Comprehensive textbook of echocardiography (Volume 1): Part 1

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(BQ) Part 1 of the document 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,...).

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Comprehensive Vol. 1 Textbook of Echocardiography .
Comprehensive Vol. 1 Textbook of Echocardiography Editor 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 Under the Aegis of The International Society of Cardiovascular Ultrasound and The Indian Academy of Echocardiography ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi • London • Philadelphia • Panama
® Jaypee Brothers Medical Publishers (P) Ltd 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 Email: info@jpmedpub.com Fax: +1 507-301-0499 Email: jpmed.us@gmail.com Email: cservice@jphmedical.com Jaypee Brothers Jaypee Brothers Medical Publishers (P) Ltd Medical Publishers (P) Ltd 17/1-B Babar Road, Block-B Shorakhute, Kathmandu Shaymali, Mohammadpur Nepal Dhaka-1207, Bangladesh Phone: +00977-9841528578 Mobile: +08801912003485 Email: jaypee.nepal@gmail.com Email: jaypeedhaka@gmail.com Website: www.jaypeebrothers.com Website: www.jaypeedigital.com © 2014, Jaypee Brothers Medical Publishers The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book. 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. Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com Comprehensive Textbook of Echocardiography (Vol. 1) First Edition: 2014 ISBN 978-93-5090-634-7 Printed at:
Dedicated to 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
Contributors Masood Ahmad M D FRCP (C) FACP FACC Manreet Basra MBBS Monodeep Biswas MBBS MD FAHA FASE Professor of Medicine Division of Cardiology Division of Cardiology University at Buffalo School of Medicine Geisinger-Community Medical Department of Internal Medicine and Biological Sciences Center, and The Wright Center for University of Texas Medical Branch New York, USA Graduate Medical Education Galveston Texas, USA Scranton, Pennsylvania, USA Charles E Beale MD Dheeraj Arora DNB PDCC MNAMS Department of Medicine Steven Bleich MD Institute of Critical Care and Anesthesia Division of Cardiovascular Diseases Department of Medicine Stony Brook University Medical Center Division of Internal Medicine Medanta The Medicity Stony Brook, New York, USA University of Alabama at Birmingham Gurgaon, Haryana, India Birmingham, Alabama, USA Roy Beigel MD Mohammad Al-Admawi MD The Heart Institute, Cedars Sinai Medical O Julian Booker MD King Faisal Specialist Hospital and Center, Los Angeles, California, USA Division of Cardiovascular Disease Research Center The Leviev Heart Center Sheba Medical University of Alabama at Birmingham Heart Center Center, Affiliated to the Sackler Birmingham, Alabama, USA Riyadh, Saudi Arabia School of Medicine Tel Aviv University, Tel Aviv, Israel Eduardo Bossone MD PhD FCCP FESC FACC Bader Almahdi MD Via Principe Amedeo Lauro (AV), Italy King Faisal Specialist Hospital and Ricardo Benenstein MD Heart Department, University of Research Center Echocardiography and Vascular Lab Salerno, “Scuola Medica Salernitana” Heart Center Assistant Professor of Medicine Salerno, Italy Riyadh, Saudi Arabia New York University School of Medicine Department of Cardiac Surgery IRCCS New York, New York, USA Policlinico San Donato, Milan, Italy Ahmed Almomani MBBS Division of Cardiology Kunal Bhagatwala MBBS Luis Bowen MD Department of Medicine Division of Cardiovascular Disease Department of Medicine University of Texas Medical Branch University of Alabama at Birmingham University of Alabama at Birmingham Galveston, Texas, USA Birmingham, Alabama, USA Birmingham, Alabama, USA Neeraj Awasthy FNB Aditya Bharadwaj MD Gerald Buckberg MD Fortis Escorts Heart Institute Department of Cardiology Department of Cardiothoracic Surgery Loma