Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography

Mitchell, Carol; Rahko, Peter S.; Blauwet, Lori A.; Canaday, Barry; Finstuen, Joshua A; Foster, Michael; Horton, Kenneth; Ogunyankin, Kofo O.; Palma, R.; Velázquez, Eric J.

doi:10.1016/j.echo.2018.06.004

Cited by 1,502 publications

(1,235 citation statements)

References 74 publications

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“…Further tilting of the transducer inferiorly will demonstrate the right and left innominate veins draining into the SVC (Figure ). Color‐flow imaging can be used to further demonstrate the venous anatomy and demonstrate the patency of the veins . When there is a prominent brachiocephalic vein overlying the aortic arch, it may mimic an aortic arch dissection flap.…”

Section: Discussionmentioning

confidence: 99%

A prominent brachiocephalic vein masquerading as an aortic dissection flap on transthoracic echocardiogram: A case for multimodality imaging

Gajjar

Biederman

2020

Echocardiography

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A 30‐year‐old female patient with past medical history of supraventricular tachycardia presented with shortness of breath and underwent a transthoracic echocardiogram (TTE). The TTE noted a concerning partially mobile linear echo density, with positive Doppler color flow across it along the aortic arch, which was concerning for a dissection flap. The patient accordingly underwent a cardiac MRI which revealed that the anomaly seen on echocardiogram was in the setting of a prominent left brachiocephalic (innominate) vein and without evidence of aortic dissection. While this is a relatively common phenomenon, there is no literature on prominent brachiocephalic vein masquerading as an aortic dissection flap on TTE.

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Section: Discussionmentioning

confidence: 99%

A prominent brachiocephalic vein masquerading as an aortic dissection flap on transthoracic echocardiogram: A case for multimodality imaging

Gajjar

Biederman

2020

Echocardiography

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Section: Methodsmentioning

confidence: 99%

“…All the echocardiographic measurements were collected as an average of the data acquired from 5 consecutive beats in accordance with the latest guidelines of the American Heart Association by one fellow of echocardiography. 9,10 The MVA was measured by 3D evaluation via the multi-planar reconstruction method in the entire study population following the acquisition of full-volume images in the transesophageal (preprocedural) and transthoracic (postprocedural) echocardiographic examinations ( Figure 1).…”

Section: Echocardiographic Evaluationmentioning

confidence: 99%

Rapid improvement in right ventricular free wall longitudinal strain measures after successful percutaneous mitral commissurotomy

et al. 2019

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Background Percutaneous mitral commissurotomy (PMC) is currently the treatment of choice for patients with symptomatic mitral stenosis (MS) that have favorable valvular characteristics. We aimed to evaluate the effect of PMC on the longitudinal strain of the right ventricular (RV) free wall in patients with severe MS. Methods This prospective study recruited patients who underwent PMC. Transesophageal and transthoracic echocardiographic examinations were performed. The mitral valve area (MVA) was measured by three‐dimensional evaluation. The RV longitudinal strain was measured via the speckle‐tracking method. Results A total of 42 patients with a maximum MVA of 1.5 cm2 underwent PMC in our study. The MVA increased significantly after the procedure (pre‐PMC MVA = 0.94 ± 0.20 cm2 vs post‐PMC MVA = 1.45 ± 0.18 cm2; P < .01). Systolic pulmonary artery pressure decreased from 46.05 ± 14.08 mm Hg preprocedurally to 35.86 ± 7.53 mm Hg postprocedurally (P < .01). The mean RV free wall longitudinal strain was −19.00 ± 5.14%, which rose significantly after PMC to −20.97 ± 3.81 (P < .05). There were postprocedural increases, albeit nonsignificant, in the tricuspid annular peak systolic excursion, the peak systolic Doppler velocity of the RV free wall, and fractional area change. The improvement in the RV longitudinal strain was more prominent in the patients with an MVA of less than 1.0 cm2. Conclusions There was a significant post‐PMC rise in the RV free wall longitudinal strain measures in our study population, demonstrating an immediate improvement in the RV systolic function of the patients.

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“…A TAPSE <17 mm indicates RV dysfunction. 13 To perform the tissue Doppler imaging (TDI)-derived tricuspid lateral annular systolic velocity S 0 measurement, the apical four-chamber windows were utilized with a tissue Doppler mode region of interest that displayed the RV's free wall. The pulsed Doppler sample volume was placed on either the tricuspid annular line or the middle of the basal segment of the RV free wall.…”

Section: Andmentioning

confidence: 99%

“…11,12 Several waves can be visualized on the HV Doppler waveform: the systolic forward flow (S), the systolic flow reversal wave toward end of systole (Sr), the diastolic forward flow (D), the flow reversal wave after D-wave: (Dr), and the flow reversal wave that occurs during atrial contraction (A). [13][14][15] Thus, the HV flow exhibits some type of phasicity. 14 In the present study, we examined the HVs flow velocity waveforms, using pulsed-wave spectral Doppler ultrasonography, to determine their relationship with the sPESI and the patients' RVD status.…”

mentioning

confidence: 99%

Hepatic venous Doppler assessment can anticipate simplified pulmonary embolism severity index and right ventricle dysfunction in patients with acute pulmonary embolism

Acar

İzcı

İnanır

et al. 2020

J of Clinical Ultrasound

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Purpose: Acute pulmonary embolism (APE) is a life-threating cardiothoracic thromboembolic emergency in which right ventricle dysfunction (RVD) is a major concern. In the present study, we examined the hepatic veins (HVs) blood flow with pulsed-wave spectral Doppler ultrasonography to determine its relationship with the simplified pulmonary embolism severity index (sPESI) and the patient's RVD status.Methods: We divided the 243 patients who met the inclusion criteria into two groups based on both their sPESI scores and their RVD status. Transthoracic echocardiography was performed to evaluate the RVD and the HVs within 1 hour after patient admission. The liver was evaluated using subcostal and intercostal echocardiographic windows in grayscale B-mode, and HVs were assessed using color and spectral Doppler assessment though the same echocardiographic windows.Result: A cut-off value of the systolic reverse flow velocity-time integral (SrVTI) = 2.2 cm carried a sensitivity and specificity of 84.29% and 74.89%, respectively, for the prediction of sPESI ≥ 1. A SrVTI cut-off value of 2.1 cm yielded a sensitivity and specificity of 83.03% and 73.91%, respectively, for the prediction of RVD.Conclusion: HV Doppler assessment could be a useful method for anticipating the sPESI and the presence of RVD in patients with APE. In addition, it may provide information regarding the hemodynamic impact of APE. K E Y W O R D SDoppler ultrasonography, hepatic veins, pulmonary embolism, right ventricle

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Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography

Cited by 1,502 publications

References 74 publications

A prominent brachiocephalic vein masquerading as an aortic dissection flap on transthoracic echocardiogram: A case for multimodality imaging

A prominent brachiocephalic vein masquerading as an aortic dissection flap on transthoracic echocardiogram: A case for multimodality imaging

Rapid improvement in right ventricular free wall longitudinal strain measures after successful percutaneous mitral commissurotomy

Hepatic venous Doppler assessment can anticipate simplified pulmonary embolism severity index and right ventricle dysfunction in patients with acute pulmonary embolism

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