Ebook Comprehensive textbook of echocardiography (Volume 1): Part 1

(BQ) Part 1 book Comprehensive textbook of echocardiography presents the following contents: History and basics (history of echocardiography, basics of ultrasound, basics of 3D ultrasound,...), echocardiography/ultrasound examination and training (M-mode examination, the complete transthoracic echocardiography, nonstandard echocardiographic examination,...).

Comprehensive Textbook of Echocardiography

Vol 1

Comprehensive Textbook of Echocardiography

JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD

New Delhi • London • Philadelphia • Panama

®

Editor

Distinguished Professor of Medicine and Cardiovascular Disease and

Director, Heart Station/Echocardiography Laboratories University of Alabama at Birmingham and the University of

Alabama Health Services Foundation The Kirklin Clinic, Birmingham, Alabama, USA President, International Society of Cardiovascular Ultrasound

Under the Aegis of The International Society of Cardiovascular Ultrasound

and The Indian Academy of Echocardiography

Vol 1

Headquarters

Jaypee Brothers Medical Publishers (P) Ltd

4838/24, Ansari Road, Daryaganj

New Delhi 110 002, India

Phone: +91-11-43574357

Fax: +91-11-43574314

Email: jaypee@jaypeebrothers.com

Overseas Offices

J.P Medical Ltd Jaypee-Highlights Jaypee Medical Inc.

83, Victoria Street, London Medical Publishers Inc The Bourse

SW1H 0HW (UK) City of Knowledge, Bld 237 111 South Independence Mall East Phone: +44-2031708910 Clayton, Panama City, Panama Suite 835, Philadelphia, PA 19106, USA Fax: +02-03-0086180 Phone: +1 507-301-0496 Phone: +1 267-519-9789

Jaypee Brothers Jaypee Brothers

Medical Publishers (P) Ltd Medical Publishers (P) Ltd

All rights reserved No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.

All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners The publisher is not associated with any product or vendor mentioned in this book

Medical knowledge and practice change constantly This book is designed to provide accurate, authoritative information about the subject matter

in question However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications It is the responsibility of the practitioner to take all appropriate safety precautions Neither the publisher nor the author(s)/ editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.

This book is sold on the understanding that the publisher is not engaged in providing professional medical services If such advice or services are required, the services of a competent medical professional should be sought.

Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity.

My late parents Balwant Rai Nanda MD and Mrs Maya Vati Nanda

My wife Kanta Nanda MD Our children Nitin Nanda, Anita Nanda Wasan MD and Anil Nanda MD

Their spouses Sanjeev Wasan MD and Seema Tailor Nanda, and our grandchildren Vinay and Rajesh Wasan, and Nayna and Ria Nanda

Masood Ahmad MD FRCP (C) FACP FACC

FAHA FASE

Division of Cardiology

Department of Internal Medicine

University of Texas Medical Branch

Galveston Texas, USA

Dheeraj Arora DNB PDCC MNAMS

Institute of Critical Care and Anesthesia

Medanta The Medicity

Gurgaon, Haryana, India

University of Texas Medical Branch

Galveston, Texas, USA

Neeraj Awasthy FNB

Fortis Escorts Heart Institute

New Delhi, India

Rula BalluzMD MPH

Heart Center, St Christopher’s Hospital

for Children and

Section of Cardiology

Department of Pediatrics, Drexel

University College of Medicine

Philadelphia, Pennsylvania, USA

Piers BarkerMD

Department of Pediatrics

Division of Pediatric Cardiology

Duke University Medical Center

Durham, North Carolina, USA

Manreet Basra MBBS

Professor of Medicine University at Buffalo School of Medicine and Biological Sciences

New York, USA

Charles E Beale MD

Department of Medicine Division of Cardiovascular Diseases Stony Brook University Medical Center Stony Brook, New York, USA

Roy Beigel MD

The Heart Institute, Cedars Sinai Medical Center, Los Angeles, California, USA The Leviev Heart Center Sheba Medical Center, Affiliated to the Sackler

School of Medicine Tel Aviv University, Tel Aviv, Israel

Ricardo Benenstein MD

Echocardiography and Vascular Lab Assistant Professor of Medicine New York University School of Medicine New York, New York, USA

