Cardiac Ultrassonography II

The student must have the knowledge acquired in the Cardiac Ultrasonography 1 course.

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 practical aspect, priority is given to the practical execution of echocardiograms both in the School’s laboratory using the equipment acquired within the scope of the Innov2Care project and in a hospital environment, by teachers with accumulation contracts in a health unit associated with ESTESc (Centro Hospitalar e Universitário de Coimbra).

The aim is to foster a close connection between the program contents outlined and the learning objectives proposed for the curricular unit in a real environment.

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 doppler tissue. They should also acquire basic knowledge of 3D echocardiography, intracoronary echocardiography and speckle tracking.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 a better diagnosis

1 -Infectious endocarditis

Pathophysiology of endocarditis. Clinical manifestations.

Echocardiographic characteristics of vegetation

Complications

2 –Echocardiographic evaluation of cardiomyopathies

Hypertrophic cardiomyopathy: Obstructive and non-obstructive form. The presence of SAM and dynamic gradient.

Echocardiographic findings in:

Dilated cardiomyopathy,

Restrictive cardiomyopathy,

Infiltrative cardiomyopathy,

RV cardiomyopathy.

The uncompressed VE.

Arrhythmogenic RV dysplasia

3 –Diseases of pericardium

Pericarditis.

The pericardial effusion. The hemopericardium.

Echocardiographic signs of stroke and their quantification. Cardiac tamponade.

The preural effusion. Echocardiographic differences between pericardial and pleural effusion.

The cystic masses.

The pericardiocentesis.

Echocardiographic signs of constrictive pericarditis.

4 –Aortic diseases

Echocardiographic incidences for visualization of the aorta artery.

Measurements of the different segments of the aorta artery. The importance of ETE.

Aortic dilation. Debaley and Debakey classification.

The particular case of Marfan syndrome.

Plaques and thrombi in the aorta.

Aortic dissection.

Visualization and discussion of clinical cases.

5 –Masses and tumours

Structures that can simulate masses.

Benign and malignant tumors in the heart.

The particular case of myxoma.

Thrombi and cardiac masses.

6 –Congenital cardiopathies

The patent foramen ovale.

Types of CIA. Indirect signals. View of the Amplitzer prosthesis.

The membranous and muscular VSD.

OTHER CONGENITAL HEART DISEASES:
Patent ductus arteriosus.
Subortic and supra-aortic membranes.
Coarctation of the aorta
Ebstein’s disease
Color Triatriatum
Congenital valve stenoses.
Tetralogy of Fallot
Transposition of the great vessels
single ventricle

7 –The echocardiogram in arterial hypertension.

The LV remodeling

Calculation of LV mass.

8 –New technologies in Echocardiography

Three-dimensional echocardiogram

Intracardiac echocardiography

Speckle Tracking

Portable echocardiography

Other echocardiographic techniques

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 values and a weight in the final grade of 75%.

The practical component will be evaluated continuously and subject to an individual practical exam. This component will have a weight of 25% in the final grade of the curricular unit, being mandatory a classification equal to or greater than 9,5 values.

The minimum final classification of the UC will be 10 values.

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