Introduction Echocardiography is an essential tool in the evaluation and management of patients with prosthetic valves. Its use requires an understanding of valve design, normal prosthetic appearance and function, imaging artifacts introduced by valve elements, and the spectrum of valve…
Introduction Echocardiography plays a unique role in the assessment of the tricuspid and pulmonic valves. However, their evaluation is often suboptimal because typical imaging protocols may overlook the views that best display pulmonic and tricuspid anatomy and function. Recent advances…
Introduction Aortic valve (AV) disease is the most common valve disease in developed countries. Aortic stenosis (AS), which is most often due to calcification and degeneration of congenitally normal tricuspid valves, affects approximately 1.5 million people in the United States…
Introduction Approximately 2.5% of the general US population suffers from significant valvular heart disease. Mitral valve disease (MVD) constitutes one of the most prevalent forms and is associated with significant cardiovascular morbidity and mortality. Furthermore, the prevalence of MVD increases…
Introduction Ischemic Cascade Myocardial ischemia is classically characterized by a consistent, time-sequenced series of events known as the “ischemic cascade” ( Fig. 27.1 ), which form the physiologic basis for greater sensitivity of stress testing with imaging (including echocardiography) compared…
Introduction Mechanical circulatory support is increasing in the acute and chronic management of heart failure patients. Both short-term and longer-term support ventricular assist devices (VADs) are in clinical use. Echocardiography may help guide patient selection as well as placement, optimization,…
Introduction Electromechanical association in a normal heart results in synchronous regional left ventricular (LV) contraction. Differences in the timing of regional contraction may be associated with the failing human heart. Interest in echocardiographic assessment of synchrony began with applications for…
Introduction Restrictive cardiomyopathy (RCM) refers to either an idiopathic or a systemic myocardial disorder in the absence of underlying atherosclerotic coronary artery disease, valvular disease, congenital heart disease, or systemic hypertension, which is characterized by abnormal left ventricular filling, and…
Introduction Hypertrophic cardiomyopathy (HCM) is characterized by unexplained myocardial hypertrophy, that is, hypertrophy that has developed in the absence of other attributable etiology, myocyte disarray, and myocardial fibrosis ( Fig. 23.1 ). In large part, through cardiac imaging and molecular…
Introduction Dilated cardiomyopathy (DCM) is predominantly diagnosed according to echocardiographic features that include left ventricular or biventricular dilation and reduced systolic function. Current classification schemes from major heart societies exclude primary ischemic heart disease or abnormal loading conditions (such as…