As the MitraClip procedure becomes more available to hospitals it is imperative that sonographers understand the goals of the transthoracic echocardiogram prior to the MitraClip procedure. In this blog we will review the 7 components for a complete MitraClip echo protocol..
“Isn’t there a black box warning for contrast?” “I don’t feel comfortable giving contrast to my ICU patient” “The patient has acute coronary syndrome, I don’ think you should give contrast” These are just a few of the responses you may face from an ICU nurse or critical care staff in response to your decision to perform a contrast echocardiogram. So what’s the deal?
Earlier this year the American Society released a new guideline paper on Chagas Disease with recommendations for cardiac imaging. What the heck is Chagas Disease?! Then after never hearing of Chagas Disease in relation to cardiology it suddenly began to pop up in more and more articles and conferences.
We are breaking down the basics of diastolic dysfunction into easy to understand blogs! Last week we discussed the topic of diastole and the 4 stages that occur during this phase within the cardiac cycle. If you missed it, you can read it here! This week, we are going to go a step further and discuss the physiology in regards to the 4 stages of diastole. We are going to cover:
In the past weeks we had guest writer, Michael Owen, share how to assess diastolic dysfunction. He broke down the algorithm that ASE uses to evaluate the presence of dysfunction. The full ASE article is long and intense. Michael did a great job at simplifying the evaluation process. While featuring this Mastering Diastology series we started to receive a lot of questions. We realized that it would be helpful to take a step back and review the basics. All this great information regarding diastolic dysfunction means nothing to us unless we have a basic understanding of the topic and how it relates to our daily use. We are going to go back to the beginning. Let’s talk diastole!
MODERATE TO SEVERE MITRAL REGURGITATION
There are elevated filling pressures if any of the following are true:
Pulmonary venous AR duration minus mitral A-wave duration > 30 msec
IVRT < 60 msec
Average E/e’ > 14 (only in patients with reduced EF)
IVRT/T E-e’ < 5.6 (only in patients with normal EF)
HYPERTROPHIC CARDIOMYOPATHY
There are elevated filling pressures if any of the following are true:
Average E/e’ > 14
Pulmonary venous AR duration minus mitral A-duration > 30 msec
TR Peak Velocity > 2.8 m/s
LA Volume Index > 34 mL/m²
If average E/e’ is unobtainable or not used routinely in your lab, use “septal E/e’ >15” or “lateral E/e’ >13” to determine elevated filling pressures.
For the past 2 weeks, we have discussed two algorithms used for determining the presence & grade of diastolic function. If you missed out or want to review them, you can find them here:
Last week we discussed the algorithm for determining the presence of diastolic function in patients with normal ejection fraction (EF). This week, we are going to discuss determining the presence of diastolic function in patients with depressed EF or pathologic left ventricular hypertrophy (LVH) with preserved EF.
What better way to celebrate our 10 year anniversary than a world tour! We are dedicating our 10th year to giving back to the diagnostic imaging community. During our 10th year we are visiting facilities around the nation and world to spread our passion for excellence in imaging. We will include educational speaking events, volunteering and networking activities to our World Tour. If you would like us to come speak at your facility or join you in a volunteer or networking event let us know! Apply now and submit a request form.
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