Table of Contents
Cover
Table of Contents
Half title page
Title page
Copyright page
Dedication
Preface
Acknowledgments
CHAPTER ONE The Physics of Ultrasound
Basic Physics
Transducers and Resolution
Doppler Physics
Artifacts
Summary
CHAPTER TWO The Two-Dimensional Echocardiographic Exam
Introduction
Patient Preparation
Patient Positioning
Transducer Selection
Two-Dimensional Images
Two-Dimensional Imaging Controls
CHAPTER THREE The M-Mode and Doppler Examination
Introduction
M-Mode Echocardiography
Color-Flow Doppler
Spectral Doppler
Tissue Doppler Imaging
CHAPTER FOUR Evaluation of Size, Function, and Hemodynamics
Measurement and Assessment of Two-Dimensional Images
Measurement and Assessment of M-Mode Images
Measurement and Assessment of Spectral Doppler Flow
Measurement and Assessment of Tissue Doppler Imaging
Evaluation of Color-Flow Doppler
Evaluation of Ventricular Function
Hemodynamic Information Obtained From Echocardiographic Exams
CHAPTER FIVE Acquired Valvular Disease
Mitral Regurgitation
Aortic Regurgitation
Tricuspid Regurgitation
Pulmonary Regurgitation
Endocarditis
CHAPTER SIX Hypertensive Heart Disease
Pulmonary Hypertension
Systemic Hypertension
CHAPTER SEVEN Myocardial Diseases
Hypertrophic Cardiomyopathy
Dynamic Right Ventricular Outflow Obstruction
Moderator Bands
Dilated Cardiomyopathy
Right Ventricular Cardiomyopathy
Restrictive Cardiomyopathy
Endocardial Fibroelastosis
Arrhythmogenic Right Ventricular Cardiomyopathy
Myocardial Infarction
Myocardial Contusions
CHAPTER EIGHT Pericardial Disease, Effusions, and Masses
Pericardial Effusion
Neoplasia as a Cause of Pericardial Effusion
Pericardial Disease
Abscesses
Pericardial Cysts
Thrombus
CHAPTER NINE Congenital Shunts and AV Valve Dysplasia
Ventricular Septal Defect
Patent Ductus Arteriosus
Aorticopulmonary Window
Right to Left Shunting PDA
Atrial Septal Defects
Endocardial Cushion Defects
Bubble Studies
Atrioventricular Valve Dysplasia
CHAPTER TEN Stenotic Lesions
Outflow Obstructions
Inflow Obstructions
Tetralogy of Fallot
APPENDIX ONE Bovine
APPENDIX TWO Canine
APPENDIX THREE Equine
APPENDIX FOUR Feline
APPENDIX FIVE Miscellaneous Species
Index
VETERINARY ECHOCARDIOGRAPHY
SECOND EDITION
This edition first published 2011 © 2011 by June A. Boon
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Library of Congress Cataloging-in-Publication Data
Boon, June A.
Veterinary echocardiography / June A. Boon. – 2nd ed.
p. ; cm.
Rev. ed. of: Manual of veterinary echocardiography / June A. Boon. ©1998.
Includes bibliographical references and index.
ISBN 978-0-8138-2385-0 (hardcover : alk. paper)
1. Veterinary echocardiography. I. Boon, June A. Manual of veterinary echocardiography. II. Title.
[DNLM: 1. Echocardiography–veterinary. SF 811]
SF811.B66 2011
636.089´61207543–dc22
2010028092
A catalogue record for this book is available from the British Library.
This book is published in the following electronic formats: ePDF 9780470958841; ePub 9780470958919
For the people who make my life rich and bring joy to my days:
Dave—my best friend and soul mate for 23+ years—thank you for all you do—I love you
Denali and Logan—you have both become such exceptional individuals
Reuben—I am so glad you are part of our family
Mike and Stephan—I could not be prouder of you guys
When I started this project, I thought it would be easy. The first 20 years of veterinary echocardiography were done; I simply had to write about new developments over the past ten years. It was not so easy. The past ten years have brought with it significant advances in technology including better transducers, tissue harmonic imaging, better color flow mapping, and color and spectral tissue Doppler imaging. The echocardiographic examination now provides so much more information than it did 10 years ago. The amount of information continues to grow exponentially – because of and thanks to the many cardiologists who have been trained, certified and working to expand our knowledge over this past decade.
The format of this edition is different from the previous one in the hope that it makes this book easier to use. Chapter 1, a necessary evil, still covers the pertinent physical principles of sound that allow us to use ultrasound as a diagnostic tool. Chapters 2 and 3 describe the two dimensional, m-mode and Doppler examinations. All imaging planes are described with instructions and pictures for obtaining these images. I have included images of common mistakes and directions for fixing them. After all these years, I still find myself discovering little pearls of wisdom about obtaining and evaluating certain imaging planes. This is a skill that continuously develops, so don’t give up. With this in mind, I would like to acknowledge Dr. Jim Woods – creator of Woods’ Criteria - for reminding me that a study does not need to be perfect in order to obtain valuable information. Assessment of the echocardiographic examination is covered in Chapter 4. This chapter describes how to measure, and interpret the ultrasound examination. It describes the application of each parameter in a general way. It also tells of the factors that influence their interpretation, factors like heart rates, age, blood pressure, preload and afterload. The chapters following this cover the echocardiographic features of the most common cardiac diseases seen in veterinary medicine. Chapter 5 discusses acquired valvular diseases. Chapter 6 describes the features of systemic and pulmonary hypertension. Chapter 7 deals with all of the myopathies seen in animals. Pericardial effusion and cardiac masses are described in Chapter 8. Congenital shunts and stenotic lesions are covered in Chapters 9 and 10.
I have as usual probably overdone the references that are included in each chapter. Many offer viewpoints form the human side of echocardiography. I hope that this comprehensive reference list provides insight into the how and why of echocardiographic parameters and interpretation. I also hope that they spark some new ideas. I continue to learn every day, and this is what keeps me interested and loving what I do.
As with the first edition, it is my sincere wish that this book provides a comprehensive reference and instruction manual for echocardiographers at all levels of experience.
My sincere gratitude goes to Dr. Chris Orton and Dr. Jan Bright for their support in my endeavors. I couldn’t ask for better people to work with and have as mentors.
I would also like to acknowledge all of the cardiology residents that I have had the pleasure of working with over the past 10 years: Julie Martin, Sarah Zimmerman, TJ Morrison, Leigh Griffiths, Sarah Scruggs, Cassidy Sedacca, and Holly MacLea. I have become a better teacher because of you, and you have kept me on my toes. Many images in this book are from studies you have obtained, and I am thankful for your dedication to creating excellent echocardiographic studies.
June A. Boon