Focused Transthoracic Echocardiography by Sports Medicine Physicians
|
|
- Berniece Fletcher
- 8 years ago
- Views:
Transcription
1 ORIGINAL RESEARCH Focused Transthoracic Echocardiography by Sports Medicine Physicians Measurements Relevant to Hypertrophic Cardiomyopathy Eugene S. Yim, MD, MPH, Edward F. Gillis, RDCS, Krystin Ojala, CSCS, James MacDonald, MD, Frederick C. Basilico, MD, Gianmichael D. Corrado, MD Received May 9, 2012, from the Division of Sports Medicine, Children s Hospital Boston, Boston, Massachusetts USA (E.S.Y., J.M., G.D.C.); Department of Cardiology, New England Baptist Hospital, Boston, Massachusetts USA (E.F.G., F.C.B.); and Division of Sports Performance and Sports Medicine, Northeastern University, Boston, Massachusetts USA (K.O., G.D.C.). Revision requested June 15, Revised manuscript accepted for publication July 5, Address correspondence to Eugene S. Yim, MD, MPH, Division of Sports Medicine, Children s Hospital Boston, 319 Longwood Ave, Boston, MA USA. eyim@bidmc.harvard.edu Abbreviations ECG, electrocardiography; ICC, intraclass correlation coefficient; IVSd, end-diastolic interventricular septal thickness; LVIDd, end-diastolic left ventricular internal diameter; LVPWd, end-diastolic left ventricular posterior wall thickness Objectives The purpose of this study was to investigate whether sports medicine physicians can use portable echocardiography to obtain measurements pertinent to hypertrophic cardiomyopathy. Methods Thirty male collegiate athletes, aged 18 to 21 years, were prospectively enrolled. Focused portable echocardiography was performed by a board-certified sports medicine physician and a resident physician, followed by comprehensive echocardiography within 2 weeks by a registered diagnostic cardiac sonographer. A left parasternal long-axis view was acquired to measure 3 dimensions: (1) end-diastolic interventricular septal thickness (IVSd),(2) end-diastolic left ventricular internal diameter (LVIDd), and (3) end-diastolic left ventricular posterior wall thickness (LVPWd). Results Intraclass correlation coefficients between the sports medicine physician and the sonographer were strong: 0.77 for IVSd, 0.73 for LVIDd, and 0.64 for LVPWd. Intraclass correlation coefficients between measurements by the resident physician and sonographer were strong to moderate: 0.61 for IVSd, 0.62 for LVIDd, and 0.63 for LVPWd. Across all 3 readers, intraclass correlation coefficient calculations were 0.77 for IVSd, 0.81 LVIDd, and 0.75 for LVPWd, which indicated strong inter-rater reliability. Conclusions Sports medicine physicians are able to obtain measurements relevant to the diagnosis of hypertrophic cardiomyopathy with focused portable echocardiography that are consistent with comprehensive echocardiography by a registered sonographer. Key Words athletes; echocardiography; hypertrophic cardiomyopathy; sports medicine; sudden cardiac death Sudden cardiac death has captured the attention of the medical community and the general population over the years. It has been of particular interest to the sports medicine community because of its potentially devastating impact on the lives of young athletes. The underlying causes of sudden cardiac death vary by region, with arrhythmogenic right ventricular cardiomyopathy/dysplasia accounting for most cases (22%) of sudden cardiac death in certain regions, such as the Venuto region of Italy, whereas in the United States most cases (up to 48%) are associated with hypertrophic cardiomyopathy. 1,2 Conditions such as hypertrophic cardiomyopathy are therefore especially relevant to the care of athletes in countries such as the United States because they represent the leading causes of sudden cardiac death in the young population during physical exertion. 1, by the American Institute of Ultrasound in Medicine J Ultrasound Med 2013; 32:
2 Although often asymptomatic, athletes with hypertrophic cardiomyopathy can present with symptoms associated with left ventricular outflow tract obstruction: dyspnea, fatigue, exercise intolerance, dizziness, and syncope. 4 Hypertrophic cardiomyopathy also predisposes athletes to arrhythmias, including atrial fibrillation, premature ventricular depolarization, ventricular couplets, nonsustained ventricular tachycardia, and sustained ventricular tachycardia. 5 Unfortunately, sudden cardiac death can also be the first and only manifestation of hypertrophic cardiomyopathy. 6 The potential lethality of hypertrophic cardiomyopathy explains why it has been incorporated into screening programs for athletes participating in competitive sports worldwide. In countries across Europe and Asia, screening echocardiography has been incorporated as a part of screening programs that are used to determine eligibility for participation in competitive sports. These programs incorporate screening echocardiography selectively or routinely as a part of comprehensive evaluations that include medical evaluation, electrocardiography (ECG), and additional workups such as exercise stress testing, continuous rhythm monitoring, and cardiac imaging. 7,8 Hypertrophic cardiomyopathy is classically associated with asymmetric septal hypertrophy, with the following 2-dimensional echocardiographic criteria that have been used for diagnosis: unexplained maximal wall thickness greater than 15 mm in any myocardial segment, septal/ posterior wall thickness ratio greater than 1.3 in normotensive patients, and septal/posterior wall thickness ratio greater than 1.5 in hypertensive patients. 9 Although comprehensive echocardiography by a sonographer is traditionally used to diagnose hypertrophic cardiomyopathy with these criteria, a focused protocol for point-of-care echocardiography could be developed for use by sports medicine physicians to help screen for hypertrophic cardiomyopathy. Such a protocol may be feasible given the development of portable and handheld ultrasound devices that have proven equally reliable and accurate in measuring cardiac parameters relevant to hypertrophic cardiomyopathy. 10 Similar precedence has also been set in other fields, in which focused sonographic protocols have become a part of standard practice. 11,12 As sonography becomes more avidly incorporated into the field of sports medicine, the potential use of portable sonography in this manner should be considered. This study began to explore that possibility by evaluating the reliability of portable sonography in the hands of a sports medicine physician and a resident physician. Materials and Methods Study Population Thirty male athletes participating in National Collegiate Athletic Association Division I collegiate sports, aged 18 to 21 years, were prospectively enrolled. Athletes participated in one of the following sports: track and field (10), crew (7), soccer (6), baseball (6), and ice hockey (1). All participants were healthy and had no known history of cardiovascular disease. Participants were recruited by convenience sampling at the athletic training facility of the university. The study was approved by the Institutional Review Board at Northeastern University as well as New England Baptist Hospital. Written informed consent was obtained from all participating athletes. Echocardiography Protocol Portable echocardiography was performed initially at university facilities by a sports medicine physician and a resident physician. Within 2 weeks, the participants followed up at a local hospital to receive