Linda University and David Geffen School of Medicine New Delhi, India VA Medical Centers University of California-Los Angeles Loma Linda, California, USA Los Angeles, California, USA Rula Balluz MD MPH Heart Center, St Christopher’s Hospital Michael J Campbell MD Aarti H Bhat MBBS for Children and Department of Pediatrics Assistant Professor Section of Cardiology Division of Pediatric Cardiology Division of Pediatric Cardiology Department of Pediatrics, Drexel Seattle Children’s Hospital and Duke University Medical Center University College of Medicine University of Washington Durham, North Carolina, USA Philadelphia, Pennsylvania, USA Seattle, Washington, USA Premindra PAN Chandraratna MD Piers Barker MD Nicole Bhave MD FRCP FACC Department of Pediatrics University Health Network Professor Emeritus Division of Pediatric Cardiology Toronto General Hospital Division of Cardiology Duke University Medical Center University of Toronto UC-Irvine School of Medicine Durham, North Carolina, USA Toronto, Ontario, Canada Irvine, California, USA
viii Comprehensive Textbook of Echocardiography Leon H Charney Michele D’ Alto MD PhD Daniel Forsha MD Division of Cardiology Department of Cardiology Department of Pediatrics New York University Medical Center Second University of Naples: Division of Pediatric Cardiology New York, New York, USA Monaldi Hospital, Naples, Italy Duke University Medical Center Durham, North Carolina, USA Farooq A Chaudhry M D FACP FACC David Daly MD FASE FAHA Department of Medicine Gary P Foster MD Professor of Medicine University of Alabama at Birmingham Department of Cardiology Director, Echocardiography Laboratories Birmingham, Alabama, USA Loma Linda University and Associate Director, Mount Sinai Heart VA Medical Centers, Loma Linda Network, Icahn School of Medicine at Hisham Dokainish M D FRCPC California, USA Mount Sinai, Zena and Michael A Wiener Associate Professor of Medicine Cardiovascular Institute and McMaster University Leon J Frazin MD Marie-Josée and Henry R Kravis Center Director of Echocardiography and for Cardiovascular Health University of Illinois Hospital & Health Medical Diagnostic Units Science System New York, New York, USA Hamilton Health Sciences Jesse Brown VA Medical Center Hamilton, Ontario, Canada Chicago, Illinois, USA Preeti Chaurasia MD Division of Cardiovascular Disease Maximiliano German University of Alabama at Birmingham Naveen Garg MBBS Dip. Cardiology Amado Escañuela MD Birmingham, Alabama Fellow, Noninvasive Cardiac Lab Division of Cardiovascular Disease Indraprastha Apollo Hospitals University of Alabama at Birmingham Reema Chugh MD FACC Birmingham, Alabama, USA New Delhi, India Consultant in Cardiology/Specialist in Adult Congenital Heart Disease and Luna Gargani MD Bahaa M Fadel MD Heart Disease in Pregnancy Institute of Clinical Physiology Kaiser Permanente Medical Center King Faisal Specialist Hospital and National Research Council Panorama City, California, USA Research Center Pisa, Italy Heart Center Krishnaswamy Chandrasekaran MD Riyadh, Saudi Arabia Eleonora Gashi DO MPhil Mayo Clinic, Scottsdale, Arizona, USA Abid Ali Fakhri MD Senior Cardiology Fellow Rochester, Minnesota, USA Fellow, Division of Cardiology Lenox Hill Hospital Allegheny General Hospital Non-Invasive Cardiology Michael Chen MD Pittsburgh, Pennsylvania, USA New York, New York, USA University of Washington Seattle, Washington DC, USA Francesco Faletra MD Robert P Gatewood Jr MD FACC HK Chopra MD Division of Cardiology Chief of Cardiac Services Moolchand City Hospital Fondazione Cardiocentro Ticino Kaleida Heath; Clinical Associate New Delhi, India Lugano, Switzerland Professor of Medicine University at Buffalo School of Cecil Coghlan MD Francesco Ferrara MD Medicine and Biological Sciences Division of Cardiovascular Disease Heart Department, University