Kunal Bhagatwala MBBS

Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham, Alabama, USA

Aditya Bharadwaj MD

Department of Cardiology Loma Linda University and

VA Medical Centers Loma Linda, California, USA

Aarti H Bhat MBBS

Assistant Professor Division of Pediatric Cardiology Seattle Children’s Hospital and University of Washington Seattle, Washington, USA

Nicole Bhave MD

University Health Network Toronto General Hospital University of Toronto Toronto, Ontario, Canada

Monodeep Biswas MBBS MD

Division of Cardiology Geisinger-Community Medical Center, and The Wright Center for Graduate Medical Education Scranton, Pennsylvania, USA

Steven Bleich MD

Department of Medicine Division of Internal Medicine University of Alabama at Birmingham Birmingham, Alabama, USA

O Julian Booker MD

Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham, Alabama, USA

Eduardo Bossone MD PhD FCCP FESC FACC

Via Principe Amedeo Lauro (AV), Italy Heart Department, University of Salerno, “Scuola Medica Salernitana” Salerno, Italy

Department of Cardiac Surgery IRCCS Policlinico San Donato, Milan, Italy

Luis Bowen MD

Department of Medicine University of Alabama at Birmingham Birmingham, Alabama, USA

Gerald Buckberg MD

Department of Cardiothoracic Surgery David Geffen School of Medicine University of California-Los Angeles Los Angeles, California, USA

Michael J Campbell MD

Department of Pediatrics Division of Pediatric Cardiology Duke University Medical Center Durham, North Carolina, USA

Premindra PAN Chandraratna MD

FRCP FACC

Professor Emeritus Division of Cardiology UC-Irvine School of Medicine Irvine, California, USA

Leon H Charney

Division of Cardiology

New York University Medical Center

New York, New York, USA

Farooq A Chaudhry MD FACP FACC

FASE FAHA

Professor of Medicine

Director, Echocardiography Laboratories

Associate Director, Mount Sinai Heart

Network, Icahn School of Medicine at

Mount Sinai, Zena and Michael A Wiener

Cardiovascular Institute and

Marie-Josée and Henry R Kravis Center

for Cardiovascular Health

New York, New York, USA

Preeti Chaurasia MD

Division of Cardiovascular Disease

University of Alabama at Birmingham

Birmingham, Alabama

Reema Chugh MD FACC

Consultant in Cardiology/Specialist in

Adult Congenital Heart Disease and

Heart Disease in Pregnancy

Kaiser Permanente Medical Center

Panorama City, California, USA

Krishnaswamy Chandrasekaran MD

Mayo Clinic, Scottsdale, Arizona, USA

Rochester, Minnesota, USA

Michael Chen MD

University of Washington

Seattle, Washington DC, USA

HK Chopra MD

Moolchand City Hospital

New Delhi, India

Cecil Coghlan MD

Division of Cardiovascular Disease

University of Alabama at Birmingham

Birmingham, Alabama, USA

Neil L Coplan MD FACC

Director, Division of Clinical Cardiology

Program Director, Cardiovascular

Fellowship, Lenox Hill Hospital

New York, USA

Monaldi Hospital, Naples, Italy

David Daly MD

Department of Medicine University of Alabama at Birmingham Birmingham, Alabama, USA

Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham, Alabama, USA

Bahaa M Fadel MD

King Faisal Specialist Hospital and Research Center

Heart Center Riyadh, Saudi Arabia

Abid Ali Fakhri MD

Fellow, Division of Cardiology Allegheny General Hospital Pittsburgh, Pennsylvania, USA

Francesco Faletra MD

Division of Cardiology Fondazione Cardiocentro Ticino Lugano, Switzerland

Francesco Ferrara MD

Heart Department, University of Salerno

“Scuola Medica Salernitana”

Salerno, Italy Department of Internal Medicine and Cardiovascular Sciences

University “Federico II” of Naples Naples, Italy

Brandon Fornwalt MD PhD

Assistant Professor of Pediatrics Department of Pediatrics University of Kentucky Lexington, Kentucky, USA

Daniel ForshaMD

Department of Pediatrics Division of Pediatric Cardiology Duke University Medical Center Durham, North Carolina, USA

