Echocardiography — МЕДТРЕЙН Asia

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Heart ultrasound for doctors: standards, protocols, calculations, and interpretation according to international standards.

Echocardiography

Bubble Study for Patent Foramen Ovale: Procedure Technique

The bubble study (agitated saline contrast) in transthoracic echocardiography is used to detect right-to-left shunting, including through a patent foramen ovale. A key element of the …

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Echocardiography

Dilated Cardiomyopathy: Echo Approaches and Differential Diagnosis (in the Context of ESC 2023)

The provided excerpts do not contain direct echocardiographic criteria for dilated cardiomyopathy and its differential from the ESC 2023 guidelines. Only general parameters for assessing chamber …

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Echocardiography

Arrhythmogenic Right Ventricular Cardiomyopathy: Echo Criteria of the Task Force

Echocardiographic diagnosis of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC) relies on the modified Task Force criteria (Marcus FI et al., Circulation 2010) and the updated Padua criteria …

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Echocardiography

Noncompaction of the LV Myocardium: Echocardiographic Diagnostic Criteria and the Problem of Overdiagnosis

The diagnosis of left ventricular noncompaction (LVNC) relies on echocardiographic criteria such as Jenni's (N/C ratio > 2 at end-systole from PSAX), Chin's (X/Y index < …

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Echocardiography

Echocardiography Artifacts: Reverberations, Side Lobes, and Mirror Artifacts — How to Recognize

Reverberations, side lobes, and refraction artifacts can mimic real structures (thrombi in the LAA, floating membranes in aortic dissection). Recognition relies on the nature of movement, …

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Echocardiography

Stress Echocardiography with Physical Exercise in Valvular Heart Disease: Indications for Physicians

Stress echocardiography with physical exercise in valvular heart disease is used to detect symptoms and functional changes that do not manifest at rest. According to EACVI/ASE …

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Echocardiography

Aortic Dissection on Echo: TTE Findings and the Role of Transesophageal Examination

On Echo, a true aortic dissection flap is a wave-like linear mobile echogenic structure that respects physical boundaries and acts as a flow divider in the …

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Echocardiography

Takotsubo Syndrome: Echocardiographic Differentiation from ACS

Echocardiography in Takotsubo syndrome reveals regional wall motion abnormalities (hypokinesis, akinesis, dyskinesis with apical ballooning). However, the method alone does not reliably distinguish reversible dysfunction from …

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Echocardiography

Post-Infarction Mechanical Complications in Echocardiography: Rupture, Pseudoaneurysm, Acute VSD

Post-infarction mechanical complications (free wall rupture, pseudoaneurysm, acute VSD) are life-threatening conditions requiring urgent echocardiographic diagnosis. Key echocardiographic markers include local wall motion abnormalities (akinesis, dyskinesis …

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Echocardiography

Pulmonary Regurgitation: Severity Criteria on EchoCG

Assessment of pulmonary regurgitation (PR) on EchoCG is performed in the LAX RVOT position with CFD flow in the RVOT, PV, PA, and bifurcation of the …

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Echocardiography

Tricuspid Stenosis: Severity Criteria and Gradient Measurement

Assessment of tricuspid stenosis (TS) requires an integrative approach using all Doppler and 2D data. Key quantitative parameters are peak velocity and mean trans-tricuspid flow gradient; …

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Echocardiography

ASD: Echo-Diagnosis of Types and Shunt Volume Assessment Qp/Qs

Atrial septal defect (ASD) is a communication between the atria, creating a shunt and volume overload with chamber dilation. Echocardiography verifies flow using color Doppler mapping, …

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Echocardiography

Detection of LV Thrombus: The Role of Contrast Echocardiography (LVO)

Contrast echocardiography with intravenous ultrasound contrast agents is used to enhance visualization of the LV apex in suboptimal acoustic windows, aiding in the detection of apical …

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Echocardiography

Contrast Echocardiography (Echo Contrast): Indications, Safety, and Technique

Contrast echocardiography with ultrasound contrast agents (UCA) enhances the assessment of cardiac structure and function at rest and during stress echocardiography; its safety is well documented …

