Andersons pediatric cardiology 464

19 Cross-Sectional Echocardiography and Doppler Imaging Conall T Morgan, Luc L Mertens Abstract This chapter on cross-sectional echocardiography and Doppler imaging covers a wide range of topics including ultrasound physics, Doppler echocardiography, image optimization and anatomic principles guiding echocardiography We discuss transthoracic imaging in addition to transoesphageal imaging and special uses of echocardiography including postoperative echocardiography, contrast echocardiography and stress echocardiography Keywords Echocardiography; Doppler; physics; transesophageal Since the late 1970s, perhaps the most important change in the practice of clinical pediatric cardiology has been the introduction of cross-sectional echocardiography and its subsequent technical improvements Echocardiography currently allows highly accurate diagnosis of nearly all morphologic abnormalities, for the most part making invasive diagnostic techniques obsolete Cardiac catheterization and angiography are no longer a routine investigation in most patients prior to cardiac surgery, as it used to be a few decades ago Indeed, the main indication for such an investigation, apart from the purposes of assessing hemodynamics and intervention, is the display of structures beyond echocardiographic visualization, such as peripheral pulmonary arteries, distal coronary arteries, and more rarely complex abnormalities of systemic and pulmonary venous return Even so, for many of these indications, magnetic resonance and computerized tomographic imaging have replaced cardiac catheterization All pediatric cardiologists, cardiac intensivists, and pediatric cardiac surgeons should therefore be familiar with echocardiographic imaging and diagnosis More recently point-of-care echocardiography has been introduced in the neonatal intensive care unit for specific diagnostic applications such as monitoring ductal patency and pulmonary arterial hypertension of the newborn The increased availability of handheld echo machines has expanded their use in the pediatric emergency department, potentially allowing faster diagnosis of cardiac dysfunction and pericardial effusion in life-threatening conditions This chapter is devoted to the principles of cross-sectional and ... resonance and computerized tomographic imaging have replaced cardiac catheterization All pediatric cardiologists, cardiac intensivists, and pediatric cardiac surgeons should therefore be familiar with echocardiographic imaging... Echocardiography; Doppler; physics; transesophageal Since the late 1970s, perhaps the most important change in the practice of clinical pediatric cardiology has been the introduction of cross-sectional echocardiography and its subsequent technical improvements... such as monitoring ductal patency and pulmonary arterial hypertension of the newborn The increased availability of handheld echo machines has expanded their use in the pediatric emergency department, potentially allowing faster diagnosis of cardiac dysfunction and pericardial effusion in life-threatening