comprehensive echocardiography by a registered diagnostic cardiac sonographer. The sports medicine physician was board certified in sports medicine and had greater than 5 years of clinical experience in the use of sonography, although most of the experience was in musculoskeletal sonography. The physician received training in sonography through residency training and also completed a weekend course in advanced echocardiography before the onset of the study. The resident physician was a postgraduate year 2 resident in emergency medicine planning for specialization in sports medicine. The resident physician had 2 years of clinical experience in the use of sonography, through requisite teaching in sonographic techniques provided by residency training in emergency medicine. Both individuals received targeted training by a sonographer before the study. Training sessions comprised 4 hour-long sessions focused on obtaining the measurements relevant to the study. Echocardiographic examinations were performed with the participants at rest in the left lateral decubitus position. The readers obtained their measurements independently and were blinded to the results of other readers. Portable echocardiography was performed with a commercially available battery-powered portable platform (MicroMaxx; SonoSite Inc, Bothell, WA) equipped with a 2.5-MHz phased array transducer and a 10.4-in/26.4-cm diagonal liquid crystal display screen. Comprehensive echocardiography was performed with a Vivid 7 ultrasound system (GE Healthcare, Wauwatosa, WI) equipped with an M4S phased array transducer using second-harmonic 334 J Ultrasound Med 2013; 32:
3 (1.7/3.4-MHz) imaging. Images were viewed on a 21-in liquid crystal display. Measurements were acquired from a frozen-frame image captured during end diastole. An ECG signal was used to identify end diastole on comprehensive echocardiography. However, this signal was not available for portable echocardiography. With portable echocardiography, end diastole was identified by selecting the frame with the largest left ventricular areas, with associated closure of aortic and mitral valves. A left parasternal long-axis view was acquired to measure 3 dimensions (Figure 1): (1) end-diastolic interventricular septal wall thickness (IVSd), (2) end-diastolic left ventricular internal diameter (LVIDd), and (3) end-diastolic left ventricular posterior wall thickness (LVPWd). The IVSd was measured from the leading edge of the right septal echo to the leading edge of the left septal echo, approximately 1 cm from the aortic outflow tract. The LVIDd was measured from the leading edge of the left septal echo to the leading edge of the endocardial echo. The LVPWd was measured from the leading edge of the endocardial echo to the leading edge of the epicardial echo. These measurements were chosen in consultation with the sports cardiologist involved as an author of the study because of their reliability and relevance to the diagnosis of hypertrophic cardiomyopathy in athletes. As mentioned previously, measurements of IVSd and LVPWd are not only helpful as absolute measures of wall thickness but also useful in calculating the septal/posterior wall ratios used as diagnostic criteria for hypertrophic cardiomyopathy. The LVIDd was also chosen because it has also been used in diagnosing hypertrophic cardiomyopathy, which is classically associated with decreased internal diameters of the left ventricle as a result of hypertrophy. Figure 1. A parasternal, long-axis view of the heart was obtained from each athlete. Three measurements were taken for each athlete: (1) IVSd, (2) LVIDd, and (3) LVPWd. Statistical Analysis Continuous data are presented as mean ± standard deviation. The measurements obtained by the sports medicine physician and resident physician were compared to the values obtained by the sonographer through pair-wise evaluations of concordance using intraclass correlation coefficients (ICCs) for each of the 3 parameters measured. To evaluate agreement/concordance among all 3 readers, ICC calculations were computed across all 3 readers for each parameter. P <.05 was considered statistically significant. All analyses were performed with an online opensource statistical program. 13 Results Study Population Thirty athletes were recruited for the study, and all athletes were able to follow up within 2 weeks of the initial echocardiographic examinations for comprehensive echocardiography. Portable Versus Comprehensive Echocardiography The means ± standard deviations for each of the measured parameters by all 3 readers are displayed in Table 1. The ICCs between measurements by the sports medicine physician and the sonographer were 0.77 for IVSd, 0.73 for LVIDd, and 0.64 for LVPWd.The ICCs between measurements by the resident physician and sonographer were 0.61 for IVSd, 0.62 for LVIDd, and 0.63 for LVPWd. Comparing concordance across all 3 readers, ICC calculations were 0.77 for IVSd, 0.81 LVIDd, and 0.75 for LVPWd. Discussion Echocardiographic measurements by a sports medicine physician and a resident physician were found to have strong or strong to moderate agreement when compared to values obtained by a sonographer in a dedicated echocardiography laboratory. Pair-wise comparison between the sports medicine physician and the sonographer showed strong agreement for IVSd and LVIDd and strong to Table 1. Measurements by 3 Readers Sports Medicine Resident Registered Parameter Physician Physician Sonographer IVSd, mm 10.0 ± ± ± 1.0 LVIDd, mm 53 ± ± ± 3.0 LVPWd, mm 9.1 ± ± ± 0.9 Values are mean ± SD. J Ultrasound Med 2013; 32:
4 moderate agreement for LVPWd. Pair-wise comparison between the resident physician and the sonographer showed strong to moderate agreement across the board. Measurements for IVSd, LVIDd, and LVPWd by the 3 readers had similar means, with slight overestimation of values obtained by portable echocardiography compared to comprehensive echocardiography. Despite this trend, none of the measurements by the sports medicine physician or the resident physician fell into the range of abnormal. This finding was expected given that all athletes in the study were otherwise healthy, with no history of cardiovascular disease. Although the sports medicine physician measured IVSd and LVIDd accurately, LVPWd was measured with less precision. The correlation coefficients for IVSd and LVIDd were comparable to those shown in previous studies comparing portable and comprehensive echocardiography in the hands of sonographers. 10 Of note, these previous studies also showed that LVPWd was more difficult to measure reliably than the other parameters, although sonographers were still able to maintain a strong correlation between portable and comprehensive echocardiography. Our data support the idea that IVSd and LVIDd are more accurately measured by portable echocardiography than LVPWd. Technical differences between portable ultrasound systems and standard echocardiography machines may be responsible, although further study would be required to investigate these factors. Although the measurements by the resident physician did not have as strong a correlation to comprehensive echocardiography as those obtained by the sports medicine physician, the level of agreement across all 3 readers was strong. Inter-rater agreement across all readers involved in the study showed strong agreement, with ICC calculations ranging from 0.77 to This level of agreement is comparable to that shown in previous studies comparing linear measurements by portable versus comprehensive echocardiography in the hands of certified sonographers. 