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Echocardiography

Calculation of Stroke Volume and Cardiac Output via LVOT VTI: Methodology and Common Errors

Stroke volume is calculated as the product of the cross-sectional area of the LVOT (πd²/4) and the LVOT VTI: SV = CSA × VTI. Cardiac output …

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Echocardiography

Assessment of the Inferior Vena Cava and Right Atrial Pressure on Echocardiography

Assessment of right atrial pressure (RAP) is based on measuring the diameter of the inferior vena cava (IVC) and its inspiratory collapse. Normally, the diastolic diameter …

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Echocardiography

Assessment of Volume Status and Fluid Responsiveness with POCUS: VTI and IVC

Bedside assessment of volume status and fluid responsiveness with POCUS is based on a comprehensive analysis: morphology and respiratory variability of the inferior vena cava (IVC), …

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Echocardiography

Bicuspid Aortic Valve: Anatomy, Classification, and Associated Aortopathy

The bicuspid aortic valve (BAV) is a congenital anomaly where assessing the number of cusps in adults is often complicated by superimposed calcification. An international consensus …

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Echocardiography

HCM: Mitral Valve SAM and Dynamic LVOT Obstruction, Provocative Tests

In HCM, if a patient does not reach the gradient thresholds for considering septal reduction therapy (SRT), it is essential to perform provocative maneuvers to identify …

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Echocardiography

Cardiac Tamponade on Echocardiography: Chamber Collapse and Respiratory Variation of Transvalvular Flows

Echocardiographic signs of cardiac tamponade include early diastolic collapse of the RV free wall (best seen in M-mode), signs of increased ventricular interdependence — respiratory discordance …

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Echocardiography

Constrictive Pericarditis: Septal Bounce, Annulus Reversus, and Respiratory Variation in Echocardiographic Diagnosis

In constrictive pericarditis, enhanced interventricular dependence forms a triad of echocardiographic signs: septal bounce (rapidly changing early diastolic gradients between RV and LV), annulus reversus (lateral …

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Echocardiography

Measurement of the Root and Ascending Aorta: Points, Cycle Phase, Leading-edge vs Inner-edge (BSE, ASE)

Aortic dimensions are measured from PLAX in 2D perpendicular to the long axis of the aorta. The aortic annulus is measured in mid-systole (I-I method); the …

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Echocardiography

Differentiation of Intracardiac Masses: Thrombus, Myxoma, Vegetation, and Tumor in Echocardiography

A key tool for differentiating intracardiac masses is contrast echocardiography with perfusion assessment: myxomas exhibit heterogeneous (patchy) contrast accumulation, while an avascular mass without contrast uptake …

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Echocardiography

Echo Signs of PE: McConnell's Sign and the 60/60 Rule

McConnell's sign and the 60/60 rule are echocardiographic indicators of acute right ventricular overload, aiding in the suspicion of pulmonary embolism (PE) at the bedside. Both …

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Echocardiography

Mitral Stenosis: Assessment of Valve Area by Planimetry, PHT, Continuity, and Wilkins Score

The assessment of the severity of mitral stenosis (MS) relies on the calculation of the mitral valve area (MVA). When leaflet excursion is restricted, MVA is …

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Echocardiography

Evaluation of Prosthetic Valve Function: EOA, DVI, and Acceleration Time (ASE 2024)

The evaluation of aortic prosthesis function is based on the same Doppler principles as the assessment of native stenosis. Key indicators of obstruction include peak velocity …

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Echocardiography

Thrombosis vs. Pannus of Mechanical Valve Prosthesis: Echocardiographic Differential

Differentiation between thrombus and pannus on an obstructive mechanical prosthesis is based on a comprehensive assessment of clinical, transthoracic, and transesophageal echocardiographic parameters (Barbetseas et al., …

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Echocardiography

Echo Criteria for Infective Endocarditis: Vegetations and Abscess (Duke-ISCVID 2023)

The provided source fragments do not contain specific echocardiographic criteria for infective endocarditis according to Duke-ISCVID 2023 (definitions of vegetations, abscess, pseudoaneurysm, or their dimensional thresholds). …

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Echocardiography

EchoCG in TAVI: Assessment of Paravalvular Regurgitation Before and After Implantation