of Salerno Buffalo Cardiology and Pulmonary University of Alabama at Birmingham “Scuola Medica Salernitana” Associates, Main Street Williamsville Birmingham, Alabama, USA Salerno, Italy New York, USA Department of Internal Medicine and Neil L Coplan MD FACC Cardiovascular Sciences Shuping Ge MD FAAP FACC FASE Director, Division of Clinical Cardiology University “Federico II” of Naples Chief, Section of Cardiology Program Director, Cardiovascular Naples, Italy St Christopher’s Hospital for Children Fellowship, Lenox Hill Hospital Associate Professor of Pediatrics New York, USA Brandon Fornwalt MD PhD Drexel University College of Medicine Assistant Professor of Pediatrics Philadelphia, Pennsylvania, USA David Cosgrove MD Department of Pediatrics Acting Chair, Pediatric Cardiology Honorary Consultant University of Kentucky Deborah Heart and Lung Center Imperial and King's Colleges, London, UK Lexington, Kentucky, USA Browns Mills, New Jersey, USA
Contributors ix Gopal Ghimire MD DM MRCP Donald Hagler MD Rachel Hughes-Doichev MD FASE Division of Cardiovascular Diseases Mayo Clinic Temple University School of Medicine University of Alabama at Birmingham Rochester, Minnesota, USA Pittsburgh, Pennsylvania, USA Birmingham, Alabama, USA Stephanie El-Hajj MD Arzu Ilercil MD Nina Ghosh MD Department of Internal Medicine Associate Professor of Medicine Division of Cardiovascular Medicine Louisiana State University Health Department of Cardiovascular Sciences Sciences Center University of South Florida Brigham and Women’s Hospital Baton Rouge, Louisiana, USA Tampa, Florida, USA Harvard Medical School Francis Street Kamran Haleem MD Trevor Jenkins MD Boston, Massachusetts, USA Yale University Harrington Heart and New Haven, Connecticut, USA Vascular Institute Edward Gill MD University Hospital Case Professor of Medicine and Medical Center, Cleveland Dan G Halpern MD Cardiology, University of Washington Ohio, USA St Luke’s-Roosevelt Hospital Center Seattle, Washington DC, USA Columbia University, College of Physicians and Surgeons Madhavi Kadiyala MD Rohit Gokhale MBBS New York, New York, USA Saint Francis Hospital, Roslyn University at Buffalo New York, USA Buffalo, New York, USA Rachel Harris MD MPH Arshad Kamel MD Morehouse School of Medicine Aasha S Gopal MS MD FACC FAHA FASE Department of Medicine Section of Cardiology University of Alabama at Huntsville Associate Professor of Medicine Assistant Professor Huntsville, Alabama, USA Stony Brook University Echo Lab Co-Director Stony Brook, New York, USA Grady Memorial Hospital Atlanta, Georgia, USA Abdallah Kamouh MD Director, Advanced Echocardiography University of Buffalo St Francis Hospital, Washington Blvd Buffalo, New York, USA Roslyn, New York, USA Christine Henri MD Department of Cardiology Poonam Malhotra Kapoor MD Willem Gorissen Heart Valve Disease Clinic CHU Sart Tilman, University of All India Institute of Clinical Market Manager Medical Sciences Toshiba Medical Systems Europe Liège, Belgium New Delhi, India Zoetermeer, The Netherlands Julien IE Hoffman MD Kanwal K Kapur MD Department of Pediatrics Luis Gruberg MD FACC DM Cardiology, Sr Consultant and Chief University of California Department of Medicine Noninvasive Cardiology San Francisco, California, USA Division of Cardiovascular Diseases Indraprastha Apollo Hospitals Stony Brook University Medical Center New Delhi, India Brian D Hoit MD Department of Noninvasive Cardiology Stony Brook, New York, USA Director of Echocardiography Indraprastha Apollo Hospitals Harrington Heart & Vascular Center New Delhi, India Rakesh Gupta MD University Hospitals of Cleveland JROP Healthcare Texas, USA Nidhi M Karia MBBS New Delhi, India Division of Cardiovascular Disease Steven J Horn MD FACC FASE FASNC University of Alabama at Birmingham Fadi G Hage MD SUNY Buffalo Birmingham, Alabama, USA Division of Cardiovascular Disease Buffalo, New York, USA University of Alabama at Birmingham Jarosław D Kasprzak MD Birmingham, Alabama, USA Ming Chon Hsiung MD Chair and Department of Cardiology Section of Cardiology, Birmingham Cardiologist Biegański Hospital Veteran’s, Administration Medical Center Cheng Hsin General Hospital Medical University of Lodz Birmingham, Alabama, USA Taipei, Taiwan Lodz, Poland