Gary P Foster MD

Department of Cardiology Loma Linda University and

VA Medical Centers, Loma Linda California, USA

Naveen Garg MBBS Dip Cardiology

Fellow, Noninvasive Cardiac Lab Indraprastha Apollo Hospitals New Delhi, India

Luna Gargani MD

Institute of Clinical Physiology National Research Council Pisa, Italy

Eleonora Gashi DO MPhil

Senior Cardiology Fellow Lenox Hill Hospital Non-Invasive Cardiology New York, New York, USA

Robert P Gatewood Jr MD FACC

Chief of Cardiac Services Kaleida Heath; Clinical Associate Professor of Medicine

University at Buffalo School of Medicine and Biological Sciences Buffalo Cardiology and Pulmonary Associates, Main Street Williamsville New York, USA

Shuping Ge MD FAAP FACC FASE

Chief, Section of Cardiology

St Christopher’s Hospital for Children Associate Professor of Pediatrics Drexel University College of Medicine Philadelphia, Pennsylvania, USA Acting Chair, Pediatric Cardiology Deborah Heart and Lung Center Browns Mills, New Jersey, USA

Gopal Ghimire MD DM MRCP

Division of Cardiovascular Diseases

University of Alabama at Birmingham

Birmingham, Alabama, USA

Nina Ghosh MD

Division of Cardiovascular Medicine

Brigham and Women’s Hospital

Harvard Medical School

Francis Street

Boston, Massachusetts, USA

Edward Gill MD

Professor of Medicine and

Cardiology, University of Washington

Seattle, Washington DC, USA

Rohit Gokhale MBBS

University at Buffalo

Buffalo, New York, USA

Aasha S Gopal MS MD FACC FAHA FASE

Associate Professor of Medicine

Stony Brook University

Stony Brook, New York, USA

Director, Advanced Echocardiography

St Francis Hospital, Washington Blvd

Roslyn, New York, USA

Willem Gorissen

Clinical Market Manager

Toshiba Medical Systems Europe

Zoetermeer, The Netherlands

Luis Gruberg MD FACC

Department of Medicine

Division of Cardiovascular Diseases

Stony Brook University Medical Center

Stony Brook, New York, USA

Rakesh Gupta MD

JROP Healthcare

New Delhi, India

Fadi G Hage MD

Division of Cardiovascular Disease

University of Alabama at Birmingham

Birmingham, Alabama, USA

Section of Cardiology, Birmingham

Veteran’s, Administration Medical Center

Birmingham, Alabama, USA

Donald Hagler MD

Mayo Clinic Rochester, Minnesota, USA

Stephanie El-Hajj MD

Department of Internal Medicine Louisiana State University Health Sciences Center

Baton Rouge, Louisiana, USA

Kamran Haleem MD

Yale University New Haven, Connecticut, USA

Dan G Halpern MD

St Luke’s-Roosevelt Hospital Center Columbia University, College of Physicians and Surgeons New York, New York, USA

Rachel Harris MD MPH

Morehouse School of Medicine Section of Cardiology

Assistant Professor Echo Lab Co-Director Grady Memorial Hospital Atlanta, Georgia, USA

Christine Henri MD

Department of Cardiology Heart Valve Disease Clinic CHU Sart Tilman, University of Liège, Belgium

Julien IE Hoffman MD

Department of Pediatrics University of California San Francisco, California, USA

Brian D Hoit MD

Director of Echocardiography Harrington Heart & Vascular Center University Hospitals of Cleveland Texas, USA

Steven J Horn MD FACC FASE FASNC

SUNY Buffalo Buffalo, New York, USA

Ming Chon Hsiung MD

Cardiologist Cheng Hsin General Hospital Taipei, Taiwan

Rachel Hughes-Doichev MD FASE

Temple University School of Medicine Pittsburgh, Pennsylvania, USA

Arzu Ilercil MD

Associate Professor of Medicine Department of Cardiovascular Sciences University of South Florida

Tampa, Florida, USA

Trevor Jenkins MD

Harrington Heart and Vascular Institute University Hospital Case Medical Center, Cleveland Ohio, USA

