Tag Archives: echocardiography

Introduction Breast cancer is one of the major public health problems; it is the second most common cancer among women and it has a high mortality rate.1 Doxorubicin, which is an antibiotic of the anthracycline group, has a cytotoxic antineoplastic activity and is commonly used in a broad spectrum of malignancies, either alone or in combination with other drugs. Despite its usefulness in chemotherapy of breast cancer, its cardiac side effects, such as cardiomyopathy and congestive heart failure, cause considerable limitations and obstacles for oncologists and cardiologists.2,3 Doxorubicin’s cardiotoxicity is mainly due to oxidative stress,

Figure 1. A. Pre-thrombolysis transthoracic echocardiogram. Technically difficult study: large mobile thrombus extending from the tricuspid valve into the right ventricle; dilated right heart chambers (with impaired right ventricular function). B. Pre-thrombolysis transthoracic echocardiogram: in addition to the findings described in panel A, colour flow shows a jet of severe tricuspid valve regurgitation. C. Post-thrombolysis transthoracic echocardiogram: complete dissolution of the right heart thrombus (with improved right ventricular function). D. Postthrombolysis transthoracic echocardiogram: colour flow shows mild regurgitation only A 90

Introduction Heart failure and valve disease are common. The population prevalence of each is 2–3% and this rises to more than 10% aged ≥75 years.1,2 Echocardiography is a key diagnostic investigation but it is a relatively scarce resource and is also underutilised.3 It has been suggested that access can be improved by targeting high-risk individuals using limited ‘point-of-care’ studies also called ‘quick-scans’.4 There has been an increase in the application of ‘quick-scans’ with the development of hand-held machines, which allow near-patient testing in the community or on ward-rounds, in clinics or in emergency departments.

Introduction In volume overload states, such as aortic regurgitation (AR), ischaemic cardiomyopathy (ICM), and non-ischaemic cardiomyopathy (NICM), spherical dilation occurs.1 Khouri et al. described four remodelling patterns based on the indexed left ventricle (LV) end-diastolic volume and LV concentricity.2 Standard LV chamber quantification, according to the American Society of Echocardiography (ASE) guidelines, involves obtaining a single-dimensional measurement of the LV diameter from the parasternal long-axis acoustic window at the level of mitral valve leaflet tips. Although it is the combination of qualitative and quantitative measure

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Echocardiography and enlarged cardiothoracic ratio Dear Sirs, The Guys’ and St Thomas’s echo team are to be congratulated on producing evidence-based advice that could result in a significant reduction in cardiac ultrasound referrals, which may be enhanced if our radiology colleagues are taken on board.1 Many years ago, our echo department was overloaded with requests for studies as a consequence of radiology reports that included the emotive term ‘cardiomegaly’. This expression is, of course, speculative, as enlargement of the ‘cardiac’ shadow may be due to an expiratory radiograph, prominent epicardial fat pads, pericardial effu

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The case study in this issue (see pages 46–7) demonstrates a potential use of CT scanning in the diagnosis of a patient with endocarditis. Electrocardiogram (ECG)-gated multi-detector cardiac computed tomography (MDCT) scanning has been proposed by many to have potential in the evaluation of endocarditis by demonstration of vegetations, complications (coronary artery occlusion, fistulae) and peripheral embolism.3 The major limitations of the technique include availability, spatial resolution, failure to demonstrate leaflet perforations and lack of haemodynamic information (table 1). Further, CT findings have not been correlated with clinica

Introduction Heart failure is one of the most common conditions in industrialised society. Today, in the UK, around 900,000 people have heart failure with a further similar number who have yet to develop symptoms.1 Heart failure is predominantly a disease of the elderly, and the increasing age of the population, combined with improvements in the treatment of ischaemic heart disease (IHD), account for the increasing prevalence. Heart failure has a poor prognosis: just under 40% of patients diagnosed with heart failure die within a year, depending on initial severity, although, thereafter, mortality is less than 10% per year. This suggests that

Introduction Rheumatic fever is the leading cause of acquired heart disease in children and young adults in the world.1,2 The relationship between rheumatic fever and streptococcal infection has been well documented.3,4 Stenosis of the mitral valve, either alone or in combination with other valvular diseases, is caused almost exclusively by rheumatic fever.3 Involvement of the mitral valve represents the most common of all sites affected by the rheumatic process.5 However, as many as half of the population with mitral stenosis give no history of rheumatic fever.5 On the other hand, the majority of patients with mitral stenosis remain asympto