10 Therefore, agreement may have been even stronger had the images been taken by the same type of machine by all readers in the study. If a similar level of accuracy can be attained broadly by other sports medicine physicians, this technique holds the potential to affect clinical practice in the future. In the United States, where hypertrophic cardiomyopathy is the most common cause of sudden cardiac death in young athletes, current screening practices have been proven to be haphazard and inconsistent. Although the American Heart Association has published recommendations for cardiovascular screening in athletes, most physicians and athletic directors are either unaware of these recommendations or have not implemented them into practice. 14 Furthermore, incorporating particular diagnostic tests, such as ECG, has faced controversy and disagreement, with some advocates pointing to its successful use in other countries, whereas opponents claim that the diagnostic test lacks specificity and leads to unnecessary referrals to specialists Since comprehensive echocardiography is considered an accurate diagnostic test for evaluating the presence of cardiovascular abnormalities such as hypertrophic cardiomyopathy, the development of a focused protocol for echocardiography could serve as a critical addition to a broader, more effective screening strategy for hypertrophic cardiomyopathy. The most prevalent argument against this idea, however, is that it would not be cost-effective because of the low prevalence of abnormalities in the athletic population and the resultantly large number of athletes that would have to be screened to detect one athlete with abnormalities. 19 Training sports medicine physicians in portable echocardiography may address this point by potentially improving accessibility of the diagnostic test. In addition, such testing could be administered selectively to athletes at higher risk or in individuals who screen positive by conventional methods (history, physical examination, and ECG), in an attempt to reduce false-positive rates and unnecessary referral to specialists. Once a specific strategy incorporating this focused technique is implemented, cost-effectiveness analyses will be invaluable in justifying utility in this setting. Limitations Although our study showed a strong correlation between values obtained by a sports medicine physician and a sonographer, a stronger correlation has been documented in previous studies comparing sonographers. 20 Part of this discrepancy should be attributed to the difference in devices used by the physician and the echocardiographer in our study. Although differences in the imaging characteristics of the echocardiography machines themselves may explain part of this variability, the method for identifying end diastole may also have contributed to this discrepancy. An electrocardiographic tracing was not available to identify end diastole on portable echocardiography, adding a degree of complexity to obtaining correct imaging for the sports medicine physician and resident physician. Regardless, as discussed previously, studies comparing the correlation between echocardiographers using portable and comprehensive echocardiography machines have shown a similar level of correlation as that seen in our study. The discrepancy between measurements obtained by the sports medicine physician and resident physician will 336 J Ultrasound Med 2013; 32:
5 also require further investigation. Although the sports medicine physician had a moderate to strong correlation compared to the sonographer, the resident physician had a weaker correlation in measurements. This finding can presumably be attributed to the level of training and experience with sonography that differed between the two readers, but it remains to be proven. The quality and substance of training likely affect accuracy in these techniques, but the exact quantity and content of required training remain an open question. If such techniques are to be incorporated more widely into practice, appropriate training programs will have to be developed to ensure adequate proficiency. This process may require general training in sonography, focused training in taking particular measurements relevant to hypertrophic cardiomyopathy, as well as a certain amount of clinical experience. Another major limitation of our study was its sample size. The study was designed as a pilot to assess feasibility for further investigation and was not meant to produce definitive results. However, the small sample size of 30 restricts heterogeneity of the sample and also limits generalizability of the data to larger populations. Further investigation with larger numbers and even recruitment of multiple study sites will help improve validity and generalizability of data. Another limitation to the implications of our study is that only healthy athletes without a history of cardiovascular disease were recruited for the study. As expected, measurements obtained by all readers were within normal cardiac physiologic limits. Although this study provides preliminary evidence that trained physicians can obtain accurate measurements using portable echocardiography, it does not prove that this technique can be applied toward the diagnosis of hypertrophic cardiomyopathy. Before this technique can be applied specifically in this manner, additional studies including high-risk athletes as well as athletes with abnormal cardiac dimensions will be required to validate this method in its application for evaluating athletes for hypertrophic cardiomyopathy. Last, the parameters chosen for the focused protocol in our study may not be adequate to detect all cases of hypertrophic cardiomyopathy. A full evaluation for hypertrophic cardiomyopathy by comprehensive echocardiography includes not only the static measurements obtained in our study but also a number of more specialized dynamic techniques: spectral Doppler imaging to assess provoked gradients and dynamic outflow tract obstruction, color Doppler imaging to assess regurgitation and valve incompetence, and M-mode assessment to evaluate systolic anterior motion of the mitral valve. Our focused protocol was admittedly less comprehensive than such a formal evaluation, but the static measurements in our study were chosen because they could feasibly be applied to a broader screening protocol used by less experienced operators. The sensitivity and specificity of this limited evaluation must be evaluated before this technique can be justifiably incorporated into screening strategies for hypertrophic cardiomyopathy. Conclusions Sports medicine physicians may be able to obtain measurements with portable echocardiography that are relevant to the diagnosis of hypertrophic cardiomyopathy and consistent with those measured by sonographers in dedicated echocardiography laboratories. As more sports medicine physicians become proficient in the use of portable echocardiography, a focused protocol could provide the basis for a screening strategy for detecting hypertrophic cardiomyopathy in athletes. Such a protocol will hopefully lead to improved detection of this life-threatening condition and decreased morbidity and mortality in an otherwise healthy and active population. References 1. Maron BJ, Shirani J, Poliac LC, Mathenge R, Roberts WC, Mueller FO. Sudden death in young competitive athletes: clinical, demographic, and pathological profiles. JAMA 1996; 276: Maron BJ, Roberts WC, McAllister HA, Rosing DR, Epstein SE. Sudden death in young athletes. Circulation 1980; 62: Maron BJ, Doerer JJ, Haas TS, Tierney DM, Mueller FO. Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, Circulation 2009; 119: Maron BJ. Hypertrophic cardiomyopathy: a systematic review. JAMA 2002; 287: Adabag AS, Maron BJ. Implications of arrhythmias and prevention of sudden death in hypertrophic cardiomyopathy. Ann Noninvasive Electrocardiol 2007; 12: Stroumpoulis KI, Pantazopoulos IN, Xanthos TT. Hypertrophic cardiomyopathy and sudden cardiac death. World J Cardiol 2010; 2: Corrado D, Migliore F, Bevilacqua M, Basso C, Thiene G. Sudden cardiac death in athletes: can it be prevented by screening? Herz 2009; 34: Corrado D, Basso C, Schiavon M, Pelliccia A, Thiene G. Pre-participation screening of young competitive athletes for prevention of sudden cardiac death. J Am Coll Cardiol 2008; 52: Doi YL, Deanfield JE, McKenna WJ, Dargie HJ, Oakley CM, Goodwin JF. Echocardiographic differentiation of hypertensive heart disease and hypertrophic cardiomyopathy. Br Heart J 1980; 44: J Ultrasound Med 2013; 32:
6 10. Coletta C, De Marchis E, Lenoli M, et al. Reliability of cardiac dimensions and valvular regurgitation assessment by sonographers using hand- carried ultrasound devices. Eur J Echocardiogr 2006; 7: Heller K, Reardon R, Joing S. Ultrasound use in trauma: the FAST exam. Acad Emerg Med 2007; 14: Criniti A, Lin PC. Applications of intraoperative ultrasound in gynecological surgery. Curr Opin Obstet Gynecol 2005; 17: Chinese University of Hong Kong. Statistical tests. Chinese University of Hong Kong website. Accessed May 5, Miller R. Athletic directors and doctors want standard screening form for SCD. Heartwire website. Accessed May 7, Myerburg RJ, Vetter VL. Electrocardiograms should be included in preparticipation screening of athletes. Circulation2007; 116: Chaitman BR. An electrocardiogram should not be included in routine preparticipation screening of young athletes. Circulation2007; 116: Pelliccia A, Corrado D. Can electrocardiographic screening prevent sudden death in athletes? Yes. BMJ 2010; 341:c Bahr R. Can electrocardiographic screening prevent sudden death in athletes? No. BMJ 2010; 341:c Faber L, van Buuren F. Athlete screening for occult cardiac disease: no risk, no fun? J Am Coll Cardiol 2008; 51: Vignola PA, Bloch A, Kaplan AD, Walker HJ, Chiotellis PN, Myers GS. Interobserver variability in echocardiography. J Clin Ultrasound 1977; 5: J Ultrasound Med 2013; 32:
Focused Physician-Performed Echocardiography in Sports Medicine
ORIGINAL RESEARCH Focused Physician-Performed Echocardiography in Sports Medicine A Potential Screening Tool for Detecting Aortic Root Dilatation in Athletes Eugene S. Yim, MD, MPH, Daniel Kao, BS, Edward
More informationPotential Causes of Sudden Cardiac Arrest in Children
Potential Causes of Sudden Cardiac Arrest in Children Project S.A.V.E. When sudden death occurs in children, adolescents and younger adults, heart abnormalities are likely causes. These conditions are
More informationRACE I Rapid Assessment by Cardiac Echo. Intensive Care Training Program Radboud University Medical Centre NIjmegen
RACE I Rapid Assessment by Cardiac Echo Intensive Care Training Program Radboud University Medical Centre NIjmegen RACE Goal-directed study with specific questions Excludes Doppler ultrasound Perform 50
More informationCARDIAC SONOGRAPHER SERIES
CARDIAC SONOGRAPHER SERIES Occ. Work Prob. Effective Code No. Class Title Area Area Period Date 4636 Cardiac Sonographer I 02 447 6 mo. 04/15/05 4637 Cardiac Sonographer II 02 447 6 mo. 04/15/05 4638 Cardiac
More informationTeaching Medical Students Diagnostic Sonography
Article Teaching Medical Students Diagnostic Sonography Peter H. Arger, MD, Susan M. Schultz, RDMS, Chandra M. Sehgal, PhD, Theodore W. Cary, Judith Aronchick, MD Objective. The purpose of this pilot project
More informationThe P Wave: Indicator of Atrial Enlargement
Marquette University e-publications@marquette Physician Assistant Studies Faculty Research and Publications Health Sciences, College of 8-12-2010 The P Wave: Indicator of Atrial Enlargement Patrick Loftis
More informationHYPERTROPHIC CARDIOMYOPATHY
HYPERTROPHIC CARDIOMYOPATHY Most often diagnosed during infancy or adolescence, hypertrophic cardiomyopathy (HCM) is the second most common form of heart muscle disease, is usually genetically transmitted,
More informationBASIC STANDARDS FOR RESIDENCY TRAINING IN CARDIOLOGY
BASIC STANDARDS FOR RESIDENCY TRAINING IN CARDIOLOGY American Osteopathic Association and the American College of Osteopathic Internists Specific Requirements For Osteopathic Subspecialty Training In Cardiology
More information1p36 and the Heart. John Lynn Jefferies, MD, MPH, FACC, FAHA
1p36 and the Heart John Lynn Jefferies, MD, MPH, FACC, FAHA Director, Advanced Heart Failure and Cardiomyopathy Services Associate Professor, Pediatric Cardiology and Adult Cardiovascular Diseases Associate
More informationDiagnostic and Therapeutic Procedures
Diagnostic and Therapeutic Procedures Diagnostic and therapeutic cardiovascular s are central to the evaluation and management of patients with cardiovascular disease. Consistent with the other sections,
More informationCardiology Fellowship Manual. Goals & Objectives -Cardiac Imaging- 1 Page
Cardiology Fellowship Manual Goals & Objectives -Cardiac Imaging- 1 Page 2015-2016 UNIV. OF NEBRASKA CHILDREN S HOSPITAL & MEDICAL CENTER DIVISION OF CARDIOLOGY FELLOWSHIP PROGRAM CARDIAC IMAGING ROTATION
More informationHow to read the ECG in athletes: distinguishing normal form abnormal
How to read the ECG in athletes: distinguishing normal form abnormal Antonio Pelliccia, MD Institute of Sport Medicine and Science www.antoniopelliccia.it Cardiac adaptations to Rowing Vagotonia Sinus
More informationINHERIT. The Lancet Diabetes & Endocrinology In press
INHibition of the renin angiotensin system in hypertrophic cardiomyopathy and the Effect on hypertrophy a Randomized Intervention Trial with losartan Anna Axelsson, Kasper Iversen, Niels Vejlstrup, Carolyn
More informationCarcinoid Hjärtsjukdom
Carcinoid Hjärtsjukdom CARCINOID TUMORS 20/milj/år FORE-GUT 10% bronchial pancreatic gastric duodenal MID-GUT 70% 40% appendiceal jejunal 30% (6/m/år) ileal prox colonic HIND-GUT 20% distal colonic rectal
More informationElectrocardiographic Issues in Williams Syndrome
Electrocardiographic Issues in Williams Syndrome R. Thomas Collins II, MD Assistant Professor, Pediatrics and Internal Medicine University of Arkansas for Medical Sciences Arkansas Children s Hospital
More informationChest Pain in Young Athletes. Christopher Davis, MD, PhD Pediatric Cardiology Rady Children s Hospital San Diego cdavis@rchsd.
Chest Pain in Young Athletes Christopher Davis, MD, PhD Pediatric Cardiology Rady Children s Hospital San Diego cdavis@rchsd.org 858-966-5855 None Disclosures Chest Pain: the good news and the bad news:
More informationEcho-Web.Com. Planning for Success in the Field of Echocardiography. Echo-Web Catalog and the iechoschool Curriculum
Planning for Success in the Field of Echocardiography Echo-Web.Com Echo-Web Catalog and the iechoschool Curriculum Richard Keith H. Duncan, RDCS, RCS, RCIS, BBA Contents The Echo-Web Course Catalog...
