About
INTRODUCTION
echocardiography, is a noninvasive diagnostic test based on ultrasound scanning allows anatomical and functional heart. The echocardiography was a major breakthrough in cardiology both human and veterinary, since it allowed to replace other invasive techniques, more complex and dangerous as the catheterization and angiography.
is currently the most widely used technic to evaluate the functioning of the heart, to quantify the size of the heart chambers and diagnose pathologies that before the advent of echocardiography, could not be confirmed in clinical practice.
To successfully perform an echocardiogram is needed proper training in cardiology that involves a thorough knowledge of cardiac anatomy, the most common cardiovascular diseases in veterinary medicine and in particular the pathophysiological response of the heart against these pathologies.
Moreover echocardiographer prior experience is essential because, unlike other tests (eg ECG) echocardiography This method is very operator-dependent, so the practice and knowledge of the settings of the scanner are determining factors when making a diagnosis.
PREPARATION OF PATIENT:
Patient preparation for an echocardiogram is similar to that undertaken for any other ultrasound.
Since the contact between the skin and the transducer is very important both hemithorax normally pluck about the 3rd to 6th. intercostal space, from the unions costochondral to the sternum, to avoid avoiding interference caused by the hair of the patient, however, this can be avoided in patients with very short hair or a little thicker. Here are
wets the surface of contact with alcohol and place the ultrasound gel.
Usually the patient is placed in the lateral position on a stretcher and carried out the study from the bottom side, for it is generally used with a stretcher with an opening for that purpose.
can also perform the echocardiographic study with the animal in
station (standing) and work alongside the animal study, however, the lateral position with a special table that has the advantage of lying down on the side that we are evaluating avoids interference from the lungs.
TECHNICAL
In echocardiography using three imaging modalities (M-mode, B-mode and Doppler), each has its role in diagnosis of various diseases and the evaluation of treatment response. But as with other examinations, we must remember that the history, proper physical examination and other diagnostic tests (ECG, Rx, etc.) assist in determining the diagnosis.
MODE-B:
Also known as two-dimensional, allows to obtain a cut of the heart. This is the image most used and to determine cardiac anatomic structures and relationships, is the mode used to assess the anatomy, the presence of masses or effusions and to assess cardiac functionality generally
SO-M:
is a picture mode that shows a very small portion of the heart but can accurately assess the movement of this segment over time. This technique is appropriate for the correct measurement of cardiac chamber dimensions, wall thickness and valvular movements. This mode allows the identification of measures of ventricular septum, left ventricular chamber and left ventricular free wall in both systole and diastole, the relative size of the left atrium and indexes of cardiac pumping capacity, as the fraction shortening.
This index is a simple (but very incomplete) to assess systolic function (ie, pumping) of the left ventricle. Match the left ventricular internal diameter in systole and diastole, and gives an idea of \u200b\u200b
cardiac contractile capacity, the formula for calculating it is:
shortening fraction (FS%): Divide - Divis x 100DiVid
(Divide: left ventricular internal diameter in diastole)
(Currency: left ventricular internal diameter in systole)
normal values \u200b\u200b% FS and races vary between animals but is usually about 28 to 44%
MODE DOPPLER
Doppler mode allows exploiting the effect of the same name, see the blood flows and their characteristics such as speed, presence of turbulence. There are 3 types of Doppler modes: pulsed Doppler, continuous Doppler and color Doppler.
Thanks
to information provided by the Doppler examination can fully assess the heart function and detect some abnormalities communications (such as patent ductus arteriosus) that can be difficult to visualize B-mode
Echocardiographic PROJECTIONS:
The presence of the rib around the heart hinders obtaining a cardiac imaging, which is why we use a "windows" parasternal, coming from the intercostal spaces , so we paraestenral windows left and right subcostal window.
In echocardiography standardization of the projections is essential to compare measurements in either the patient's own evolution as well as between different operators.
Right parasternal :
Located between the 3rd and 6th intercostal space between the sternum and the costochondral junction.
Allows projection of 4 cameras, which observed the atria, ventricles and atrio-ventricular valves, also with a slight rotation of the transducer allows observation of the ventricular outflow tract left and the root of the aorta.
further rotating the transducer, we obtain the short-axis cardiac
(perpendicular to the long axis), revealing the heart apex, papillary muscles, chordae tendineae and mitral valves.
