Atrial septal defect echocardiography modalities: Difference between revisions
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__NOTOC__ | |||
{{Atrial septal defect}} | {{Atrial septal defect}} | ||
{{CMG}}; '''Associate | {{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com], {{CZ}}; '''Assistant Editor(s)-In-Chief:''' [[Kristin Feeney|Kristin Feeney, B.S.]] [mailto:kfeeney@elon.edu] | ||
'''For a full discussion on the usage of echocardiography for atrial septal defect diagnosis click [[atrial septal defect echocardiography|here]].''' | |||
==Overview== | ==Overview== | ||
Echocardiography is the preferred diagnostic tool in the evaluation of an atrial septal defect. A range of techniques may be employed to definitively image and diagnose the nature of an atrial septal defect. These include: | Echocardiography is the preferred diagnostic tool in the evaluation of an atrial septal defect. A range of techniques may be employed to definitively image and diagnose the nature of an atrial septal defect. These include modalities such as: M-mode, trans-thoracic, trans-esophageal, contrast, and Doppler. | ||
==Echocardiography | ==Echocardiography== | ||
A range of echocardiography techniques can be used to visualize and diagnose a suspected atrial septal defect. Each technique offers additional imaging information to support an atrial septal defect diagnosis. | A range of echocardiography techniques can be used to visualize and diagnose a suspected atrial septal defect. Each technique offers additional imaging information to support an atrial septal defect diagnosis. | ||
==M-mode== | ===M-mode=== | ||
* Effective modality for imaging moderate to large ostium secundum atrial septal defects | * Effective modality for imaging moderate to large ostium secundum atrial septal defects | ||
:* Provides imaging of: | :* Provides imaging of: | ||
::* Right ventricular enlargement | ::* Right ventricular enlargement | ||
::* Paradoxical motion involving the interventricular septum | ::* Paradoxical motion involving the interventricular septum | ||
===Disadvantages=== | ===Disadvantages=== | ||
* | * M-mode modality can appear indicative of [[right ventricular overload]]. It is not substantial enough alone to make a full diagnosis of a suspected atrial septal defect. | ||
=== | ===[[Atrial septal defect transthoracic echocardiography|Trans-thoracic echocardiography (TTE)]]=== | ||
==[[Atrial septal defect transesophageal echocardiography|Trans-esophageal echocardiography (TEE)]]== | ===[[Atrial septal defect transesophageal echocardiography|Trans-esophageal echocardiography (TEE)]]=== | ||
= | ===[[Atrial septal defect contrast echocardiography|Contrast echocardiography]]=== | ||
=== | ===Doppler=== | ||
* Used to demonstrate left to right flow. | * Used to demonstrate left to right flow. | ||
* Effective modality for: | * Effective modality for: | ||
| Line 74: | Line 35: | ||
:* Determination of high velocity flow, useful in patients with restrictive defects, obstructed pulmonary venous return and/or left atrial hypertension | :* Determination of high velocity flow, useful in patients with restrictive defects, obstructed pulmonary venous return and/or left atrial hypertension | ||
===Disadvantages=== | ====Disadvantages==== | ||
* May show false positive shunting as caval flow and incorrectly set gain may appear as left to right flow. | * May show false positive shunting as caval flow and incorrectly set gain may appear as left to right flow. | ||
* Coloring across the interatrial septum can distort the perception of the shunt flow | * Coloring across the interatrial septum can distort the perception of the shunt flow | ||
* Not effective in determination of sinus venosus defects | * Not effective in determination of sinus venosus defects | ||
===ACC / AHA 2008 Guidelines - Evaluation of the Unoperated Patient - Atrial Septal Defect (DO NOT EDIT)<ref name="pmid19038677">{{cite journal| author=Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA et al.| title=ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. | journal=J Am Coll Cardiol | year= 2008 | volume= 52 | issue= 23 | pages= e1-121 | pmid=19038677 | doi=10.1016/j.jacc.2008.10.001 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19038677 }} </ref>=== | |||
{| class="wikitable" | |||
|- | |||
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | |||
|- | |||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' ASD should be diagnosed by imaging techniques with demonstration of shunting across the defect and evidence of RV volume overload and any associated anomalies. ([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]]) <nowiki>"</nowiki> | |||
|} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[CME Category::Cardiology]] | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
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[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
[[Category:Mature chapter]] | [[Category:Mature chapter]] | ||
Latest revision as of 01:50, 15 March 2016
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Atrial Septal Defect Microchapters | |
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Atrial septal defect echocardiography modalities On the Web | |
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American Roentgen Ray Society Images of Atrial septal defect echocardiography modalities | |
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Risk calculators and risk factors for Atrial septal defect echocardiography modalities | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2], Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [4]
For a full discussion on the usage of echocardiography for atrial septal defect diagnosis click here.
Overview
Echocardiography is the preferred diagnostic tool in the evaluation of an atrial septal defect. A range of techniques may be employed to definitively image and diagnose the nature of an atrial septal defect. These include modalities such as: M-mode, trans-thoracic, trans-esophageal, contrast, and Doppler.
Echocardiography
A range of echocardiography techniques can be used to visualize and diagnose a suspected atrial septal defect. Each technique offers additional imaging information to support an atrial septal defect diagnosis.
M-mode
- Effective modality for imaging moderate to large ostium secundum atrial septal defects
- Provides imaging of:
- Right ventricular enlargement
- Paradoxical motion involving the interventricular septum
Disadvantages
- M-mode modality can appear indicative of right ventricular overload. It is not substantial enough alone to make a full diagnosis of a suspected atrial septal defect.
Trans-thoracic echocardiography (TTE)
Trans-esophageal echocardiography (TEE)
Contrast echocardiography
Doppler
- Used to demonstrate left to right flow.
- Effective modality for:
- Confirmation of a suspected atrial septal defect
- Estimation of the defect size
- Determination of the universal direction of flow across the septum
- Determination of the usage of percutaneous closure and surgical therapies
- Determination of high velocity flow, useful in patients with restrictive defects, obstructed pulmonary venous return and/or left atrial hypertension
Disadvantages
- May show false positive shunting as caval flow and incorrectly set gain may appear as left to right flow.
- Coloring across the interatrial septum can distort the perception of the shunt flow
- Not effective in determination of sinus venosus defects
ACC / AHA 2008 Guidelines - Evaluation of the Unoperated Patient - Atrial Septal Defect (DO NOT EDIT)[1]
| Class I |
| "1. ASD should be diagnosed by imaging techniques with demonstration of shunting across the defect and evidence of RV volume overload and any associated anomalies. (Level of Evidence: C) " |
References
- ↑ Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.