x Comprehensive Textbook of Echocardiography Martin G Keane MD FACC FAHA FASE Arthur J Labovitz MD Gerald R Marx MD Professor of Medicine Professor of Medicine Associate Professor Cardiology Section Chair, Department of Harvard School of Medicine Director of Echocardiography Cardiovascular Sciences Senior Associate Cardiology Temple University School of Medicine University of South Florida Boston Children’s Hospital Parkinson Pavilion, Suite Tampa, Florida, USA Boston, Massachusetts, USA North Broad Street, Philadelphia Pennsylvania, USA Jennifer K Lang MD Wilson Mathias Jr MD University at Buffalo Heart Institute (InCor) Tuğba Kemaloğlu Öz MD Buffalo, New York, USA The University of São Paulo School of Division of Cardiovascular Disease Medicine and Fleury Group University of Alabama at Birmingham Roberto M Lang MD São Paulo, Brazil Birmingham, Alabama, USA University of Chicago Medical Center Angele A A Mattoso MD Anant Kharod MD Chicago, Illinois, USA Heart Institute (InCor) Department of Medicine The University of São Paulo School of University of Alabama at Birmingham Fabrice Larrazet MD PhD Medicine, São Paulo, Brazil and Birmingham, Alabama, USA Department of Cardiology Santa Izabel Hospital, Salvador, Bahia HÔpital Saint Camille Jennifer Kiessling MD Bry sur Marne, France Sula Mazimba MD MPH Division of Cardiovascular Division of Cardiovascular Diseases, University of Steve W Leung MD Disease University of Alabama at Alabama at Birmingham Assistant Professor of Medicine Birmingham Birmingham, Alabama, USA Division of Cardiovascular Medicine Birmingham, Alabama, USA University of Kentucky Allan L Klein M D FRCP(C) FACC Lexington, Kentucky, USA Anjlee M Mehta MD FAHA FASE Fellow, Division of Cardiology Director, CV Imaging Research and Sachin Logani MD Dartmouth-Hitchcock Heart and Pericardial Center Department of Medicine Vascular Center Professor of Medicine, Cleveland Clinic Division of Cardiovascular Diseases Lebanon, New Hampshire, USA Heart and Vascular Institute Stony Brook University Department of Cardiovascular Medicine Medical Center, Stony Brook Kruti Jayesh Mehta MBBS PGDCC Cleveland, Ohio, USA New York, USA Division of Cardiovascular Disease University of Alabama at Birmingham Smadar Kort MD FACC FASE Javier López MD PhD Birmingham, Alabama, USA Professor of Medicine Hospital Clinico Universitario de State University of New York Valladolid, Spain Yatin Mehta MD MNAMS FRCA FAMS Stony Brook Director FIACTA FTEE FICCM Non Inavasive Cardiac Imaging Director Judy R Mangion MD Institute of Critical Echocardiography Diretor Division of Cardiovascular Medicine Care and Anesthesia Valve Center, Stony Brook Medicine Brigham and Women’s Hospital Medanta The Medicity Stony Brook, New York, USA Harvard Medical School Gurgaon, Haryana, India Francis Street, Boston Itzhak Kronzon M D FASE FACC FACP Massachusetts, USA Julien Magne PhD FESC FAHA Department of Cardiology Professor of Cardiology CN Manjunath MD DM Heart Valve Disease Clinic Hofstra University Director, Professor and Head CHU Sart Tilman, University of North Shore LIJ, School of Medicine Department of Cardiology Liège, Belgium Chief of Noninvasive Cardiac Imaging Sri Jayadeva Institute of Cardiovascular Lenox Hill Hospital Sciences and Research Andrew P Miller MD Noninvasive Cardiology Bannergutta Road Cardiovascular Associates New York, New York, USA Bengaluru, Karnataka, India Birmingham, Alabama, USA
