CH 6 The Stress Echo Part 4 скачать в хорошем качестве

CH 6 The Stress Echo Part 4

Chapter VI addresses the topic of stress echocardiography. Key content areas (typical for this chapter) include: Indications & clinical rationale Why perform a stress echo (exercise vs pharmacologic) Patient selection criteria, contraindications What information a stress echo adds over resting echo The physiology of stress: how the heart responds to increased workload Types of stress protocols Exercise stress (treadmill, bicycle) Pharmacologic stress (dobutamine, adenosine, others) Stress with imaging modalities (echo + Doppler, the role of contrast) Pre-test preparation (patient instructions, baseline images) Image acquisition during stress Baseline/rest images: views required (parasternal long & short axis, apical 4-chamber/2-ch/3-ch) Peak stress images: timing, how soon after exercise/pharmacologic agent to capture, how to optimize windows Post-stress recovery images: protocol for image capture in recovery phase Normal vs abnormal findings Expected normal responses: increased heart rate, increased contractility, decreased end‐systolic volume, improved wall motion Abnormal responses: new wall motion abnormalities (hypokinesis, akinesis), ischemia patterns, fixed defects (scar), viability assessment Interpretation of segmental wall motion, grading (normal, mild, moderate, severe), using standardized segment models Understanding false positives/negatives, limitations of stress echo Safety considerations & complications Monitoring: ECG, blood pressure, symptoms (angina, dyspnea), arrhythmias Contraindications/when to stop test Pharmacologic agent risks (e.g., dobutamine: arrhythmias, hypertension; adenosine: bronchospasm) Echocardiography-specific considerations: image quality, patient motion, post-exercise timing Reporting & documentation What to include in the echo report: rest vs stress images, wall motion findings, interpretation (ischemia present/absent, viability, scar) Recommendations: further workup (e.g., cardiac catheterization), follow-up imaging How to integrate findings into patient care/lab workflow Quality assurance & protocols for sonography labs Lab protocol checklist: baseline imaging, stress imaging, post-stress imaging, archiving loops, measurement standards Accreditation/certification recommendations (e.g., by American Society of Echocardiography / Intersocietal Accreditation Commission) Considerations for sonographer training and competency in stress echo #Echocardiography #CardiacUltrasound #EchoTech #EchotechStudent #EchoStudent #SonographyStudent #UltrasoundEducation #LearnEcho #EchoTraining #Echocardiogram