More informationReal-Time 3-Dimensional Transesophageal Echocardiography in the Evaluation of Post-Operative Mitral Annuloplasty Ring and Prosthetic Valve Dehiscence
Journal of the American College of Cardiology Vol. 53, No. 17, 2009 2009 by the American College of Cardiology Foundation ISSN 0735-1097/09/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2008.12.059
More informationSignal-averaged electrocardiography late potentials
SIGNAL AVERAGED ECG INTRODUCTION Signal-averaged electrocardiography (SAECG) is a special electrocardiographic technique, in which multiple electric signals from the heart are averaged to remove interference
More informationThe Role Of Early Stress Testing In Assessing Low Risk Chest Pain Patients Admitted Through The Emergency Department
The Role Of Early Stress Testing In Assessing Low Risk Chest Pain Patients Admitted Through The Emergency Department Simbo Chiadika LAY ABSTRACT A. Study purpose Cardiac stress testing has been recommended
More informationLow-gradient severe aortic stenosis with normal LVEF: A disturbing clinical entity
Low-gradient severe aortic stenosis with normal LVEF: A disturbing clinical entity Jean-Luc MONIN, MD, PhD Henri Mondor University Hospital Créteil, FRANCE Disclosures : None 77-year-old woman, mild dyspnea
More informationechocardiography practice and try to determine the ability of each primary indication to identify congenital heart disease. Patients and Methods
29 ABNORMAL CARDIAC FINDINGS IN PRENATAL SONOGRAPHIC EXAMINATION: AN IMPORTANT INDICATION FOR FETAL ECHOCARDIOGRAPHY? RIMA SAMI BADER Aim: The present study was conducted to evaluate the most common indications
More informationAuscultation of the Heart
Review of Clinical Signs uscultation of the Heart Series Editor: Bernard Karnath, MD Bernard Karnath, MD William Thornton, MD uscultation of the heart can provide clues to the diagnosis of many cardiac
More informationMINIMUM STANDARDS FOR THE CARDIAC SONOGRAPHER: A Position Paper. S. Michelle Bierig, MPH, RDCS, FASE* Donna Ehler, BS, RDCS, FASE
MINIMUM STANDARDS FOR THE CARDIAC SONOGRAPHER: A Position Paper S. Michelle Bierig, MPH, RDCS, FASE* Donna Ehler, BS, RDCS, FASE Margaret L. Knoll, RDCS, FASE Alan D. Waggoner, MHS, RDCS * * St. Louis,
More informationSpecific Basic Standards for Osteopathic Fellowship Training in Cardiology
Specific Basic Standards for Osteopathic Fellowship Training in Cardiology American Osteopathic Association and American College of Osteopathic Internists BOT 07/2006 Rev. BOT 03/2009 Rev. BOT 07/2011
More informationTeaching Med-5 Students Point-of-Care Transthoracic Echocardiography
Teaching Med-5 Students Point-of-Care Transthoracic Echocardiography Anthony M.-H. Ho, Lester A. H. Critchley, Patricia Kan, Sylvia Au, Siu Keung Ng, Simon K. C. Chan, Philip Lam, Gordon Choi, Alex Lee,
More informationSection Four: Pulmonary Artery Waveform Interpretation
Section Four: Pulmonary Artery Waveform Interpretation All hemodynamic pressures and waveforms are generated by pressure changes in the heart caused by myocardial contraction (systole) and relaxation/filling
More informationAtrial Fibrillation 2014 How to Treat How to Anticoagulate. Allan Anderson, MD, FACC, FAHA Division of Cardiology
Atrial Fibrillation 2014 How to Treat How to Anticoagulate Allan Anderson, MD, FACC, FAHA Division of Cardiology Projection for Prevalence of Atrial Fibrillation: 5.6 Million by 2050 Projected number of
More informationPerioperative Cardiac Evaluation
Perioperative Cardiac Evaluation Caroline McKillop Advisor: Dr. Tam Psenka 10-3-2007 Importance of Cardiac Guidelines -Used multiple times every day -Patient Safety -Part of Surgical Care Improvement Project
More informationConvincing Deans that Ultrasound should be in the Medical Student Curriculum. Richard Hoppmann Dean University of South Carolina School of Medicine
Convincing Deans that Ultrasound should be in the Medical Student Curriculum Richard Hoppmann Dean University of South Carolina School of Medicine Convincing Deans that Ultrasound should be in the Medical
More informationAtrial Fibrillation and Cardiac Device Therapy RAKESH LATCHAMSETTY, MD DIVISION OF ELECTROPHYSIOLOGY UNIVERSITY OF MICHIGAN HOSPITAL ANN ARBOR, MI
Atrial Fibrillation and Cardiac Device Therapy RAKESH LATCHAMSETTY, MD DIVISION OF ELECTROPHYSIOLOGY UNIVERSITY OF MICHIGAN HOSPITAL ANN ARBOR, MI Outline Atrial Fibrillation What is it? What are the associated
More informationCardiovascular Guidelines for DOT Physical Exams By Maureen Collins MSN, APRN, BC
Cardiovascular Guidelines for DOT Physical Exams By Maureen Collins MSN, APRN, BC The Federal Motor Carrier Safety Administration (FMCSA) administers the Federal Motor Carrier Safety Regulations (FMCSRs)
More informationTitle The Mental Health of Adolescents Living with Potentially Fatal Arrhythmia: A Systematic Review of the Literature
PROSPERO Registration of Systematic Review Title The Mental Health of Adolescents Living with Potentially Fatal Arrhythmia: A Systematic Review of the Literature Registration - - - to be registered in
More informationA t h e n s I n s t i t u t e o f U l t r a s o u n d 8 6 4 S u n s e t D r i v e A t h e n s G A 3 0 6 0 6
Student Catalog 2013 A t h e n s I n s t i t u t e o f U l t r a s o u n d 8 6 4 S u n s e t D r i v e A t h e n s G A 3 0 6 0 6 Table of Contents GENERAL INFORMATION 2 Mission 2 Vision 2 Facilities 2
More information4/7/2015. Cardiac Rehabilitation: From the other side of the glass door. Chicago, circa 1999. Objectives. No disclosures, no conflicts
Cardiac Rehabilitation: From the other side of the glass door No disclosures, no conflicts Charles X. Kim, MD, FACC, ABVM Objectives 1. Illustrate common CV benefits of CV rehab in real world practice.
