Effect of eliminating pre‐discharge transthoracic echocardiogram on outcomes after TAVR

2021 ◽  
Author(s):  
Garrett A. Welle ◽  
Bassim El‐Sabawi ◽  
Jeremy J. Thaden ◽  
Kevin L. Greason ◽  
Kyle W. Klarich ◽  
...  
Keyword(s):  
Transthoracic Echocardiogram

Acute Aortic Intramural Hematoma Presenting with Painless Recurrent Syncope

2012 ◽  
Vol 15 (5) ◽  
pp. 286
Author(s):  
Jan Droste ◽  
Heidar Zafarani Zadeh ◽  
Mohammed Arif ◽  
Ian Craig ◽  
A K Thakur
Keyword(s):  
Aortic Wall ◽  
Surgical Intervention ◽  
Intramural Hematoma ◽  
Pericardial Tamponade ◽  
Transthoracic Echocardiogram ◽  
Type A Aortic Dissection ◽  
Severe Hypotension ◽  
Patient’S History ◽  
Aortic Intramural Hematoma ◽  
Venous Pulse

<p>A patient presented with recurrent syncope due to transient severe hypotension. The patient's history, physical examination, and initial baseline investigation did not suggest a cardiovascular cause. After fluid resuscitation, a raised jugular venous pulse was noted. Bedside transthoracic echocardiogram showed a pericardial effusion and a proximally dilated aorta. Computed tomography of the thorax confirmed these findings and also demonstrated an intramural hematoma of the proximal aortic wall.</p><p>The patient was transferred to a cardiothoracic center, where he was at first treated medically. He then developed sudden cardiogenic shock due to pericardial tamponade and was successfully operated on.</p><p>It is important to recognize an acute intramural hematoma of the proximal aortic wall as a cardiothoracic emergency. This condition can present atypically, but nevertheless warrants urgent surgical intervention, equal to type A aortic dissection. Echocardiography can help in making the diagnosis.</p>

scholarly journals EFFECT OF ELIMINATING PRE-DISCHARGE TRANSTHORACIC ECHOCARDIOGRAM ON OUTCOMES AFTER TAVR

2021 ◽  
Vol 77 (18) ◽  
pp. 1117
Author(s):  
Garrett A. Welle ◽  
Bassim El-Sabawi ◽  
Jeremy Thaden ◽  
Kevin Greason ◽  
Kyle Klarich ◽  
...  
Keyword(s):  
Transthoracic Echocardiogram

scholarly journals Septic Cerebral Embolisation in Fulminant Mitral Valve Infective Endocarditis

2015 ◽  
Vol 7 (2) ◽  
pp. 134-141
Author(s):  
Gemina Doolub
Keyword(s):  
Intensive Care Unit ◽  
Mitral Valve ◽  
Acute Onset ◽  
Valve Surgery ◽  
Acute Pulmonary Oedema ◽  
Severe Mitral Regurgitation ◽  
Biochemical Profile ◽  
Transthoracic Echocardiogram ◽  
Intravenous Drug Use ◽  
Speech Impairment

A 37-year-old male with known intravenous drug use was admitted with an acute onset of worsening confusion and speech impairment. His vitals and biochemical profile demonstrated severe sepsis, with a brain CT showing several lesions suspicious for cerebral emboli. He then went on to have a bedside transthoracic echocardiogram that was positive for vegetation on the mitral valve, with associated severe mitral regurgitation. Unfortunately, before he was stable enough to be transferred for valve surgery, he suffered an episode of acute pulmonary oedema requiring intubation and ventilation on intensive care unit.

scholarly journals Cardiac Aspergilloma: A Rare Case of a Cardiac Mass Involving the Native Tricuspid Valve, Right Atrium, and Right Ventricle in an Immunocompromised Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Christina S. Chen-Milhone ◽  
Kalyan Chakravarthy Potu ◽  
Sudhir Mungee
Keyword(s):  
Tricuspid Valve ◽  
Right Atrium ◽  
Rare Case ◽  
Opportunistic Infections ◽  
Immunocompromised Patient ◽  
Clinical Suspicion ◽  
Ventricular Rate ◽  
Immunocompromised Patients ◽  
Transthoracic Echocardiogram ◽  
The Right

Aspergillus can cause devastating opportunistic infections in immunocompromised patients. Rarely does this fungus invade the heart, and when it does, survival is especially poor despite optimal medical and surgical treatment. We report a case of cardiac aspergilloma with involvement of the tricuspid valve and both the right atrium and ventricle found on a transthoracic echocardiogram in an immunocompromised patient after developing atrial fibrillation with rapid ventricular rate. The findings from this case suggest that early clinical suspicion is critical in early diagnosis and thus early treatment.

Abstract 361: Utility of Transthoracic Echocardiogram to Assess Volume Status in the Intensive Care Unit

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Yasotha Rajeswaran ◽  
Brooke Hill ◽  
Anthony Gemignani ◽  
Scott Friedman ◽  
Robert Palac ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Management ◽  
Left Ventricular ◽  
Volume Status ◽  
Intravenous Fluids ◽  
Transthoracic Echocardiogram ◽  
Echocardiographic Parameters

Background: There is increasing concern regarding the value and cost of using transthoracic echocardiograms (TTEs) to assess volume status in critically ill patients. Using clinical and echocardiographic parameters, we assessed whether TTE changed clinical management of patients in the intensive care unit (ICU). Methods: Using the Dartmouth-Hitchcock echocardiography database, we identified 218 ICU patients whose TTE was performed to assess volume status from 4/1/11 to 3/31/14. The following TTE parameters were assessed: left ventricular ejection fraction (LVEF), diastolic function parameters, left atrial size, significant valvular disease, pericardial effusion, inferior vena cava (IVC) size and collapsibility, right ventricular (RV) function and pulmonary artery systolic pressure. In addition, clinical data were collected from review of the medical record including: age, vitals, intubation status, labs, and management change after TTE results became available. Results: Of the 218 patients, cardiac tamponade was present in 6 patients and right heart strain suggestive of pulmonary embolus was present in 2 patients. Of the remaining 210 patients, TTE did not affect clinical management in 186 (88.6%), led to administration of diuretics in 8 (3.8%), and intravenous fluids in 16 (7.6%). Of the 218 total patients, 123 (56.4%) were intubated. Compared to non-intubated patients, intubated patients were more likely to have elevated right atrial pressure, RV dysfunction, IVC size and collapsibility index (p<0.05). There was no difference in the severity of pulmonary hypertension, LVEF, or indices of elevated left ventricular filling pressure (p=NS). Although the echo parameters were different, the decision by physicians to administer intravenous fluids or diuretics was similar for both groups (p=NS). Conclusions: Transthoracic echocardiogram is commonly ordered to assess volume status in the ICU. The use of echocardiographic parameters to assess volume status did not change clinical management in majority of patients and should be used with caution in this cohort. Continued investigation to identify the best modality to assess volume status in critically ill patients is warranted.

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