RT Book, Section
A1 Shindler, Daniel M.
A1 Shindler, Olga I.
A1 Wright, Alicia
SR Print(0)
ID 1175627638
T1 The Stethoscope
T2 Practical Echocardiography for Cardiac Sonographers
YR 2020
FD 2020
PB McGraw Hill
PP New York, NY
SN 9781260457797
LK accesscardiology.mhmedical.com/content.aspx?aid=1175627638
RD 2024/04/19
AB The  finding  of  mitral  or  aortic  regurgitation  on  color  flow  should  prompt  a  search  for  the  corresponding  murmur.An  absent  murmur  when  there  is  evidence  of  severe  regurgitation  on  color  flow  needs  an  explanation.The  echocardiographic  explanation  of  a  murmur  may  reside  in  the  left  ventricle:  hypertrophy,  outflow  obstruction,  chamber  dilatation,  mitral  annulus  dilatation.Color  flow  Doppler  is  highly  capable  of  detecting  valvular  regurgitation.It  is  an  instantaneous  spatial  display  of  mean  blood  flow  velocities—different  from  an  angiogram.Regurgitant  murmurs  are  commonly  found  by  color  flow  Doppler  without  being  heard  on  auscultation.Connecting  color  flow  with  a  murmur  is  not  always  straightforward,  but  correlation  of  the  color  flow  Doppler  exam  with  auscultation  is  extremely  valuable  clinically.Innocent  flow  murmurs  may  become  audible  in  the  recumbent  position  due  to  increased  venous  return.  There  is  no  color  flow  Doppler  equivalent  to  a  murmur  caused  by  normal  forward  flow  through  the  right  cardiac  chambers.Turbulent  blood  flow  is  displayed  with  a  variance  map  on  color  flow,  and  by  spectral  broadening  on  pulsed-wave  Doppler.Practical  example:  A  sclerotic  aortic  valve  may  give  rise  to  a  prominent  systolic  ejection  murmur,  but  there  will  be  no  significant  gradient  on  pulsed-  and  continuous-wave  Doppler.Color  flow  Doppler  is  useful  during  the  assessment  of  the  severity  of  aortic  stenosis.  Multiple  transducer  positions  are  used  to  align  the  continuous-wave  Doppler  beam  with  the  stenotic  jet.  Color  flow  can  help  find  the  turbulent  flow  in  the  aorta  in  the  right  parasternal  and  suprasternal  transducer  positions  during  the  “hunt”  for  the  fastest  aortic  stenosis  velocity.Bedside  scanning  tip:  Palpate  for  the  thrill  of  the  aortic  stenosis  murmur  first,  and  place  the  transducer  directly  over  that  spot  on  the  chest.