More informationNormal ranges of left ventricular global longitudinal strain: A meta-analysis of 2484 subjects
Normal ranges of left ventricular global longitudinal strain: A meta-analysis of 2484 subjects Teerapat Yingchoncharoen MD. Shikar Agarwal MD. MPH. Thomas H. Marwick MBBS. Ph.D. MPH. Cleveland Clinic Foundation
More informationTreating AF: The Newest Recommendations. CardioCase presentation. Ethel s Case. Wayne Warnica, MD, FACC, FACP, FRCPC
Treating AF: The Newest Recommendations Wayne Warnica, MD, FACC, FACP, FRCPC CardioCase presentation Ethel s Case Ethel, 73, presents with rapid heart beating and mild chest discomfort. In the ED, ECG
More informationAutomatic External Defibrillators
Last Review Date: May 27, 2016 Number: MG.MM.DM.10dC2 Medical Guideline Disclaimer Property of EmblemHealth. All rights reserved. The treating physician or primary care provider must submit to EmblemHealth
More informationThe Field. Specialty Areas
Cardiovascular Technologist Overview The Field - Specialty Areas - Preparation - Day in the Life - Earnings - Employment - Career Path Forecast - Professional Organizations The Field Cardiovascular technologists
More informationAcquired, Drug-Induced Long QT Syndrome
Acquired, Drug-Induced Long QT Syndrome A Guide for Patients and Health Care Providers Sudden Arrhythmia Death Syndromes (SADS) Foundation 508 E. South Temple, Suite 202 Salt Lake City, Utah 84102 800-STOP
More informationRequirements for Provision of Outreach Paediatric Cardiology Service
Requirements for Provision of Outreach Paediatric Cardiology Service Dr Shakeel A Qureshi, Consultant Paediatric Cardiologist, Evelina Children s Hospital, London, UK On behalf of British Congenital Cardiac
More informationMobile Echocardiography
Mobile Echocardiography Heart failure, valvular heart disease, cardiomyopathies and echocardiography are areas of special interest to Dr. Steensgaard-Hansen. He has worked in the field of echocardiography
More informationDysfunction of aortic valve prostheses
Dysfunction of aortic valve prostheses Kai Andersen Oslo University Hospital Rikshospitalet, Norway Dysfunction of aortic valve prostheses Kai Andersen Oslo University Hospital Rikshospitalet, Norway No
More informationGE Healthcare. Rest assured. MAC 5500 resting ECG analysis system
GE Healthcare Rest assured MAC 5500 resting ECG analysis system Since 1965, GE has introduced on-going innovation, which has profoundly impacted healthcare delivery, clinical guidelines and ECG standards.
More informationEchocardiography for the Sonographer
New Program Format! 20th Annual Echocardiography for the Sonographer Update on Echo in Valvular Heart Disease September 8 9, 2012 Rochester Marriott Hotel Rochester, Minnesota REGISTER ONLINE NOW! http://www.mayo.edu/cme/cardiovascular-diseases-2012r593
More informationCardiac Rehabilitation (Outpatient Phase II) Corporate Medical Policy. Medical Policy
Cardiac Rehabilitation (Outpatient Phase II) Corporate Medical Policy File name: Cardiac Rehabilitation (Outpatient Phase II) File code: UM.REHAB.04 Origination: 08/1994 Last Review: 08/2011 Next Review:
More informationCARDIOLOGY ROTATION GOALS AND OBJECTIVES
CARDIOLOGY ROTATION GOALS AND OBJECTIVES PGY-1 Core Medicine Rotation The trainee will have the opportunity to develop clinical skills, the ability to analyze patients problems, and make treatment plans
More information5. Management of rheumatic heart disease
5. Management of rheumatic heart disease The fundamental goal in the long-term management of RHD is to prevent ARF recurrences, and therefore, prevent the progression of RHD, and in many cases allow for
More informationDiagnosis Code Crosswalk : ICD-9-CM to ICD-10-CM Cardiac Rhythm and Heart Failure Diagnoses
Diagnosis Code Crosswalk : to 402.01 Hypertensive heart disease, malignant, with heart failure 402.11 Hypertensive heart disease, benign, with heart failure 402.91 Hypertensive heart disease, unspecified,
More informationMYOCARDIAL PERFUSION COMPUTED TOMOGRAPHY PhD course in Medical Imaging. Anne Günther Department of Radiology OUS Rikshospitalet
MYOCARDIAL PERFUSION COMPUTED TOMOGRAPHY PhD course in Medical Imaging Anne Günther Department of Radiology OUS Rikshospitalet CORONARY CT ANGIOGRAPHY (CTA) Accurate method in the assessment of possible
More informationAustralian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Training and Practice of Perioperative Cardiac Ultrasound in Adults
PS46 2014 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Training and Practice of Perioperative Cardiac Ultrasound in Adults 1. INTRODUCTION Ultrasound imaging of the heart is
More informationElectrocardiography Review and the Normal EKG Response to Exercise
Electrocardiography Review and the Normal EKG Response to Exercise Cardiac Anatomy Electrical Pathways in the Heart Which valves are the a-v valves? Closure of the a-v valves is associated with which heart
More informationHow To Treat Heart Valve Disease
The Valve Clinic at Baptist Health Madisonville The Valve Clinic at Baptist Health Madisonville Welcome to the Baptist Health Madisonville Valve Clinic at the Jack L. Hamman Heart & Vascular Center. We
More informationWhat is echo? CHAPTER 1 1.1 BASIC NOTIONS. Ultrasound production and detection
What is echo? CHAPTER 1 1.1 BASIC NOTIONS Echocardiography (echo) the use of ultrasound to examine the heart is a safe, powerful, non-invasive and painless technique. Echo is easy to understand as many
More informationCurriculum on Inpatient Cardiology Internal Medicine Residency Program Ochsner Clinic Foundation
Curriculum on Inpatient Cardiology Internal Medicine Residency Program Ochsner Clinic Foundation Authors: Bijesh Maroo MD David Elizardi MD, FACC Hector Ventura MD, FACC This document was created with
More informationVascular Technology (VT) Content Outline Anatomy & physiology 20% Cerebrovascular Cerebrovascular normal anatomy Evaluate the cerebrovascular vessels
Vascular Technology (VT) Content Outline Anatomy & physiology 20% normal anatomy Evaluate the cerebrovascular vessels hemodynamics Evaluate the cerebrovascular vessels for normal perfusion normal anatomy
More informationDisclosure. All the authors have no conflict of interest to disclose in this study.
