विवरण
To evaluate left ventricular function, an echocardiography is typically performed. According to NICE (National Institute for Health and Clinical Excellence) recommendations, this is frequently asked for when patients exhibit heart failure-related symptoms. Despite the fact that clinical data and fundamental studies frequently reveal patients with severe left ventricular systolic dysfunction,4-6 echocardiography can measure the severity and pinpoint the underlying reason. It may be more challenging to diagnose clinically, but many heart failure patients also have concurrent or predominant diastolic dysfunction which should be suspected in patients who have heart failure symptoms but normal systolic function, especially the elderly and those with hypertension.
सारांश
- Doppler echocardiography is a non-invasive ultrasound test that uses high-pitched sound waves emitted by a transducer to create images of the heart. Reflected sound waves from heart structures are converted into visual representations displayed on a video monitor.
- The transducer emits sound waves after gel is applied to facilitate transmission between the skin and the transducer. This converts mechanical energy (sound waves) into electrical signals, which are then processed into a grayscale image. Calcifications appear white, fluids appear black, and myocardium appears gray.
- Echocardiography machines include a pulse generator, transducer, receiver, display, and memory. The transducer transmits and receives signals, using piezoelectric crystals that deform in response to electrical currents to create sound waves.
- Different types of echocardiography exist, including transthoracic (TTE), transesophageal (TEE), and intracardiac. TTE uses higher frequency sound waves for higher resolution images, while TEE uses lower frequencies.
- Standard TTE involves placing the transducer on the patient's chest in different "acoustic windows": parasternal, apical, subcostal, and suprasternal. Common views include parasternal long axis, parasternal short axis, apical four-chamber, apical five-chamber, apical two-chamber, and subcostal.
- The parasternal long axis view visualizes the mitral valve, aortic valve, left ventricle, left ventricular outflow tract, aorta, and right ventricular outflow tract. Key assessments include ventricular size and function, aortic size, valve structure and function, and presence of pericardial effusion.
- The apical four-chamber view provides a comprehensive view of all four heart chambers (right and left atria and ventricles) and valves. The apical five-chamber view is a modification of the four-chamber view that includes the aortic valve and aorta.
- Echocardiography modes include 2D (two-dimensional), M-mode (motion mode), and Doppler. Doppler modes include continuous wave (CW), pulsed wave (PW), and color flow (CF).
- 2D echocardiography visualizes heart structures and motion, while M-mode provides a time-motion display of cardiac dimensions and motion patterns. Doppler echocardiography detects the direction and velocity of blood flow within the heart.
- Pulse Wave Doppler measures low-velocity flow, continuous wave Doppler measures high-velocity flow, and color flow Doppler visualizes the direction of blood flow. Red indicates flow towards the transducer, blue indicates flow away, and green indicates turbulent flow.
- Transesophageal echocardiography (TEE) involves inserting a transducer into the esophagus for closer views of the heart. It is particularly useful for assessing structures like the left atrium, aorta, and mitral valve. TEE is contraindicated in patients with esophageal pathologies.
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Dr Nikhilesh jain
सीएचएल हॉस्पिटल्स में क्रिटिकल केयर विभाग के निदेशक और सलाहकार
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