treatment options vary dependent on the severity of the left ventricular outflow tract obstruction (LVOTO) and the variable degree of left ventricular hypoplasia as well as the associated lesions such as arch hypoplasia and coarctation...
June 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29674478/quadruple-valve-replacement-in-a-patient-with-severe-rheumatic-heart-disease
#18
Isaac Adembesa, Adriaan Myburgh, Justiaan Swanevelder
SummaryWe present a patient with rheumatic heart disease involving all the heart valves. An intraoperative transoesophageal echocardiography confirmed severe mitral stenosis, severe aortic regurgitation, severe tricuspid regurgitation and stenosis, and severe pulmonary stenosis. The patient underwent successful quadruple valve replacement during a single operation at the Groote Schuur Hospital, Cape Town, South Africa. LEARNING POINTS: Rheumatic heart disease can affect all the heart valves including the pulmonary valve...
June 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29643125/what-is-the-minimum-change-in-left-ventricular-ejection-fraction-which-can-be-measured-with-contrast-echocardiography
#19
Tan Suwatanaviroj, Weimin He, Edith Pituskin, Ian Paterson, Jonathan Choy, Harald Becher
BACKGROUND: There are limited data on what is the minimum change that can be detected in cancer patients undergoing treatment with cardiotoxic drugs and are referred for monitoring left ventricular (LV) function. OBJECTIVE: To assess the variability in the measurement of LV volumes and ejection fraction (EF) in contrast echocardiography and to determine the minimum detectable difference (MDD) between two EF measurements that can be deemed significant. METHODS: A total of 150 patients were divided into three groups according to EF (EF <53, 53-60, and >60%)...
June 2018: Echo Research and Practice
https://www.readbyqxmd.com/read/29643124/myocardial-ischaemia-as-a-result-of-external-coronary-compression-from-infective-aortic-root-aneurysm-atypical-presentation-of-prosthetic-valve-endocarditis
#20
Baskar Sekar, Richard Wheeler, Navroz Masani, Sean Gallagher
SummaryThis case describes an unusual presentation of prosthetic valve endocarditis (PVE): an acute coronary syndrome. A 67-year-old male presented with cardiac sounding chest pain on a background of a short history of night sweats, weight loss and general malaise. Four months previously, he had undergone bio-prosthetic aortic valve replacement for severe aortic stenosis and single vessel bypass grafting of the obtuse marginal. Whilst having chest pain, his ECG showed infero-lateral ST depression. Early coronary angiography revealed a new right coronary artery (RCA) lesion that was not present prior to his cardiac surgery...
June 2018: Echo Research and Practice
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