Assessment of Diastolic Function

Module 1: Ultrasound Physics

Introduction to Ultrasound Physics

Sound Waves

Period, Frequency and Wavelength

Amplitude, Power and Intensity

Characteristics of a Medium

Pulsed Ultrasound

Intensities

Decibel Notation

Acoustic Properties of Tissue

Acoustic Properties of Sound Continued

Components of the Transducer

Anatomy of a Sound Beam

Resolution

Instrumentation

Ultrasound Transducers

Principles of Doppler

Positive Doppler Shift

Negative Doppler Shift

The Doppler Angle

Pulsed Wave Doppler

Continuous Wave Doppler

Color Flow Imaging

Artifacts

Missing Structures

Erroneously Perceived Structures

Mislocated Structures

Safety, Bioeffects and Ergonomics

Conclusion

Module 2: Cardiovascular Anatomy and Physiology

Introduction to Cardiovascular Anatomy and Physiology

Pericardium

Myocardium

Chambers

Valves

Atrioventricular Valves

Semilunar Valves

Septa

Coronary Arteries and Veins

Electrophysiology

Conduction System

Action Potential

The Electrocardiogram

Cardiac Hemodynamics

Heart Pressures

Heart Sounds

Abnormal Heart Sounds

Physiology terms

Embryology

Conclusion

Recommended simulator work

Module 3: Introduction to Transthoracic Echocardiography

Introduction to Echocardiography

Probe Manipulation

Patient positioning and standard TTE Views

Parasternal Views

Parasternal Long Axis (PLAX)

Right Ventricular Inflow (RVIT)

Right Ventricular Outflow Tract (RVOT)

Parasternal Short Axis at the AV level (PSAX- AV)

Parasternal Short Axis of the Mitral Valve (PSAX-MV)

Parasternal Short Axis of the Left ventricle/Papillary Level (PSAX-LV)

Parasternal Short Axis at the LV Apex Level

Apical Views

Apical Four Chamber (A4C)

Apical Five Chamber (A5C)

Apical Two Chamber (A2C)

Apical Three Chamber (A3C)

Subcostal Views

Subcostal Four Chamber (SC 4C)

Subcostal of the Inferior Vena Cava (SC IVC)

Suprasternal Views

Suprasternal Notch of the Aortic Arch (SSN)

Introduction of M-mode Imaging

M-mode of the Aorta

M-mode of the Mitral Valve

M-mode of the Left Ventricle

2D Measurements

Color Flow Imaging

Spectral Doppler

Doppler of the MV

Doppler Tissue Imaging

Doppler of the LVOT

Doppler of the AV

Doppler of the TV

Doppler of the PV

Additional Echo Measurements

Ejection Fraction

Tricuspid Annular Plane Systolic Excursion (TAPSE)

Assessment of Diastolic Function

Normal Diastolic Function Parameters

Sample Protocol

Conclusion

Recommended simulator work

2D Imaging

Measuring from M-mode and the 2D Image

Color Flow Imaging and Spectral Doppler

Module 4: Valve Disease

Introduction to Valve Disease

Mitral Valve Disease

Mitral Stenosis

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Mitral Stenosis Calculations

MS Calculation Values

Treatments

Mitral Regurgitation

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Mitral Regurgitation Calculations

MR Calculation Values

Treatments

Mitral Valve Prolapse

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Aortic Valve Disease

Aortic Stenosis

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Aortic Stenosis Calculations

AS Calculation Values

Treatments

Aortic Regurgitation

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Aortic Regurgitation Calculations

AR Calculation Values

Treatments

Tricuspid Valve Disease

Tricuspid Stenosis

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Tricuspid Stenosis Calculations

TS Calculation Values

Treatments

Tricuspid Regurgitation

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Tricuspid Regurgitation Calculations

TR Calculation Values

Treatments

Pulmonic Valve Disease

Pulmonic Regurgitation

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Pulmonic Regurgitation Calculations and Values

Treatments

Infective Endocarditis

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow imaging and Doppler findings