Assessment of Left Atrial Deformation and Dyssynchrony by Three-dimensional Speckle Tracking Imaging: Comparative Studies in Healthy Subjects and Patients with Atrial Fibrillation Atsushi Mochizuki, MD*;
More informationValve Disease and Diastology Summit
Heart & Vascular Institute Valve Disease and Diastology Summit is offered in cooperation with the American Society of Echocardiography. Valve Disease and Diastology Summit March 4 6, 2016 Eden Roc Hotel
More informationGERIATRYCZNE PROBLEMY KLINICZNE/GERIATRICS MEDICAL PROBLEMS
65 G E R I A T R I A 2011; 5: 65-69 GERIATRYCZNE PROBLEMY KLINICZNE/GERIATRICS MEDICAL PROBLEMS Otrzymano/Submitted: 24.02.2011 Poprawiono/Corrected: 01.03.2011 Zaakceptowano/Accepted: 06.03.2011 Akademia
More informationOsama Jarkas. in Chest Pain Patients. STUDENT NAME: Osama Jarkas DATE: August 10 th, 2015
STUDENT NAME: Osama Jarkas DATE: August 10 th, 2015 PROJECT TITLE: Analysis of ECG Exercise Stress Testing and Framingham Risk Score in Chest Pain Patients PRIMARY SUPERVISOR NAME: Dr. Edward Tan DEPARTMENT:
More informationDERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) MANAGEMENT of Atrial Fibrillation (AF)
DERBYSHIRE JOINT AREA PRESCRIBING COMMITTEE (JAPC) MANAGEMENT of Atrial Fibrillation (AF) Key priorities Identification and diagnosis Treatment for persistent AF Treatment for permanent AF Antithrombotic
More informationPalpitations & AF. Richard Grocott Mason Consultant Cardiologist THH NHS Foundation Trust & Royal Brompton & Harefield NHS Foundation Trust
Palpitations & AF Richard Grocott Mason Consultant Cardiologist THH NHS Foundation Trust & Royal Brompton & Harefield NHS Foundation Trust Palpitations Frequent symptom Less than 50% associated with arrhythmia
More informationDeriving the 12-lead Electrocardiogram From Four Standard Leads Based on the Frank Torso Model
Deriving the 12-lead Electrocardiogram From Four Standard Leads Based on the Frank Torso Model Daming Wei Graduate School of Information System The University of Aizu, Fukushima Prefecture, Japan A b s
More informationStress Echocardiogram
Purpose: Heart First Guidelines Stress Echocardiogram To outline the guidelines and protocols for performing Stress Echocardiograms as established by the American College of Cardiology References: 1. Stress
More information6/18/2014. Primary Care Sports Medicine Care of sport related and general medical needs of athletes Weekend Warriors Active individuals
6/8/04 3 Primary Care Sports Medicine: Principles and Reasons for Referral Ricardo Guirola MD M Ed Rheumatology and Sports Medicine Objectives Discuss basic principles of Primary Care Sports Medicine Discuss
More informationCASE STUDY. Bayleigh s Heart Disease. Written by Mark Stephenson, DVM Case Managed & Co-Written by Sonya Gordon, DVM, DVSc, DACVIM-CA
CASE STUDY Bayleigh s Heart Disease Written by Mark Stephenson, DVM Case Managed & Co-Written by Sonya Gordon, DVM, DVSc, DACVIM-CA Patient Information PATIENT: Bayleigh PET OWNER: Ms. K. BREED: Irish
More informationPreparation iagnostic Medical Sonographer Overview"
Diagnostic Medical Sonographer Overview The Field - Preparation - Specialty Areas - Day in the Life - Earnings - Employment - Career Path Forecast - Professional Organizations The Field Diagnostic imaging
More informationProvider Checklist-Outpatient Imaging. Checklist: Nuclear Stress Test, Thallium/Technetium/Sestamibi (CPT Code 78451-78454 78469)
Provider Checklist-Outpatient Imaging Checklist: Nuclear Stress Test, Thallium/Technetium/Sestamibi (CPT Code 78451-78454 78469) Medical Review Note: Per InterQual, if any of the following are present,
More informationCardiovascular Disease and Maternal Mortality what do we know and what are the key questions?
Cardiovascular Disease and Maternal Mortality what do we know and what are the key questions? AFSHAN HAMEED, MD, FACOG, FACC Associate Clinical Professor Maternal Fetal Medicine and Cardiology University
More informationDevelopment of a Pilot Family Medicine Hand-carried Ultrasound Course
HEALTH INNOVATIONS Development of a Pilot Family Medicine Hand-carried Ultrasound Course Felix Wong, MD; Zeno Franco, PhD; Mary Beth Phelan, MD; Cesar Lam, MD; Alan David, MD ABSTRACT Background and Objectives:
More informationPress conference: Rheumatic Heart Disease a forgotten but devastating disease
www.worldcardiocongress.org Chairpersons: Bongani M. Mayosi Jonathan Carapetis Press conference: Rheumatic Heart Disease a forgotten but devastating disease www.worldcardiocongress.org www.worldcardiocongress.org
More informationMagnetic Resonance Quantitative Analysis. MRV MR Flow. Reliable analysis of heart and peripheral arteries in the clinical workflow
Magnetic Resonance Quantitative Analysis MRV MR Flow Reliable analysis of heart and peripheral arteries in the clinical workflow CAAS MRV Functional Workflow Designed for imaging specialists, CAAS MRV
More informationExercise Science Concentration In the Biomedical Sciences Program
Exercise Science Concentration In the Biomedical Sciences Program Contact: Bill Brewer, MLS, CES Director of Exercise Science Rochester Institute of Technology CBET Office 75-3161 153 Lomb Memorial Drive
More informationHeart Disease: Diagnosis & Treatment
How I Treat Cardiology Peer Reviewed Heart Disease: Diagnosis & Treatment Amara Estrada, DVM, DACVIM (Cardiology) University of Florida Background Clinical heart disease is the stage of disease when a
More informationwww.irishheart.ie CARDIOMYOPATHY SUPPORT GROUP IRELAND
www.irishheart.ie CARDIOMYOPATHY SUPPORT GROUP IRELAND Cardiomyopathy Support Group This is a voluntary group of people, all of whom have cardiomyopathy. It was set up in association with the Irish Heart
More informationNy teknologi: Fagdagene ved St. Olavs Hospital Lasse Løvstakken Dept. Circulation and Medical Imaging 11.06.2010
1 Ny teknologi: Ultralyd måler m blodstrøm Fagdagene ved St. Olavs Hospital Lasse Løvstakken Dept. Circulation and Medical Imaging 11.06.2010 2 Conventional imaging methods of blood flow using ultrasound
More informationHEART HEALTH WEEK 3 SUPPLEMENT. A Beginner s Guide to Cardiovascular Disease HEART FAILURE. Relatively mild, symptoms with intense exercise
WEEK 3 SUPPLEMENT HEART HEALTH A Beginner s Guide to Cardiovascular Disease HEART FAILURE Heart failure can be defined as the failing (insufficiency) of the heart as a mechanical pump due to either acute
More informationAtrial Septal Aneurysm: A Study in Five Hundred Adult Patients
Premio al mejor Tema Libre Realizado por Médicos Residentes Atrial Septal Aneurysm: A Study in Five Hundred Adult Patients Olivares-Reyes Alexander; Al-Kamme Ahmad; Gonzalez Javier Cardiology Department
More information510(k) Summary May 7, 2012
510(k) Summary Medicalgorithmics 510(k) Premarket Notification 510(k) Summary May 7, 2012 1. Submitter Name and Address Medicalgorithmics LLC 245 West 107th St., Suite 11A New York, NY 10025, USA Contact
More informationSteven J. Yakubov, MD FACC For the CoreValve US Clinical Investigators
Long-Term Outcomes Using a Self- Expanding Bioprosthesis in Patients With Severe Aortic Stenosis Deemed Extreme Risk for Surgery: Two-Year Results From the CoreValve US Pivotal Trial Steven J. Yakubov,
More informationEKG Technician Program TST Tuition - $999; Total Hours 50
EKG Technician Program TST Tuition - $999; Total Hours 50 January 25 January 27 February 1 February 3 February 8 February 10 February 15 February 17 February 22 February 24 February 29 March 2 March 7
More informationGE Healthcare CASE. Cardiac Assessment System for Exercise Testing. Connecting hearts and minds.
