Elias B. Hanna - Practical Cardiovascular Medicine

30 Chapter 32Figure 32.1 (a) Frontal view showing how the parasternal short-axis views cut...Figure 32.2 (a)Diagram of the parasternal short-axis viewand various LV se...Figure 32.3 (a)Parasternal short-axis view at the level of the mitral valve...Figure 32.4 Diagram of the parasternal short-axis viewat the level of the a...Figure 32.5 Parasternal short-axis viewas described in Figure 32.4. A bicus...Figure 32.6 (a)Diagram of the parasternal long-axis view. Concerning the ao...Figure 32.7 (a) Parasternal long-axis view. Measurements are obtained from t...Figure 32.8 (a) Parasternal RV inflow view, which is obtained by angling the...Figure 32.9 (a)Diagram and (b)echocardiogram of the apical four-chamber vi...Figure 32.10 (a)Diagram and (b)echocardiogram of the apical two-chamber vi...Figure 32.11 (a)Diagram and (b)example of the subcostal view.Figure 32.12 Subcostal viewwith a medial tilt to visualize the IVC. A large...Figure 32.13 Arterial distribution of various echo segmentson the short-axi...Figure 32.14 (a)Example of RV enlargement and RV volume overloadon the para...Figure 32.15 During systole, in LBBB: ( 1 ) the septum moves in towards the LV...Figure 32.16 M-mode imaging shows paradoxical septal motion of RV volume ove...Figure 32.17 Constrictive pericarditis. Two septal abnormalities and one pos...Figure 32.18 Pericardial processesare characterized by septal compression t...Figure 32.19 Posterior mitral leaflet prolapse.In systole, the leaflet prol...Figure 32.20 Rheumatic mitral valve. (a)Long-axis view in diastole. See the...Figure 32.21 Posterior mitral annular calcifications (MAC)in the long-axis ...Figure 32.22 Difference in aortic orifice shape between the tricuspid and bi...Figure 32.23 MR, four-chamber view. The blue, backward flow between the LV a...Figure 32.24 Severe MR on four-chamber TEE view. Severity criteria of MR:...Figure 32.25 MR,long-axis view. The blue flow between LV and LA is MR ( arro ...Figure 32.26 Systolic flow reversal of pulmonary venous flow in a patient wi...Figure 32.27 CW Doppler across the mitral valve on an apical four-chamber vi...Figure 32.28 Severe TRseen from the short-axis view (aortic valve level) ( a ...Figure 32.29 TR. CW Doppler across the tricuspid valve on a four-chamber vie...Figure 32.30 Aortic insufficiency (AI).Long-axis view shows blue–backward f...Figure 32.31 AI. The width of the AI jet may also be assessed on the aortic ...Figure 32.32 AIon three-chamber apical view. This view is not accurate for ...Figure 32.33 AI spectral Doppler assessmenton an apical five-chamber view. ...Figure 32.34 AS. CW Doppler across the aortic valve on the apical five-chamb...Figure 32.35 Severely increased velocity on aortic Doppler. Several features...Figure 32.36 MS assessment. (a)CW Doppler across the mitral valve (MV) on ...Figure 32.37 PW Doppler at the level of the mitral valve. During diastole, f...Figure 32.38 PW Doppler across the pulmonary veins on a four-chamber view, p...Figure 32.39 Myocardial tissue Doppler at the level of the mitral annulus.T...Figure 32.40 2D tissue strain imaging of the LV on a two-chamber view.Strai...Figure 32.41 M -mode across the mitral valve on the parasternal long-axis vie...Figure 32.42 M-mode across the aortic valve on the long-axis view.The first...Figure 32.43 Examples of M-mode across the mitral valve. (a)Posterior mitral...Figure 32.44 Diffuse pericardial effusion on long-axis view, identified as a...Figure 32.45 Pericardial effusion on multiple views.In a supine position, a...Figure 32.46 (a)Pericardial effusion ( stars ) and pleural effusion ( bar ). Th...Figure 32.47 Diagnosis of diastolic dysfunction and assessment of LA pressur...Figure 32.48 Assessment