Treatments

Conclusion

Recommended Simulator Work

Module 5: Ischemic Heart Disease

Introduction to Ischemic Heart Disease

Myocardial Ischemia versus Myocardial Infarction

Etiology

Signs and Symptoms

Regional Wall Motion Abnormality

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Left Ventricular Apical Thrombus

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Papillary Muscle Dysfunction

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatment

Aneurysm

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatment

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatment

Ventricular Septal Defect

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatment

Dressler's Syndrome

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Assessment of Diastolic Function

Normal Diastolic Function Parameters

Grade I Diastolic Dysfunction

Grade II Diastolic Dysfunction

Grade III Diastolic Dysfunction

Conclusion

Recommended Simulator work

Module 6: Cardiomyopathies

Introduction to Cardiomyopathies

Dilated Cardiomyopathy

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow and Doppler findings

Treatments

Hypertrophic Cardiomyopathy

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow and Doppler findings

Treatments

Restrictive Cardiomyopathy

Idiopathic Restrictive Cardiomyopathy

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow and Doppler findings

Treatments

Infiltrative Cardiomyopathy

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow imaging and Doppler findings

Treatments

Takotsubo Cardiomyopathy

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Conclusion

Recommended Simulator work

Module 7: Pericardial Disease

Introduction to Pericardial Disease

Pericardial Effusion

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Cardiac Tamponade

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Constrictive Pericarditis

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Conclusion

Recommended Simulator work

Module 8: Systemic and Pulmonary Hypertension

Introduction to Systemic and Pulmonary Hypertension

Systemic Hypertension

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Pulmonary Hypertension

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Conclusion

Recommended Simulator work

Module 9: Diseases of the Aorta

Introduction to Diseases of the Aorta

Aortic Dissection

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow imaging and Doppler findings

Treatments

Sinus of Valsalva Aneurysm

Etiology

Signs and Symptoms

2D and M-mode findings

Color Flow imaging and Doppler findings

Treatments

Conclusion

Recommended Simulation Work

Module 10: Cardiac Masses

Introduction to Cardiac Tumors

Benign Cardiac Tumors

Etiology

Signs and Symptoms

2D and M-mode findings

Myxoma

Papilloma

Fibroma

Lipoma

Lipomatous Hypertrophy of the Interatrial Septum

Rhabdomyoma

Color Flow Imaging and Doppler findings

Treatments

Malignant Cardiac Tumors

Etiology

Signs and Symptoms

2D findings

Angiosarcoma

Rhabdomyosarcoma

Metastatic Tumors

Color Flow Imaging and Doppler findings

Treatments

Miscellaneous Structures

Conclusion

Recommended Simulator work

Module 11: Congenital Heart Defects

Introduction to Congenital Heart Defects

Atrial Septal Defect

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Ventricular Septal Defect

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Patent Ductus Arteriosus

Signs and Symptoms

2D and M-mode findings

Color Flow Imaging and Doppler findings

Treatments

Atrioventricular septal defect

Transposition of the Great Arteries

Tetralogy of Fallot

Ebstein's Anomaly

Eisenmenger's Syndrome

Conclusion

Recommended Simulator work

Module 12: Miscellaneous Diseases

Introduction to Miscellaneous Diseases

AIDS

The Aging Heart

Aortic Valve Sclerosis

Athlete's Heart

Atrial fibrillation

Cocaine

Kawasaki's Disease

Left Bundle Branch Block

Marfan's Syndrome

Non-compaction of Ventricular Myocardium

Persistent Left Superior Vena Cava

Pulmonary Embolus

Recommended Simulator Work

Module 13: Interventional Echocardiography

Pacemaker Implantation

Transcatheter Aortic Valve Replacement

Transcatheter Septal Closure

Transcatheter Mitral Valve Repair

Left Ventricular Assist Devices

Recommended Simulator Work

Module 14: Echocardiographic Equations

Velocity

Ejection Fraction: Modified Simpson's calculation

Fractional Area Change

Fractional Shortening

Right Ventricular Systolic Pressure / Systolic Pulmonary Artery Pressure

Shunt Ratio

Gradient: the Modified Bernoulli Equation

dP/dt

PISA: Proximal Isovelocity Surface Area

Pressure Half Time

Continuity Equation

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