Cardiac Ultrassonography I

The student must have basic knowledge of cardiac anatomy and physiology, as well as the contents covered in the UC of Initiation to Clinical Physiology.

In the theoretical aspect of teaching, a detailed presentation of the syllabus of the curricular unit is used, with an expository-active methodology appealing to the direct intervention of students, clearly favoring abundant iconography to the detriment of merely theoretical-descriptive teaching.

In the theoretical-practical aspect, presentation, discussion and technical reports of clinical cases will be carried out using images and videos.

In the practical aspect, priority is given to the practical execution of echocardiograms in the School’s laboratory, using the simulation equipment acquired within the scope of the Innov2Care project as well as student binomials.

The student must acquire knowledge of:

• Cardiac ultrasound in the modes: M, two-dimensional, classical doppler and colour doppler as well as transesophageal echocardiography, stress echocardiography, contrast echocardiography and tissue doppler.

The student must acquire skills for:

• Identify and describe the normal anatomic aspect of the observed structures.

• Identify and describe the echocardiographic patterns of pathologies taught

• Make the best echocardiographic plans for obtaining the diagnosis

• To report the observations made

The student must acquire competences of:

• Develop the ability to expand their knowledge in cardiac ultrasound

• Be able to identify the best option among the different possibilities that technology offers for the best diagnosis

1-Guedlines for assessment of cardiac chambers.

The importance of calculating body surface area.

Linear measurements of the aortic cavities and root.

Calculation of volumes and areas.

Study of ventricular function. LV ejection and shortening fraction.

Abnormal LV relaxation.

Echocardiographic parameters for studying the RV.

Volume and pressure overload. Assessment of global RV function.

PSAP calculation.

Study of the left and right auricles.

2-The Transesophageal echocardiogram

Indications for ETE.

Advantages, disadvantages and contraindications of TEE.

History of transesophageal echocardiography.

Probe and patient preparation.

The study plans by ETE.

3-Doppler echocardiographic Valvular Study

Mitral valve disease:

The echocardiographic pattern of the normal mitral valve.

The echocardiographic pattern of mitral stenosis.

Methods for evaluating the area: planimetry, THP and PISA.

Balloon valvuloplasty.

Mitral insufficiency. Grade quantification.

Mitral valve prolapse. The importance of the MM.

Concentric and eccentric regurgitation.

Aortic valve disease:

The normal aortic valve.

The bicuspid aortic valve.

Aortic stenosis. calculations of maximum, average, and area gradient.

Hemodynamic severity of aortic stenosis

Aortic insufficiency and its quantification

Calcification of the mitral annulus.

Tricuspid valve disease.

Calculation of PASP using the inspiratory collapse of the IVC.

Pulmonary valvulopathy.

4 – Prosthetic valve

Types of prostheses.

Normal functioning of the prosthetic. The echocardiographic difference between mechanical and biological prostheses.

The prosthesis dysfunction.

5 – The tissue doppler echocardiogram

Clinical applications.

The center of gravity of the LV.

Intraparietal velocity gradients.

Speed calculations longitudinal in the mitral and tricuspid annulus

6- Echocardiography with contrast

History of contrast echocardiography.

Importance of second harmonic in echocardiographs.

Main applications

7 – Echocardiographic evaluation of coronary heart disease

The ischemic cascade.

The coronary territories.

Echocardiographic changes in myocardial infarction. The movement normal, hypokinetic, akinetic and dyskinetic walls.

Structural and hemodynamic complications of MS.

8-Stress Echocardiography

Protocols: dipyridamole; adenosine; dobutamine

Quantitative analysis of LV function

Echocardiographic evaluation of viability

Stress echocardiography with contrast

The evaluation of the theoretical /practical component will be carried out at the end of the semester, in the form of a written and individual questionnaire about the entire program taught, with a minimum grade of 9.5 points.This component will have a weight of 75% in the final grade of the unit.

The practical component will be evaluated continuously with the practical execution of echocardiograms and technical reports and subject to a final exam. This component will have a weight of 25% in the final grade of the unit. A classification in the practical component equal to or greater than 9,5 values is mandatory.

The assessment by examination will be carried out in accordance with the provisions of the current Academic Regulations at ESTeSC, with the percentages used being the same as those for continuous assessment.

NAO