Abdallah Kamouh MD

University of Buffalo Buffalo, New York, USA

Poonam Malhotra Kapoor MD

All India Institute of Medical Sciences New Delhi, India

Martin G Keane MD FACC FAHA FASE

Professor of Medicine

Cardiology Section

Director of Echocardiography

Temple University School of Medicine

Parkinson Pavilion, Suite

North Broad Street, Philadelphia

Pennsylvania, USA

Tuğba Kemaloğlu Öz MD

Division of Cardiovascular Disease

University of Alabama at Birmingham

Birmingham, Alabama, USA

Anant Kharod MD

Department of Medicine

University of Alabama at Birmingham

Birmingham, Alabama, USA

Jennifer Kiessling MD

Division of Cardiovascular

Diseases, University of

Alabama at Birmingham

Birmingham, Alabama, USA

Allan L Klein MD FRCP(C) FACC

FAHA FASE

Director, CV Imaging Research and

Pericardial Center

Professor of Medicine, Cleveland Clinic

Heart and Vascular Institute

Department of Cardiovascular Medicine

Cleveland, Ohio, USA

Smadar Kort MD FACC FASE

Professor of Medicine

State University of New York

Stony Brook Director

Non Inavasive Cardiac Imaging Director

Echocardiography Diretor

Valve Center, Stony Brook Medicine

Stony Brook, New York, USA

Itzhak Kronzon MD FASE FACC FACP

FESC FAHA

Professor of Cardiology

Hofstra University

North Shore LIJ, School of Medicine

Chief of Noninvasive Cardiac Imaging

Lenox Hill Hospital

Noninvasive Cardiology

New York, New York, USA

Arthur J Labovitz MD

Professor of Medicine Chair, Department of Cardiovascular Sciences University of South Florida Tampa, Florida, USA

Jennifer K Lang MD

University at Buffalo Buffalo, New York, USA

Roberto M Lang MD

University of Chicago Medical Center Chicago, Illinois, USA

Fabrice Larrazet MD PhD

Department of Cardiology HÔpital Saint Camille Bry sur Marne, France

Steve W Leung MD

Assistant Professor of Medicine Division of Cardiovascular Medicine University of Kentucky

Lexington, Kentucky, USA

Sachin Logani MD

Department of Medicine Division of Cardiovascular Diseases Stony Brook University

Medical Center, Stony Brook New York, USA

CN Manjunath MD DM

Director, Professor and Head Department of Cardiology Sri Jayadeva Institute of Cardiovascular Sciences and Research

Bannergutta Road Bengaluru, Karnataka, India

Gerald R Marx MD

Associate Professor Harvard School of Medicine Senior Associate Cardiology Boston Children’s Hospital Boston, Massachusetts, USA

Wilson Mathias Jr MD

Heart Institute (InCor) The University of São Paulo School of Medicine and Fleury Group

São Paulo, Brazil

Angele A A Mattoso MD

Heart Institute (InCor) The University of São Paulo School of Medicine, São Paulo, Brazil and Santa Izabel Hospital, Salvador, Bahia

Sula Mazimba MD MPH

Division of Cardiovascular Disease University of Alabama at Birmingham

Birmingham, Alabama, USA

Anjlee M Mehta MD

Fellow, Division of Cardiology Dartmouth-Hitchcock Heart and Vascular Center

Lebanon, New Hampshire, USA

Kruti Jayesh Mehta MBBS PGDCC

Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham, Alabama, USA

Yatin Mehta MD MNAMS FRCA FAMS

FIACTA FTEE FICCM

Institute of Critical Care and Anesthesia Medanta The Medicity Gurgaon, Haryana, India

Julien Magne PhD

Department of Cardiology Heart Valve Disease Clinic CHU Sart Tilman, University of Liège, Belgium