Left cranial parasternal :
Located between the 3rd and 5th intercostal space between the breastbone and the union
costochondral, and allows just the right window a long-axis (long axis) of the outflow tract ventricle.
Left parasternal Flow:
Located between 5th and 7th intercostal space, as close as possible to the breastbone. Allows a longitudinal 4-chamber heart, and slightly rotating the transducer to observe the aortic root.
subcostal:
window is perfectly aligns aortic flow to make the necessary measurements.
echocardiographic MAIN
measurement in echocardiography parameters and obtaining certain indices play a role as important to the visual examination of the structures so that, once certain measures, these are compared to reference values \u200b\u200bmay in thus know whether the values \u200b\u200bare within normal range or not.
For example, the major changes, we can cite:
• left ventricular
- EXPANSION:
As in the cases of canine or feline dilated cardiomyopathy, valvular regurgitation, patent ductus arteriosus, ie all those diseases characterized by volume overload.
- HYPERTROPHY:
In cases where it is due to pressure overload, as subaortic stenosis or systemic hypertension or in cases where results from a primary condition myocardium, such as hypertrophic cardiomyopathy.
• right ventricle
- EXPANSION:
As in congenital or acquired tricuspid valve insufficiency, atrial septal defects or ventricular dilated cardiomyopathy, etc.
- HYPERTROPHY
As in pulmonary stenosis, tetralogy of Fallot, pulmonary hypertension, hypertrophic or restrictive cardiomyopathy, infiltrative diseases, etc.
• Atrium
normally the size is assessed, the presence of intracavitary masses, or atrial septal defects. The left can be enlarged as a result of chronic mitral failure, dilated cardiomyopathy, mitral valve dysplasia, etc. The law as a result of tricuspid failure (congenital or acquired), dilated cardiomyopathy, heartworm, etc..
• VENTRICULAR MYOCARDIUM:
addition to see if there are alterations in wall thickness, echogenicity we see it, if you have areas of heterogeneity (eg in cases of infarction, necrosis, tumor, myocarditis, etc..), while observing the movement abnormalities mentioned above.
• HEART VALVE:
is of importance, in this case observe the movement of the same (but beyond the valve ring plane, as in mitral valve prolapse or chordal rupture, etc.) morphological characteristics, in cases of mitral valve degeneration, you can clearly see an enlargement and deformation of the valve. Another example of valvular morphological alteration is bacterial endocarditis, which can be observed deformation and calcification of the same.
• Pericardium:
The pericardium is the sac around the heart. It can be seen clearly in the echocardiographic study because it is very. Under certain conditions we can observe the presence of an abnormal amount of pericardial fluid (effusion), thus separating the two pericardial sheets. Normally the pericardial effusions are due to causes tumors or idiopathic effusions.
READING
Boon JA. Manual of veterinary echocardiography. Williams and Wilkins. Baltimore,
Maryland, 1998.
Rd Kienle, Thomas WP. Echocardiography. In: Nyland TG, Mattoon JS (eds): Veterinary
diagnostic ultrasound. WB Saunders. Philadelphia, 1995. 198-257
Tachika Ohara, VY; Méndez Aguilar, RE. echocardiography. In: Belerenian, Mucha, Camacho.
cardiovascular disease in small animals. Intermedica Ed. 2001. 47-58
Bonagura JD, Miller MW, Darke PGG. Doppler echocardiography I. Pulsed-Wave and
continuous-wave examinations. Vet Clinics North Am: Small Anim Pract, 1998; 28:1325-1359.
Bonagura JD, Miller MW. Doppler echocardiography II. Color Doppler imaging. Vet Clinics
North Am: Small Anim Pract, 1998; 28: 1361-1389
Kittleson MD, Kienle RD.:En: Kittleson, Keinle (Ed): Small Animal Cardiovascular Medicine.
Mosby. St. Louis,1998: 218-296.
Abbott, JA. Echocardiography. In: Abbott, JA. Small Animal Cardiology Secrets. Ed Hanley
& Belfus. 2000. 130-139.
SETTLEMENT CLEANER TYPHON SALT 
the end is found in the bio 