of LA pressure in patients with depressed EF:criter...Figure 32.49 Aliasing velocity of the regurgitant color, which is red in thi...Figure 32.50 Simultaneous LV pressure and PCWP recording is shown on the lef...Figure 32.51 PISA of MS on a long-axis view. PISA of MS consists of flow acc...Figure 32.52 LV–aortic pressure tracings in acute AI and chronic AI. In acut...Figure 32.53 Correlations between A, X, V, and Y waves on the LA pressure tr...Figure 32.54 Types of prosthetic valves.Surgical bioprostheses typically ha...Figure 32.55 Bioprosthetic porcine valve as evidenced by the large struts/ve...Figure 32.56 (a)Metallic mitral prosthesis. As in bioprostheses, a hyperech...Figure 32.57 (a)Frequency of the reflected wave. On pulsed-wave Doppler, the...Figure 32.58 In this interrogation of the aortic valve in the apical five-ch...Figure 32.59 The Doppler cursor is placed across the mitral valve ( double ar ...Figure 32.60 Illustration of angle rotation and anteflexion on TEE.Figure 32.61 TEE: 0° four- and five-chamber views.Figure 32.62 TEE two-chamber and long-axis views.To understand the orientat...Figure 32.63 Illustration of an axial view of the mitral plane, showing the ...Figure 32.64 TEE four-chamber 0° view. Note the calcification of the mi...Figure 32.65 TEE five-chamber view. Another case of restricted leaflets from...Figure 32.66 Severe eccentric MR is seen on the TEE four-chamber view, “hugg...Figure 32.67 MR is seen on the 90° two-chamber view. Note that, in this view...Figure 32.68 TEE long-axis (120°) view.Figure 32.69 Aortic valve short-axis view.Anteflexion is necessary to see t...Figure 32.70 Anteflexion from the level of the short-axis view leads to the Figure 32.71 (a)Clockwise torque from the 0° four-chamber view allows a focu...Figure 32.72 From a 90–120° LV/aortic view, torquing the TEE probe to the le...Figure 32.73 Interatrial septum (IAS) bicaval view(“Mickey Mouse” view). Tr...Figure 32.74 (a)Bicaval view opening the thin part of the interatrial septu...Figure 32.75 Bicaval view showing an ostium secundum ASD. ASD is a defect; i...Figure 32.76 (a)Bicaval view showing sinus venous ASD ( arrow ). Note the lac...Figure 32.77 0° view at a high level, allowing visualization of structures a...Figure 32.78 Anteflexion from Figure 32.77 shows an even higher level. The P...Figure 32.79 Short-axis 0° transgastric view, showing both the LV and RV.Figure 32.80 (a)Short-axis 0° transgastric view with more anteflexion than ...Figure 32.81 (a)Transgastric two-chamber view showing the LA–LV (90°). (b)...Figure 32.82 Transgastric long-axis view (120°) (deeper gastric level than F...Figure 32.83 Three-dimensional TEE view of the mitral valve (en-face view)....Figure 32.84 Three layers of LV myocardial fibers: (1) outer oblique fibers ...

31 Chapter 33Figure 33.1 Stress testing modality. *Baseline ECG abnormalities precluding ...Figure 33.2 During sinus tachycardia, atrial repolarization becomes accentua...Figure 33.3 Nuclear images are displayed in three views: Short-axis cuts...Figure 33.4 A severe defect ( arrows ) is noted in the inferior and septal wal...Figure 33.5 Gated SPECT myocardial excursion of the previous case (Figure 33...Figure 33.6 This is an axial CT view. The right ventricle is the most anteri...Figure 33.7 This is an oblique view of the proximal LAD (a vertical cut thro...Figure 33.8 This is a curved view of the RCA. The curved view is a processed...Figure 33.9 This is an axial CT view. The LAD has a soft plaque proximally (...Figure 33.10 The basal septum is normal, that is, black and does not enhance...Figure 33.11 Patterns of LGE in ischemic and various non-ischemic cardiomyop...Figure 33.12 Myocarditis in a 26-year-old man. Note the subepicardial white ...