Andrew P Miller MD

Cardiovascular Associates Birmingham, Alabama, USA

Dilbahar S Mohar MD

Division of Cardiology

UC-Irvine School of Medicine

Irvine, California, USA

Caroline Morbach MD

Yale University

New Haven, Connecticut, USA

Hoda Mojazi-Amiri MD

Loma Linda University Medical Center

Loma Linda, California , USA

Eisenhower Medical Center

Rancho Mirage, California, USA

Nagaraja Moorthy MD DM

Assistant Professor

Department of Cardiology

Sri Jayadeva Institute of Cardiovascular

Sciences and Research

Bengaluru, Karnataka, India

Hirohiko Motoki MD

Cardiovascular Research

Imaging Fellow, Cleveland Clinic

Foundation, Cleveland, Ohio, USA

Bernhard Mumm

President and COO

TomTec Imaging Systems

GmbH, Edisonstr

Unterschleissheim, Germany

Rachel Myers RDCS

Allegheny General Hospital

Pittsburgh, Pennsylvania, USA

Navin C Nanda MD

Distinguished Professor of Medicine and

Cardiovascular Disease and

Director, Heart Station/Echocardiography

Laboratories, University of Alabama at

Birmingham and the University of

Alabama Health Services Foundation

The Kirklin Clinic, Birmingham

Alabama, USA, President, International

Society of Cardiovascular Ultrasound

Elizabeth Ofili MD MPH FACC

Morehouse School of Medicine

Chief of Section of Cardiology

Associate Dean of Clinical Research

Ahmad S Omran MD FACC FESC FASE

Consultant Cardiologist Head, Non-Invasive Cardiology Lab King Abdulaziz Cardiac Center–Riyadh Health Affairs–Ministry of National Guard Kingdom of Saudi Arabia

Jatinder Singh Pabla BSc (Hons) MBBS

Ramdas G Pai MD

Professor of Medicine Loma Linda University Medical Center Loma Linda, California, USA

Natesa G Pandian MD

Professor, Tufts University School of Medicine, Director, Heart Valve Center Co-Director, Cardiovascular

Imaging Center Director, Cardiovascular Ultrasound Research, Tufts Medical Center Boston, Massachusetts, USA

Ashvin K Patel MD

University of Wisconsin School of Medicine and Public Health Madison, Wisconsin, USA

Eugenio Picano MD PhD

Institute of Clinical Physiology National Research Council Pisa, Italy

Luc A Pierard MD PhD

Department of Cardiology Heart Valve Disease Clinic CHU Sart Tilman, University of Liège, Belgium

Atif N Qasim MD MSCE

Assistant Professor of Medicine University of California San Francisco, California, USA

Anita Radhakrishnan MD

Fellow, Division of Cardiology Allegheny General Hospital Pittsburgh, Pennsylvania, USA

Peter S Rahko MD

Professor of Medicine Division of Cardiovascular Medicine Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA

The Netherlands

Lindsay Rogers MD

Heart Center, St Christopher’s Hospital for Children and Section of Cardiology Department of Pediatrics Drexel University, College of Medicine Philadelphia, Pennsylvania, USA

Asad Ullah Roomi MD

Prince Sultan Cardiac Center Military Hospital Riyadh Riyadh, Kingdom of Saudi Arabia

José Alberto San Román MD PhD FESCC

Hospital Clínico, Universitario de

Valladolid, Spain

Emanuele Romeo MD

Department of Cardiology

Second University of Naples

Monaldi Hospital, Naples, Italy

Utpal N Sagar MD

Advanced Cardiovascular Imaging Fellow

Heart and Vascular Institute

Department of Cardiovascular Medicine

Cleveland, Ohio, USA

Hamid Reza Salehi MD

Research Fellow in Echocardiography

Tufts Medical Center

Boston, Massachusetts, USA

Ivan S Salgo MD MSc

Philips Healthcare

Andover, Massachusetts, USA

Giovanni Di Salvo MD

King Faisal Specialist

Hospital and Research Center

Heart Center

Riyadh, Saudi Arabia

Muhamed Saric MD PhD

Director, Echocardiography Lab

Associate Professor of Medicine

New York University

Langone Medical Center

New York, New York, USA

San Francisco, California, USA

Roxy Senior MD DM FRCP FESC FACC

Cardiovascular Biomedical

Research Unit, Royal

Brompton Hospital, London, UK

National Heart and Lung Institute

Imperial College, London, UK

Department of Cardiovascular Medicine

Northwick Park Hospital, Harrow, UK

Benoy Nalin Shah BSc (Hons) MBBS MRCP

Department of Cardiovascular Medicine Northwick Park Hospital

Harrow, UK Cardiovascular Biomedical Research Unit

Royal Brompton Hospital London, UK

National Heart and Lung Institute Imperial College

Savitri Shrivastava MD DM FACC FAMS

Director Pediatric and Congenital Heart Diseases Fortis Escorts Heart Institute New Delhi, India