Contributors xi Dilbahar S Mohar MD Ryozo Omoto MD Eugenio Picano MD PhD Division of Cardiology Professor Emeritus, Saitama Medical Institute of Clinical Physiology UC-Irvine School of Medicine University National Research Council Irvine, California, USA Honorary Director, Saitama Medical Pisa, Italy University Hospital Caroline Morbach MD Moro-Hongou, Moroyama Luc A Pierard MD PhD Yale University Iruma-Gun, Saitama, Japan Department of Cardiology New Haven, Connecticut, USA Heart Valve Disease Clinic Ahmad S Omran MD FACC FESC FASE CHU Sart Tilman, University of Hoda Mojazi-Amiri MD Consultant Cardiologist Liège, Belgium Loma Linda University Medical Center Head, Non-Invasive Cardiology Lab Loma Linda, California , USA King Abdulaziz Cardiac Center–Riyadh Eisenhower Medical Center Health Affairs–Ministry of National Guard Atif N Qasim MD MSCE Rancho Mirage, California, USA Kingdom of Saudi Arabia Assistant Professor of Medicine University of California Nagaraja Moorthy MD DM Jatinder Singh Pabla BSc (Hons) MBBS San Francisco, California, USA Assistant Professor MRCP Department of Cardiology Department of Cardiovascular Medicine Anita Radhakrishnan MD Sri Jayadeva Institute of Cardiovascular Northwick Park Hospital, Harrow, UK Fellow, Division of Cardiology Sciences and Research Allegheny General Hospital Bengaluru, Karnataka, India Shyam Padmanabhan MD Pittsburgh, Pennsylvania, USA Division of Cardiovascular Disease Hirohiko Motoki MD University of Alabama at Birmingham Peter S Rahko MD Cardiovascular Research Birmingham, Alabama, USA Professor of Medicine Imaging Fellow, Cleveland Clinic Division of Cardiovascular Medicine Foundation, Cleveland, Ohio, USA Ramdas G Pai MD Department of Medicine, University of Professor of Medicine Wisconsin School of Medicine and Public Bernhard Mumm Loma Linda University Health, Madison, Wisconsin, USA President and COO Medical Center TomTec Imaging Systems Loma Linda, California, USA GmbH, Edisonstr Rajesh Ramineni MD Unterschleissheim, Germany Natesa G Pandian MD University of Texas Medical Branch Professor, Tufts University School of Galveston, Texas, USA Rachel Myers RDCS Medicine, Director, Heart Valve Center Allegheny General Hospital Co-Director, Cardiovascular JRTC Roelandt MD Pittsburgh, Pennsylvania, USA Imaging Center Professor of Cardiology Director, Cardiovascular Ultrasound Honorary Chairman, Thoraxcentre Navin C Nanda MD Research, Tufts Medical Center Erasmus University Medical Boston, Massachusetts, USA Distinguished Professor of Medicine and Centre, Rotterdam Cardiovascular Disease and The Netherlands Director, Heart Station/Echocardiography Satish K Parashar MD Laboratories, University of Alabama at Metro Heart Institute Lindsay Rogers MD Birmingham and the University of New Delhi, India Heart Center, St Christopher’s Alabama Health Services Foundation Hospital for Children and The Kirklin Clinic, Birmingham David A Parra MD Section of Cardiology Alabama, USA, President, International Department of Pediatrics Division of Pediatric Cardiology Department of Pediatrics Society of Cardiovascular Ultrasound Vanderbilt University Medical Center Drexel University, College of Medicine Nashville, Tennessee, USA Philadelphia, Pennsylvania, USA Elizabeth Ofili MD MPH FACC Morehouse School of Medicine Chief of Section of Cardiology Ashvin K Patel MD Asad Ullah Roomi MD Associate Dean of Clinical Research University of Wisconsin School of Prince Sultan Cardiac Center Professor of Medicine Medicine and Public Health Military Hospital Riyadh Atlanta, Georgia, USA Madison, Wisconsin, USA Riyadh, Kingdom of Saudi Arabia
