Comprehensive Textbook of Echocardiography (2 Volumes) Navin C Nanda
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1Comprehensive Textbook of Echocardiography2
3Comprehensive 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
4
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Comprehensive Textbook of Echocardiography
First Edition: 2014
9789350906347
Printed at:
5Dedicated 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 Nanda6
7Contributors 15Preface
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, 16different 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.
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
17Acknowledgments
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.