Peter Sidarous MD

Research Associate UC-Irvine School of Medicine Irvine, California, USA

Khadija Siddiqui DO

Division of Cardiology Department of Medicine University of Texas Medical Branch Galveston, Texas, USA

Robert J Siegel MD

The Heart Institute, Cedars Sinai Medical Center, Beverly Boulevard Los Angeles, California, USA

Satinder P Singh MD FCCP

Professor, Radiology and Medicine—Cardiovascular Disease Chief, Cardiopulmonary Radiology Chief, 3D Lab, Director, Cardiac CT Director, Combined Cardiopulmonary and Abdominal Imaging

Fellowship Program University of Alabama at Birmingham Birmingham, Alabama, USA

Siddharth Singh MD MS

Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham, Alabama, USA

Chittur A Sivaram MD

David Ross Boyd Professor Vice Chief of Cardiovascular Section Associate Dean for Continuing Professional Development University of Oklahoma Health Sciences Center Oklahoma City, Oklahama, USA

Sushilkumar K Sonavane MD

Assistant Professor Cardiopulmonary Radiology University of Alabama at Birmingham Department Radiology

Birmingham, Alabama, USA

Vincent L Sorrell MD

Anthony N DeMaria Professor of Medicine, Assistant Chief Division of Cardiovascular Medicine University of Kentucky

Lexington, Kentucky, USA

Jonathan H SoslowMD

Department of Pediatrics Division of Pediatric Cardiology Vanderbilt University Medical Center Nashville, Tennessee, USA

Anna Agnese Stanziola MD

Clinical and Surgery Department Division of Respiratory Medicine University “Federico II”of Naples Naples, Italy

Sharath Subramanian MD

Medical College of Wisconsin

Milwaukee, Wisconsin, USA

Lissa Sugeng MD

Associate Professor

Director of Yale Echo Lab and

YRCG Echo Corelab

Section of Cardiovascular Medicine

Division of Medicine

Yale University School of Medicine

New Haven, Connecticut, USA

Jie SunMD PhD

Heart Center, St Christopher’s Hospital

for Children and Section of Cardiology

Department of Pediatrics

Drexel University College of Medicine

Philadelphia, Pennsylvania, USA

Aylin Sungur MD

Division of Cardiovascular Disease

University of Alabama at Birmingham

Birmingham, Alabama, USA

Azhar Supariwala MD

Division of Cardiology

St Luke’s-Roosevelt Hospital Center

New York, New York, USA

Hitachi Aloka Medical, Ltd

Imai, Ome-Shi, Tokyo, Japan

Rohit Tandon MBBS MD

Dayanand Medical College and

Hospital Unit, Hero DMC

Heart Institute

Ludhiana, Punjab, India

George Thomas MD

Department of Cardiology Saraf Hospital, Kochi, Kerala, India

Wendy Tsang MD

University Health Network, Toronto General Hospital, University of Toronto Toronto, Ontario, Canada

Jeane M Tsutsui MD

Heart Institute (InCor), The University of São Paulo School of Medicine and Fleury Group, São Paulo, Brazil

IB Vijayalakshmi MD DM (Card) FICC FIAMS FIAE FICP FCSI FAMS DSc

Professor of Pediatric Cardiology Sri Jayadeva Institute of Cardiovascular Sciences and Research

Bengaluru, Karnataka, India

Isidre Vilacosta MD PhD FESCC

Hospital Clínico San Carlos Madrid, Spain

Victor Vacanti MD

University of Buffalo Buffalo, New York, USA

Leon Varjabedian MD

University of Buffalo Buffalo, New York, USA

Karina Wierzbowska-Drabik MD

Chair and Department of Cardiology

Biegański Hospital Medical University of Lodz Lodz, Poland

Timothy D Woods MD

Associate Professor of Medicine and Radiology Medical College of Wisconsin Cardiology Division

Milwaukee, Wisconsin, USA

Siu-Sun Yao MD FACC

Division of Cardiology Valley Health System Ridgewood

New Jersey, USA

Elisa Zaragoza-Macias MD MPH

Cardiovascular Diseases Fellow University of Washington Seattle, Washington, USA

Monumental strides have occurred in the evolution of echocardiography since its first introduction in the 1950s