xii Comprehensive Textbook of Echocardiography José Alberto San Román MD PhD FESCC Teresa Sevilla MD Robert J Siegel MD Hospital Clínico, Universitario de Hospital Clínico Universitario de The Heart Institute, Cedars Sinai Valladolid, Spain Valladolid, Spain Medical Center, Beverly Boulevard Los Angeles, California, USA Emanuele Romeo MD James Seward MD Department of Cardiology Satinder P Singh MD FCCP Mayo Clinic Second University of Naples Professor, Radiology and Rochester, Minnesota, USA Monaldi Hospital, Naples, Italy Medicine—Cardiovascular Disease Chief, Cardiopulmonary Radiology Benoy Nalin Shah BSc (Hons) MBBS MRCP Chief, 3D Lab, Director, Cardiac CT Utpal N Sagar MD Department of Cardiovascular Medicine Director, Combined Cardiopulmonary Advanced Cardiovascular Imaging Fellow Northwick Park Hospital and Abdominal Imaging Heart and Vascular Institute Fellowship Program Harrow, UK Department of Cardiovascular Medicine University of Alabama at Birmingham Cardiovascular Biomedical Cleveland, Ohio, USA Birmingham, Alabama, USA Research Unit Royal Brompton Hospital Hamid Reza Salehi MD Siddharth Singh MD MS London, UK Research Fellow in Echocardiography Division of Cardiovascular Disease National Heart and Lung Institute Tufts Medical Center University of Alabama at Birmingham Imperial College Boston, Massachusetts, USA Birmingham, Alabama, USA London, UK Ivan S Salgo MD MSc Chittur A Sivaram MD Philips Healthcare Chetan Shenoy MBBS David Ross Boyd Professor Andover, Massachusetts, USA Fellow in Cardiovascular Disease Vice Chief of Cardiovascular Section Tufts Medical Center Associate Dean for Continuing Giovanni Di Salvo MD Boston, Massachusetts, USA Professional Development King Faisal Specialist University of Oklahoma Hospital and Research Center Mark V Sherrid MD Health Sciences Center Director, Echocardiography Laboratory Oklahoma City, Oklahama, USA Heart Center Riyadh, Saudi Arabia Roosevelt Division Sushilkumar K Sonavane MD Program Director, Hypertrophic Assistant Professor Muhamed Saric MD PhD Cardiomyopathy Program Cardiopulmonary Radiology Director, Echocardiography Lab St. Luke's-Roosevelt Hospital Center University of Alabama at Birmingham Associate Professor of Medicine Professor, Clinical Medicine Department Radiology New York University Columbia University, College of Birmingham, Alabama, USA Langone Medical Center Physicians and Surgeons New York, New York, USA New York, New York, USA Vincent L Sorrell MD Anthony N DeMaria Professor of Nelson B Schiller MD Savitri Shrivastava MD DM FACC FAMS Medicine, Assistant Chief Professor of Medicine Director Pediatric and Congenital Heart Division of Cardiovascular Medicine University of California Diseases Fortis Escorts Heart Institute University of Kentucky San Francisco New Delhi, India Lexington, Kentucky, USA UCSF Division of Cardiology Parnassus Avenue Jonathan H Soslow MD Peter Sidarous MD San Francisco, California, USA Department of Pediatrics Research Associate Division of Pediatric Cardiology UC-Irvine School of Medicine Roxy Senior MD DM FRCP FESC FACC Vanderbilt University Medical Center Irvine, California, USA Cardiovascular Biomedical Nashville, Tennessee, USA Research Unit, Royal Brompton Hospital, London, UK Khadija Siddiqui DO Anna Agnese Stanziola MD National Heart and Lung Institute Division of Cardiology Clinical and Surgery Department Imperial College, London, UK Department of Medicine Division of Respiratory Medicine Department of Cardiovascular Medicine University of Texas Medical Branch University “Federico II”of Naples Northwick Park Hospital, Harrow, UK Galveston, Texas, USA Naples, Italy
