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Pediatric Echocardiography
Rani Gera
CHAPTER 1:
Introduction
CHAPTER 2:
Position of the Patient and Transducer
CHAPTER 3:
M-Mode and Doppler Examination
M-MODE
Features of an M-mode Image
Doppler velocity values in children
Doppler gradient
Mitral Valve-Tricuspid Valve
Tricuspid Regurgitation (Fig. 3.4)
DOPPLER ECHOCARDIOGRAPHY
Frequency
Pulsed and Continuous Wave Doppler
Continuous Wave Doppler
CHAPTER 4:
Echocardiographic Evaluation of Cardiac Chambers Left Ventricle
Global Systolic Function
Common Measurements
Diastolic Function
Wall Thickness (Figs 4.1A and B)
RIGHT VENTRICLE
LEFT ATRIUM (FIG. 4.2)
RIGHT ATRIUM
CHAPTER 5:
Acyanotic Congenital Heart Disease
ATRIAL SEPTAL DEFECT (ASD)
Pathology
Clinical Manifestations
ECG
X-ray chest
Echocardiography
Natural History
Patent Foramen Ovale (Fig. 5.2)
Views
Ostium Primum (Fig. 5.3)
Views
Problems
Atrial Septal Defect (Sinus Venosus) (Fig. 5.4)
VENTRICULAR SEPTAL DEFECT (VSD)
Views for VSD Evaluation
Clinical Presentations
ECG
X-ray
Echocardiography
Complications Associated with VSD
Natural History
COMMON ATRIOVENTRICULAR CANAL (FIG. 5.11)
Pathology
Clinical Manifestation
ECG
X-ray chest
Echocardiography
Natural History of AV Canal Defect
PATENT DUCTUS ARTERIOSUS (PDA)
Pathology
Clinical Manifestations
Echocardiography
Natural History
PULMONARY STENOSIS (PS) (FIG. 5.15)
Clinical Manifestations
Echocardiography
Natural History
CONGENITAL LEFT VENTRICULAR OUTFLOW OBSTRUCTION (LVOT)
Types
Subvalvular Stenosis
Echocardiography
AORTIC STENOSIS
Echocardiography
Supravalvular Aortic Stenosis
Features
Natural History
COARCTATION OF AORTA (Fig. 5.17)
Clinical Manifestations
Echocardiography
CHAPTER 6:
Cyanotic Heart Disease
TRANSPOSITION OF GREAT ARTERIES (FIG. 6.1) (D-TGA)
Pathology
Clinical Manifestations
ECG
X-ray chest
Echocardiography
Natural History
L-TGA
Pathology
Clinical Manifestation
ECG
X-ray chest
Echocardiography
TETRALOGY OF FALLOT (FIGS 6.2A AND B)
Pathology
Clinical Manifestations
ECG
X-ray chest
Echocardiography
Natural History
TRICUSPID ATRESIA (FIGS 6.3A AND B)
Pathology
Clinical Manifestations
ECG
Echocardiography
Natural History
TOTAL ANOMALOUS PULMONARY VENOUS RETURN (TAPVR) (FIG. 6.4)
Pathology
Clinical Manifestations
ECG
X-ray studies
Echocardiography
TRUNCUS ARTERIOSUS (FIG. 6.5)
Pathology
Clinical Manifestations
Echocardiography
Views
Diagnostic criteria
CHAPTER 7:
Acquired Valvular Disease
RHEUMATIC HEART DISEASE
Mitral Valve (MV) Anatomy and Function
MITRAL STENOSIS (MS) (FIG. 7.1)
Pathology
Clinical Manifestations
Diagnosis
X-ray studies
ECG
Echocardiography
Natural History
MITRAL REGURGITATION (FIG. 7.2)
Pathology
Clinical Manifestations
ECG
X-ray chest
Echocardiography
Chronic MR
Natural History
MITRAL VALVE PROLAPSE
Etiology
Clinical Manifestations
ECG
X-ray studies
Echocardiography
Natural History
Flail Mitral Valve
AORTIC REGURGITATION (FIG. 7.4)
Pathology
Clinical Manifestations
Natural History
ECG
X-ray chest
Echocardiography
TRICUSPID REGURGITATION (FIGS 7.6A TO C)
Clinical Manifestations
ECG
TRICUSPID STENOSIS
CHAPTER 8:
Cardiac Infections
INFECTIVE ENDOCARDITIS
Definition
Pathology
Clinical Manifestation
History
Laboratory investigations
Echocardiography
PERICARDIAL DISEASE
Clinical Features
X-ray chest
Echocardiography
Thickened pericardium
Constrictive pericardium
Small effusion (Figs 8.2 and 8.3)
Quantification of pericardial fluid
Cardiac tamponade
CHAPTER 9:
Disease of Myocardium
CARDIOMYOPATHY
Hypertrophic Cardiomyopathy (FIG. 9.1)
Pathology
Clinical manifestations
Natural history
ECG
X-ray studies
Echocardiography
Idiopathic Dilated Cardiomyopathy (FIG. 9.2)
Pathology
Clinical picture
Physical examination
Laboratory investigations
Natural history
Restrictive Cardiomyopathy (Fig. 9.3)
Pathology
Clinical manifestations
Infiltrative Cardiomyopathy
Infective agents
TRAUMA
Systemic Illness
CHAPTER 10:
Pediatric Echocardiogram Report and its Pitfalls
ERRORS
Source of Pitfalls
Common Difficulties
Significance of a Lesion, e.g.VSD
LV volume overload/dysfunction
Valves and associated anomaly
Assessment of pulmonary artery hypertension (PAH)
Arch anomalies
Flow across a shunt
How to avoid pitfalls?
CHAPTER 11:
Fetal Echocardiography
INDICATIONS
EQUIPMENT
ANATOMIC IMAGING
Structures Viewed in Four and Five Chamber View (Figs 11.3A and B)
Structures Viewed in the Ductal and Aortic Arch (Figs 11.4A and B)
Heart Rate and Rhythm
Color Doppler Sonography (Required)
Complementary Imaging Strategies (Optional)
Ultrasound Safety During Pregnancy
CHAPTER 12:
Neonatal Echocardiography
PERSISTENT PULMONARY HYPERTENSION (PPHN) OF NEWBORN
DUCTAL FLOW
ATRIAL SHUNTING
CARDIAC FUNCTIONS AND OUTPUT
FUNCTIONAL ECHOCARDIOGRAPHY
Targeted neonatal echocardiography (TNE) Point of care echocardiography (POC ECHO)
Indications
Components
TNE should include evaluation for the presence, size, and direction of atrial-level shunting
Left ventricular output (LVO)
Right ventricular output (RVO)
Superior vena cava (SVC) flow
CHAPTER 13:
Echocardiography in Intensive Care Unit
WHY ECHO IN ICU?
PRELOAD ASSESSMENT: PREDICTION OF VOLUME RESPONSIVENESS
Static Parameters
Dynamic Parameters
PRACTICAL EVALUATION OF LV SYSTOLIC FUNCTION
TDI Doppler
Diastolic Function in Shock
Right Ventricular Failure
Measurement of Pulmonary Artery Pressure: The Dreaded PAH
Assessment for Intracardiac and Intrapulmonary Shunts
INDEX
TOC
Index
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