It began with A-mode and M-mode echocardiography which progressed to real time two-dimensional echocardiography

in the 1970s after a hiatus of several years This development completely revolutionized the field of noninvasive cardiac imaging; and within a few years of its introduction, there were hardly any cardiology divisions in any hospital anywhere in the world which did not own an ultrasound machine The next few years saw the development of continuous and pulsed wave Doppler and color Doppler flow imaging which provided assessment of cardiac hemodynamics to supplement the structural information obtained using two-dimensional echocardiography Other advances rapidly followed

or occurred concurrently These included stress echocardiography, transesophageal echocardiography, contrast echocardiography and tissue Doppler and velocity vector imaging More recently, further innovations were introduced such as live/real time three-dimensional echocardiography and both two-and three-dimensional speckle tracking echocardiography which have obviated some of the limitations of the previous techniques and have further enhanced the clinical usefulness of echocardiography To this day, echocardiography represents the most useful and most cost-effective noninvasive modality available for the assessment of various cardiac disease entities The development of allied noninvasive technologies like magnetic resonance imaging and computed tomography has further added to the information provided by echocardiography and are useful and important additions to the armamentarium of the cardiologists and other patient care providers in the comprehensive assessment and management of cardiac disease.The aim of the current book is to provide an overview of the subject of clinical echocardiography as it is practiced to-day Given the many advances that have not only been recently introduced but are also ongoing in this field it would

be very difficult for anyone to realistically come up with a comprehensive book on echocardiography but an attempt has been made to cover as many topics as possible in this book In addition, the supplementary information provided by magnetic resonance imaging and computed tomography is also included in this book

The book consists of a total of 85 chapters organized into seven sections The first section deals with the basics of ultrasound, Doppler, speckle tracking, three-dimensional echocardiography and instrumentation A short history

of echocardiography and Doppler are also included in this section The second section consists of various aspects

of echocardiography and ultrasound examination M-mode and two- and three-dimensional transthoracic and transesophageal examination, nonstandard planes, various aspects of Doppler assessment including tissue Doppler, velocity vector and speckle tracking imaging, assessment of endothelial function, contrast echocardiography for evaluation of left ventricular endocardial border opacification and myocardial perfusion, transpharyngeal echo, epiaortic echocardiography and both intracardiac and intravascular ultrasound are dealt with in this section In addition, examination with a small hand-held ultrasound system, peripheral ultrasound, echocardiographic artifacts, quantification techniques in echocardiography and echocardiography training form a part of this section Valvular heart disease is covered in the next section It deals with evaluation of mitral valve disease, mitral regurgitation, aortic stenosis including assessment of low gradient stenosis with preserved left ventricular function, aortic regurgitation, aortic disease, tricuspid and pulmonary valves, pulmonary hypertension, infective endocarditis and prosthetic valves Rheumatic heart disease is also included in this section Section 4 deals with two- and three-dimensional echocardiographic assessment

of systolic and diastolic function of both left and right ventricles Newer aspects of structure and function to assess cardiac motion, evaluation of left atrial function, ventricular assist devices, pacemakers and intracardiac defibrillators and use

of echocardiography for the assessment of cardiac hemodynamics and guidance of therapy are also included in this section The next section contains chapters covering ischemic heart disease, coronary arteries and coronary flow reserve,

different aspects of stress echocardiography including three-dimensional stress echocardiography, obstructive and non-obstructive cardiomyopathies, differentiation of ischemic and nonischemic cardiomyopathy, pericardial disorders and tumors and masses Section 6 deals with congenital heart disease and consists of chapters on fetal cardiac imaging, M-mode and two- and three-dimensional assessment of pediatric congenital heart disease, ventricular function, adult congenital heart disease and acquired heart diseases in childhood The final section in the book, Section 7, covers systemic diseases, life-threatening conditions, echocardiography in women and the elderly, echocardiography for the electrophysiologist and lung ultrasound A separate chapter assesses the future of echocardiography and ultrasound Lastly, two chapters cover the allied techniques of magnetic resonance imaging and cardiac computed tomographic imaging A very large number of echocardiographic images and other figures illustrate most of the chapters of the book and six DVDs contain numerous movie clips to supplement the images These represent a major highlight of the book All chapters in this book are written by well-known experts in the field of echocardiography and ultrasound Because

of the large number of contributors, some overlap of content and chapters do exist in the book This has been deliberately not excluded because it provides a different perspective to the reader and also serves to reinforce important concepts and echocardiographic findings