Contributors xiii Sharath Subramanian MD George Thomas MD Isidre Vilacosta MD PhD FESCC Medical College of Wisconsin Department of Cardiology Hospital Clínico Milwaukee, Wisconsin, USA Saraf Hospital, Kochi, Kerala, India San Carlos Lissa Sugeng MD Madrid, Spain Wendy Tsang MD Associate Professor University Health Network, Toronto Victor Vacanti MD Director of Yale Echo Lab and YRCG Echo Corelab General Hospital, University of Toronto University of Buffalo Section of Cardiovascular Medicine Toronto, Ontario, Canada Buffalo, New York, USA Division of Medicine Yale University School of Medicine Jeane M Tsutsui MD New Haven, Connecticut, USA Heart Institute (InCor), The University of Leon Varjabedian MD São Paulo School of Medicine and Fleury University of Buffalo Jie Sun MD PhD Group, São Paulo, Brazil Buffalo, New York, USA Heart Center, St Christopher’s Hospital for Children and Section of Cardiology Teena Tulaba RDCS Karina Wierzbowska-Drabik MD Department of Pediatrics Allegheny General Hospital Drexel University College of Medicine Chair and Department of Pittsburgh, Pennsylvania, USA Cardiology Philadelphia, Pennsylvania, USA Biegański Hospital Aylin Sungur MD Padmini Varadarajan MD Medical University of Lodz Division of Cardiovascular Disease Department of Cardiology Lodz, Poland University of Alabama at Birmingham Loma Linda University and VA Medical Birmingham, Alabama, USA Centers, Loma Linda, California, USA Timothy D Woods MD Azhar Supariwala MD Mahdi Veillet-Chowdhury MD Associate Professor of Division of Cardiology Stony Brook University Medical Center Medicine and Radiology St Luke’s-Roosevelt Hospital Center Health Sciences Center Medical College of Wisconsin New York, New York, USA Stony Brook, New York, USA Cardiology Division Pooja Swamy MD Milwaukee, Wisconsin, USA Colette Veyrat MD Department of Cardiology Loma Linda University and VA Centre National de la Recherche Siu-Sun Yao MD FACC Medical Centers Scientifique Honorary Researcher Division of Cardiology Loma Linda, California, USA Department of Cardiovascular Medicine Valley Health System L’Institut Mutualiste de Montsouris Kiyoshi Tamura PhD Ridgewood Boulevard Jourdan, Paris Cedex, France Hitachi Aloka Medical, Ltd. New Jersey, USA Imai, Ome-Shi, Tokyo, Japan IB Vijayalakshmi MD DM (Card) FICC FIAMS FIAE FICP FCSI FAMS DSc Elisa Zaragoza-Macias MD MPH Rohit Tandon MBBS MD Professor of Pediatric Cardiology Cardiovascular Dayanand Medical College and Hospital Unit, Hero DMC Sri Jayadeva Institute of Cardiovascular Diseases Fellow Heart Institute Sciences and Research University of Washington Ludhiana, Punjab, India Bengaluru, Karnataka, India Seattle, Washington, USA
Preface 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,
xvi Comprehensive Textbook of Echocardiography 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
Acknowledgments 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.
Contents xix Contents Volume 1 Section 1: History and Basics 1. History of Echocardiography 3 Fadi G Hage, Anant Kharod, David Daly, Navin C Nanda • History of Ultrasound 4 • The Development of Clinical Cardiac Ultrasound: A-Mode and M-Mode Echocardiography 4 • Two-Dimensional Echocardiography 8 • Conventional Doppler Ultrasound 9 • Color Doppler Ultrasound 11 • Contrast Echocardiography 11 • Transesophageal Echocardiography 13 • Tissue Doppler and Speckle Tracking Imaging 14 • Three-Dimensional Echocardiography 14 • Perspective 19 2. Early Cardiac Flow Doppler Era: A Key for a New Clinical Understanding of Cardiology 24 Colette Veyrat • The Preflow Doppler Era: Paucity of Existing Noninvasive Tools 25 • Explosive Emergence of the “Flow Concept”, an Indispensable Mutation from Pressure Measurements, which Prepared the Doppler Flow Era 27 • Return to the Doppler Technique in Search of a Noninvasive Tool Documenting the “Flow Concept” 28 3. Basics of Ultrasound 55 Caroline Morbach, Kamran Haleem, Lissa Sugeng • General Physics 55 • Imaging by Ultrasound 57 • Image Optimization and Equipment 60 • Artifacts 61 • Doppler Ultrasound 63 4. Doppler Echocardiography—Methodology, Application and Pitfalls 65 George Thomas • Doppler in Cardiology 65 • Doppler Instrumentation 66 • Continuous Wave Doppler 68 • Pulsed Wave Doppler 69 • Color Doppler 71