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Practical Echocardiography is a highly illustrated guide to the principles and practice of echocardiography written by cardiologists, radiologists and radiographers for all healthcare professionals needing to learn the techniques and interpretative skills involved in the scanning of the heart. It includes discussion of the main applications of echocardiography in the diagnosis of acquired heart disease, but also has specialist chapters on less common techniques, such as transoesophageal echo and the use of echocardiography in the investigation of congenital heart disease. The combination of emphasis on technique as well as diagnosis makes this book especially valuable to trainee clinicians, be they cardiologists, cardiac surgeons or radiologists, as well as the radiographer who (especially in the UK) will often be the person to perform the investigation.
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Greenwich Medical Media Limited 219 The Linen Hall 162-168 Regent Street London W1R 5TB
ISBN 1 900 151 863
First Published 1999
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act 1988, this publication may not be reproduced, stored, or transmitted, in any form or by any means, without the prior permission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the terms of the licences issued by the appropriate Reproduction Rights Organisations outside the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publishers at the London address printed above.
The right of Catherine Walsh and Peter Wilde to be identified as authors of this work has been asserted by them in accordance with the Copyright Designs and Patents Act 1988.
The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made.
A catalogue record for this book is available from the British Library.
Distributed worldwide by Oxford University Press
Typeset by Saxon Graphics Ltd, Derby
Printed in China
Page iii
Practical Echocardiography
By Catherine A Walsh
DipRad (Australia) DMU Senior Radiographer Department of Clinical Radiology Bristol Royal Infirmary, Bristol, UK
Peter Wilde
BSc Hons, MRCP, FRCR Consultant Cardiac Radiologist Bristol Royal Infirmary, Bristol, UK
with contributions by
Alison Heads ONC, HNC REGIONAL TUTOR IN PERINATAL ECHOCARDIOGRAPHY Freeman Hospital Newcastle upon Tyne
Jayshree Joshi BSc Hons SENIOR CHIEF TECHNICIAN Department of Echocardiography Hammersmith Hospital London
Stephen Evans BSc MRCP PhD FELLOW IN INTERVENTIONAL CARDIOLOGY Green Lane Hospital Auckland New Zealand
Page v
Contents
Contributors
iii
Preface
ix
Chapter 1 Introduction to Echocardiography
1
Brief History
3
Present Clinical Applications
3
Preparing to Scan
4
Chapter 2 Anatomy and Physiology of the Heart
9
Pericardium and External Relationships
11
Internal Cardiac Anatomical Relationships
11
Anatomical Features of Individual Structures
14
Intercardiac Flow and Pressure
16
Electrocardiogram
18
Nomenclature for Cardiac Description
19
Chapter 3 Introduction to Echocardiography Modalities
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