The assessment of paravalvular regurgitation in TAVI relies on ASE recommendations for evaluating valve regurgitation after percutaneous valve replacement (Zoghbi WA et al., J Am Soc …

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Echocardiography

Cardiac Amyloidosis on EchoCG: Apical Sparing, Wall Thickness, Granularity

Key echocardiographic signs of cardiac amyloidosis include increased wall thickness of both ventricles, reduced GLS with relative preservation of apical longitudinal strain (apical sparing) on the …

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Echocardiography

Remote Echocardiography Training According to International Standards: Opportunities of the Virtual Format and Practice Requirements

Virtual echocardiography training supports theoretical preparation; however, developing technical skills requires practical clinical experience: pediatric, fetal, and congenital echocardiography cannot be fully mastered in a virtual …

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Echocardiography

Aortic Regurgitation: Severity Criteria by Vena Contracta, PHT, and Aortic Reversal

Severe aortic regurgitation (AR) is determined by integrating parameters: dense CWD jet spectrum, pressure half-time (PHT) <200 ms, vena contracta width >0.6 cm, jet width to …

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Echocardiography

Tricuspid Regurgitation: 5-Grade Severity Scale (mild–torrential)

According to the ASE 2025 guidelines for the standardization of echocardiography reports, the severity of tricuspid regurgitation (TR) should be described in 5 categories: mild, moderate, …

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Echocardiography

EchoCG Monitoring of oHCM on Mavacamten: BSE 2025 Protocol

According to the BSE 2025 guideline for myosin inhibitor therapy, the key figures for each surveillance EchoCG are LVEF and the peak gradient in the LVOT …

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Echocardiography

Echocardiographic Assessment of Aortic Regurgitation: BSE 2025 Guide

According to the BSE 2025 practical guide, severe aortic regurgitation is likely when the vena contracta is >0.6 cm, EROA is ≥0.30 cm², regurgitant volume is …

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Echocardiography

Management of Valvular Heart Disease: ESC/EACTS 2025, Intervention Thresholds

In the ESC/EACTS 2025 guidelines, severe aortic stenosis is confirmed with Vmax ≥4.0 m/s, mean gradient ≥40 mmHg, or AVA ≤1.0 cm²; low flow is defined …

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Echocardiography

Evaluation of Prosthetic Valve Function and TAVI by EchoCG: ASE 2024

According to ASE 2024, for an aortic prosthesis, normal hemodynamics usually correspond to Vmax <3 m/s, mean gradient <20 mm Hg, DVI >0.35, and AT <80 …

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Echocardiography

How to Master Echocardiography from Scratch: A Physician's Training Plan and Necessary Skills

Mastering TTE from scratch is a sequential process: from understanding indications and preparation for the study to step-by-step execution of 2D, M-mode, and Doppler studies. An …

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Echocardiography

Diastolic Function of the LV and HFpEF by Echo: ASE 2025 Algorithm

ASE 2025 retains key thresholds for Echo assessment of diastolic function: septal e′ <7 cm/s, lateral e′ <10 cm/s, average E/e′ >14, TR Vmax >2.8 m/s, …

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Echocardiography

Strain Echocardiography GLS: Clinical Applications According to ASE/EACVI 2025

The ASE/EACVI 2025 consensus transitions speckle tracking strain from a research method to a routine quantitative component of echocardiography. For the LV, a practical guideline: GLS …

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Echocardiography

Diastolic Function of the RV on EchoCG: E/A, e′, and Hepatic Veins

According to ASE 2025, the diastolic function of the RV is assessed not by a single indicator but by a combination of transtricuspid E/A, DT, E/e′, …

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Echocardiography

Combined Valvular Lesions: Echocardiography and Severity Assessment

The EACVI/ESC 2025 consensus emphasizes: in cases of multiple valvular lesions, severity cannot be mechanically transferred from algorithms for isolated lesions. The main mistake is interpreting …

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Echocardiography

Cardio-Oncology: Monitoring Cardiotoxicity via EchoCG and GLS — When Reduction is Significant

A reduction in GLS of >15% in relative terms from baseline (BSE/BCOS, 2021) is considered significant — this is a criterion for possible subclinical cardiotoxicity. Clinical …