Navin C Nanda MD

I am most grateful to all the contributors from different countries of the world who have taken valuable time off from their busy schedule to prepare chapters for this book I am also grateful to the faculty, clinical and research fellows, medical residents, and observers, both past and present, from our institution who have directly or indirectly helped

in the preparation of this book Special mention needs to be made of Kunal Bhagatwala, Nidhi M Karia, Steven Bleich, Aylin Sungur, Tuğba Kemaloğlu Öz, Kruti Jayesh Mehta, Maximiliano German Amado Escañuela and Ming Hsuing for their invaluable help I wish to express my thanks to the International Society of Cardiovascular Ultrasound and the Indian Academy of Echocardiography for agreeing to have the book under their aegis Special thanks to all the members of the Indian Academy of Echocardiography including the current President Dr ST Yavagal as well as Drs Satish Parashar, HK Chopra and Rakesh Gupta for their unstinting support of this project I especially appreciate the constant support and encouragement of Shri Jitendar P Vij (Group Chairman) and Mr Ankit Vij (Managing Director) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, in helping publish this book and also all their associates particularly Ms Chetna Malhotra Vohra (Senior Manager–Business Development) and Ms Saima Rashid (Development Editor) who have been prompt, efficient and most helpful I also deeply appreciate the help of Lindy Chapman, Administrative Associate at the University of Alabama at Birmingham, who provided excellent editorial and secretarial assistance, and Diane Blizzard, Office Associate, for her help Last but not least, I appreciate the patience, understanding and support of my wife, Kanta Nanda

Acknowledgments

• Color M-Mode 120

• Advantages and Disadvantages of M-Mode 120

• Use of M-Mode 121

Rachel Hughes-Doichev, Anita Radhakrishnan, Abid Ali Fakhri

Teena Tulaba, Rachel Myers

Shyam Padmanabhan, Navin C Nanda, Aylin Sungur, Tuğba Kemaloğlu Öz,

Kunal Bhagatwala, Nidhi M Karia, Kruti Jayesh Mehta, Rohit Tandon

Javier López, Teresa Sevilla, José Alberto San Román, Isidre Vilacosta,

Maximiliano German Amado Escanuela, Kunal Bhagatwala, Nidhi M Karia, Navin C Nanda

Section 5: Ischemic Heart Disease, Cardiomyopathies, Pericardial Disorders,

Tumors and Masses

Rohit Gokhale, Manreet Basra, Victor Vacanti, Steven J Horn, Aylin Sungur,

Robert P Gatewood Jr, Navin C Nanda

Sula Mazimba, Arshad Kamel, Navin C Nanda, Maximiliano German Amado Escanuela,

Kunal Bhagatwala, Nidhi M Karia

Leon Varjabedian, Jennifer K Lang, Abdallah Kamouh, Steven J Horn, Tuğba Kemaloğlu Öz

Aylin Sungur, Kruti Jayesh Mehta, Kunal Bhagatwala, Nidhi M Karia

Maximiliano German Amado Escañuela, Robert P Gatewood Jr, Navin C Nanda

Part 2: Left-to-Right Shunts: Atrial Septal Defect, Ventricular Septal Defect, Patent Ductus Arteriosus, and Aortopulmonary Window 1582

Section 7: Miscellaneous and Other Noninvasive Techniques

Jennifer Kiessling, Navin C Nanda, Tuğba Kemaloğlu Öz, Aylin Sungur,

Kunal Bhagatwala, Nidhi M Karia

HISTORY AND BASICS

Chapter 1 History of Echocardiography

Chapter 2 Early Cardiac Flow Doppler Era: A Key for a New

Clinical Understanding of Cardiology

Chapter 3 Basics of Ultrasound

Chapter 4 Doppler Echocardiography—Methodology,

Application and Pitfalls

Chapter 5 Basics of 3D Ultrasound Chapter 6 Speckle Tracking Acquisition: Basics and Practical Tips

Chapter 7 Instrumentation for Transesophageal

Echocardiography Including New Technology

Chapters