Speckle tracking echocardiography (STE) is an emerging tool to characterize and quantify myocardial segmental and rotational mechanics. This literature review is aimed at clinical and academic cardiologists to provide: (1) a conceptual framework of STE to initiate understanding of myocardial mechanics; (2) evidence that three-dimensional (3D) STE overcomes the problems of time-consuming data acquisition and postprocessing seen with two-dimensional STE; and (3) illustrative clinical cases with analysis of myocardial mechanics via 3D STE to show the incremental value of strain in clinical decision making.

Medical informed consent is essential to the physician's ability to diagnose and treat patients as well as the patient's right to accept or reject clinical evaluation, treatment, or both. Medical informed consent should be an exchange of ideas that buttresses the patient-physician relationship. The consent process should be the foundation of the fiduciary relationship between a patient and a physician. Physicians must recognize that informed medical choice is an educational process and has the potential to affect the patient-physician alliance to their mutual benefit. Physicians must give patients equality in the covenant by educating them to make informed choices. When physicians and patients take medical informed consent seriously, the patient-physician relationship becomes a true partnership with shared decision-making authority and responsibility for outcomes. Physicians need to understand informed medical consent from an ethical foundation, as codified by statutory law in many states, and from a generalized common-law perspective requiring medical practice consistent with the standard of care. It is fundamental to the patient-physician relationship that each partner understands and accepts the degree of autonomy the patient desires in the decision-making process.

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