GE Healthcare CASE Cardiac Assessment System for Exercise Testing Connecting hearts and minds. Stressing better outcomes. Proven clinical excellence. Productivity-enhancing applications and features. Expanded
More informationCARDIAC CARE. Giving you every advantage
CARDIAC CARE Giving you every advantage Getting to the heart of the matter The Cardiovascular Program at Northwest Hospital & Medical Center is dedicated to the management of cardiovascular disease. The
More informationPortable, cordless, single-channel ECG Monitor HCG-801-E
Portable, cordless, single-channel ECG Monitor HCG-801-E Screening & Self -Monitoring of cardiac events Compact - Cordless - Simple operation Fast - Discrete Records about 30 seconds heart rhythm and waveform
More informationThe Cardiac Risk in the Young (Screening) Bill
10 MARCH 2004 The Cardiac Risk in the Young (Screening) Bill Bill 19 of 2003/4 Dari Taylor MP, who drew fifth place in the ballot for Private Members Bills, has introduced a Bill to require cardiac screening
More informationManagement of the Patient with Aortic Stenosis undergoing Non-cardiac Surgery
Management of the Patient with Aortic Stenosis undergoing Non-cardiac Surgery Srinivasan Rajagopal M.D. Assistant Professor Division of Cardiothoracic Anesthesia Objectives Describe the pathophysiology
More informationAtrial Fibrillation Based on ESC Guidelines. Moshe Swissa MD Kaplan Medical Center
Atrial Fibrillation Based on ESC Guidelines Moshe Swissa MD Kaplan Medical Center Epidemiology AF affects 1 2% of the population, and this figure is likely to increase in the next 50 years. AF may long
More informationTips and Tricks to Demystify 12 Lead ECG Interpretation
Tips and Tricks to Demystify 12 Lead ECG Interpretation Mission: Lifeline North Dakota Regional EMS and Hospital Conference Samantha Kapphahn, DO Essentia Health- Interventional Cardiology June 5th, 2014
More informationAnatomi & Fysiologi 060301. The cardiovascular system (chapter 20) The circulation system transports; What the heart can do;
The cardiovascular system consists of; The cardiovascular system (chapter 20) Principles of Anatomy & Physiology 2009 Blood 2 separate pumps (heart) Many blood vessels with varying diameter and elasticity
More informationCARDIOLOGY Delineation of Privileges
CARDIOLOGY Delineation of Privileges APPLICANT: INITIAL APPOINTMENT REQUIREMENTS: BASIC EDUCATION: M.D. or D.O. from an accredited school of medicine or osteopathy. Successful completion of an ACGME or
More informationUltrasound Simulators
Ultrasound Simulators Tripp Bell, MD University of South Carolina School of Medicine Objectives Give a brief history of simulation in medicine Describe the types of ultrasound simulators Show how ultrasound
More informationPre-Operative Cardiac Evaluation Kalpana Jain, MD
Pre-Operative Cardiac Evaluation Kalpana Jain, MD Cardiac evaluation is an integral part of pre-op evaluation. Perioperative cardiac events are common causes of mortality. Major cardiac complications associated
More informationHow To Understand What You Know
Heart Disorders Glossary ABG (Arterial Blood Gas) Test: A test that measures how much oxygen and carbon dioxide are in the blood. Anemia: A condition in which there are low levels of red blood cells in
More informationThe road to mitral valve repair with live 3D transesophageal echocardiography (TEE)
Clinical applications The road to mitral valve repair with live 3D transesophageal echocardiography (T) R.M. Lang I.S. Salgo A.C. Anyanwu D.H. Adams Professor of Medicine; Director, Noninvasive Cardiac
More informationECHOCARDIOGRAPHY PROPERTY OF ELSEVIER SAMPLE CONTENT - NOT FINAL CHAPTER 6. Hisham Dokainish, MD, FACC, FASE
CHAPTER 6 ECHOCARDIOGRAPHY Hisham Dokainish, MD, FACC, FASE 1. How does echocardiography work? Echocardiography uses transthoracic and transesohageal probes that emit ultrasound directed at cardiac structures.
More informationHow To Learn To Perform An Ultrasound
CAE ICCU E-Learning CAE VIMEDIX Ultrasound Simulator Master Ultrasonography of the Thoracic, Abdominal and Pelvic Cavities An Engaging Learning Solution for Ultrasound Hands-on Simulation, Multimedia Content,
More informationPodcast with Dr. Kossick
Podcast with Dr. Kossick Interviewed by Western Carolina University Graduate Anesthesia Student Kristin Andrejco From the Head of the Bed main@fromtheheadofthebed.com December 5, 2014 (33 min) EKG Lead
More information1975 M.D. University of Maryland School of Medicine, Baltimore, Maryland. 1975-1976 Internship, University of Michigan Medical Center, Ann Arbor, MI
Timothy J, Byrnes, M.D. Assistant Professor of Internal Medicine Division of Cardiology Wayne State University, Detroit, MI Office Address: Harper University Hospital Division of Cardiology 3990 John R
More informationHeart Sounds & Murmurs
Cardiovascular Physiology Heart Sounds & Murmurs Dr. Abeer A. Al-Masri MBBS, MSc, PhD Associate Professor Consultant Cardiovascular Physiologist Faculty of Medicine, KSU Detected over anterior chest wall
More informationSPECIAL COURSE REQUIREMENTS:
Jackson Community College DMS 141 Adult Echo I 4 Credit hours Online Delivery Winter 2012 Instructor: Carol Hoch, MA, RDMS, RDCS, RVT, RT(R) Office: JW 228 Main Campus Phone: 517.796.8529 Fax: 517.768.7004
More information