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Echocardiography

Right Ventricle: Size and Function Norms According to ASE 2025

According to ASE 2025, the right ventricle is not assessed by a single number: integration of size, systolic function, pulmonary artery pressure, and right atrial pressure …

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Echocardiography

Transesophageal Echocardiography (TEE): Indications, Contraindications, Technique, and Clinical Significance

TEE is a key imaging modality for structural heart disease, used for preprocedural assessment before transcatheter and surgical interventions, as well as for guiding transseptal catheterization …

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Echocardiography

Regional LV Contractility: 17-Segment Model, Dysfunction Scale, and WMSI Index

The assessment of regional LV contractility is based on the analysis of wall motion and systolic thickening by segments using a semi-quantitative scale (normokinesis, hypokinesis, akinesis, …

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Echocardiography

Left Ventricular Myocardial Mass and LVH: Calculation of LVMI, Normal Thresholds, and Relative Wall Thickness

The left ventricular myocardial mass is calculated using the linear method (Devereux formula, Penn convention) from IVSd, LVPWd, and LVIDd. LVMI = mass/BSA; the upper limit …

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Echocardiography

Dobutamine Stress Echocardiography: Protocol, Indications, and Interpretation of Contractility Disorders

Dobutamine Stress Echocardiography (DSE) is used to assess coronary artery disease (CAD) and to clarify the severity of aortic stenosis (AS) in the presence of left …

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Echocardiography

Global Longitudinal Strain (GLS) and Speckle Tracking: Measurement Methodology, Norms, and Clinical Application

GLS is measured using the 2D speckle tracking method through apical views (A4C, A2C, A3C) and reflects the longitudinal systolic function of the LV. A decrease …

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Echocardiography

Right Ventricle and Pulmonary Hypertension: Calculation of SPAP, TAPSE, S', and TAPSE/SPAP

SPAP (Systolic Pulmonary Artery Pressure) in the absence of RVOT obstruction is calculated using the modified Bernoulli equation: RVSP = 4·TRVmax² + RAP, where RVSP=SPAP. The …

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Echocardiography

Assessment of Mitral Regurgitation Severity: PISA, EROA, and Vena Contracta — A Practical Algorithm

Quantitative assessment of mitral regurgitation (MR) relies on the PISA method with EROA calculation and vena contracta measurement. According to BSE (2021), flow convergence hemispheres are …

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Echocardiography

Aortic Stenosis on EchoCG: Severity Criteria and Low-Flow Pitfalls

Severe aortic stenosis on EchoCG is suspected with transaortic Vmax ≥4 m/s, mean gradient ≥40 mmHg, AVA <1 cm², indexed AVA <0.6 cm²/m², and LVOT/AV velocity …

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Echocardiography

Left Ventricular Diastolic Function: Evaluation Algorithm Based on ASE/EACVI 2016 Criteria

According to the ASE/EACVI (2016) guidelines, the degree of left ventricular diastolic dysfunction is determined by four key parameters: average E/e' >14, e' velocity (septal <7 …

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Echocardiography

Left Ventricular Ejection Fraction: Simpson's and Teicholz Methods — When to Use Each

LVEF is preferably calculated using the biplane method of disks summation (modified Simpson's method) from EDV and ESV volumes obtained in apical 4- and 2-chamber views. …

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Echocardiography

Left Ventricular Ejection Fraction: Calculation Methods and Norms

Left Ventricular Ejection Fraction (LVEF) is the proportion of blood ejected by the left ventricle per cardiac cycle. The recommended method is the biplane method of …

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Echocardiography

Echocardiography Norms in Adults: Reference Values by ASE/EACVI and BSE

Reference values for echocardiography in adults are regulated by the ASE/EACVI guidelines for the quantitative assessment of cardiac chambers (Lang RM et al., J Am Soc …

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Echocardiography

Echocardiography Protocol: Step-by-Step Execution, Measurements, and Conclusion

Transthoracic Echocardiography (TTE) is performed as an ECG-synchronized study: first, patient and equipment preparation, followed by sequential scanning in 2D, M-modes, and Doppler modalities. Key linear …

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