Andersons pediatric cardiology 464

Cross-Sectional Echocardiography and Doppler Imaging Conall T... This chapter on cross-sectional echocardiography and Doppler imaging covers a wide range of topics including ultrasound p

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Cross-Sectional Echocardiography and Doppler Imaging

Conall T Morgan, Luc L Mertens

This chapter on cross-sectional echocardiography and Doppler imaging covers a wide range of topics including ultrasound physics, Doppler

echocardiography, image optimization and anatomic principles guiding echocardiography We discuss transthoracic imaging in addition to

transoesphageal imaging and special uses of echocardiography including postoperative echocardiography, contrast echocardiography and stress

echocardiography

Keywords

Echocardiography; Doppler; physics; transesophageal

Since the late 1970s, perhaps the most important change in the practice of

clinical pediatric cardiology has been the introduction of cross-sectional

echocardiography and its subsequent technical improvements Echocardiography currently allows highly accurate diagnosis of nearly all morphologic

abnormalities, for the most part making invasive diagnostic techniques obsolete Cardiac catheterization and angiography are no longer a routine investigation in most patients prior to cardiac surgery, as it used to be a few decades ago Indeed, the main indication for such an investigation, apart from the purposes of

assessing hemodynamics and intervention, is the display of structures beyond echocardiographic visualization, such as peripheral pulmonary arteries, distal coronary arteries, and more rarely complex abnormalities of systemic and

pulmonary venous return Even so, for many of these indications, magnetic

resonance and computerized tomographic imaging have replaced cardiac

catheterization All pediatric cardiologists, cardiac intensivists, and pediatric cardiac surgeons should therefore be familiar with echocardiographic imaging and diagnosis More recently point-of-care echocardiography has been

introduced in the neonatal intensive care unit for specific diagnostic applications such as monitoring ductal patency and pulmonary arterial hypertension of the newborn The increased availability of handheld echo machines has expanded their use in the pediatric emergency department, potentially allowing faster

diagnosis of cardiac dysfunction and pericardial effusion in life-threatening conditions This chapter is devoted to the principles of cross-sectional and