Practical Cardiovascular Medicine. Elias B. Hanna

of LA pressure in patients with depressed EF: criter...Figure 32.49 Aliasing velocity of the regurgitant color, which is red in thi...Figure 32.50 Simultaneous LV pressure and PCWP recording is shown on the lef...Figure 32.51 PISA of MS on a long-axis view. PISA of MS consists of flow acc...Figure 32.52 LV–aortic pressure tracings in acute AI and chronic AI. In acut...Figure 32.53 Correlations between A, X, V, and Y waves on the LA pressure tr...Figure 32.54 Types of prosthetic valves. Surgical bioprostheses typically ha...Figure 32.55 Bioprosthetic porcine valve as evidenced by the large struts/ve...Figure 32.56 (a) Metallic mitral prosthesis. As in bioprostheses, a hyperech...Figure 32.57 (a) Frequency of the reflected wave. On pulsed-wave Doppler, the...Figure 32.58 In this interrogation of the aortic valve in the apical five-ch...Figure 32.59 The Doppler cursor is placed across the mitral valve (double ar...Figure 32.60 Illustration of angle rotation and anteflexion on TEE.Figure 32.61 TEE: 0° four- and five-chamber views.Figure 32.62 TEE two-chamber and long-axis views. To understand the orientat...Figure 32.63 Illustration of an axial view of the mitral plane, showing the ...Figure 32.64 TEE four-chamber 0° view. Note the calcification of the mi...Figure 32.65 TEE five-chamber view. Another case of restricted leaflets from...Figure 32.66 Severe eccentric MR is seen on the TEE four-chamber view, “hugg...Figure 32.67 MR is seen on the 90° two-chamber view. Note that, in this view...Figure 32.68 TEE long-axis (120°) view.Figure 32.69 Aortic valve short-axis view. Anteflexion is necessary to see t...Figure 32.70 Anteflexion from the level of the short-axis view leads to the Figure 32.71 (a) Clockwise torque from the 0° four-chamber view allows a focu...Figure 32.72 From a 90–120° LV/aortic view, torquing the TEE probe to the le...Figure 32.73 Interatrial septum (IAS) bicaval view (“Mickey Mouse” view). Tr...Figure 32.74 (a) Bicaval view opening the thin part of the interatrial septu...Figure 32.75 Bicaval view showing an ostium secundum ASD. ASD is a defect; i...Figure 32.76 (a) Bicaval view showing sinus venous ASD (arrow). Note the lac...Figure 32.77 0° view at a high level, allowing visualization of structures a...Figure 32.78 Anteflexion from Figure 32.77 shows an even higher level. The P...Figure 32.79 Short-axis 0° transgastric view, showing both the LV and RV.Figure 32.80 (a) Short-axis 0° transgastric view with more anteflexion than ...Figure 32.81 (a) Transgastric two-chamber view showing the LA–LV (90°). (b) ...Figure 32.82 Transgastric long-axis view (120°) (deeper gastric level than F...Figure 32.83 Three-dimensional TEE view of the mitral valve (en-face view). ...Figure 32.84 Three layers of LV myocardial fibers: (1) outer oblique fibers ...

      31 Chapter 33Figure 33.1 Stress testing modality. *Baseline ECG abnormalities precluding...Figure 33.2 During sinus tachycardia, atrial repolarization becomes accentua...Figure 33.3 Nuclear images are displayed in three views: Short-axis cuts...Figure 33.4 A severe defect (arrows) is noted in the inferior and septal wal...Figure 33.5 Gated SPECT myocardial excursion of the previous case (Figure 33...Figure 33.6 This is an axial CT view. The right ventricle is the most anteri...Figure 33.7 This is an oblique view of the proximal LAD (a vertical cut thro...Figure 33.8 This is a curved view of the RCA. The curved view is a processed...Figure 33.9 This is an axial CT view. The LAD has a soft plaque proximally (...Figure 33.10 The basal septum is normal, that is, black and does not enhance...Figure 33.11 Patterns of LGE in ischemic and various non-ischemic cardiomyop...Figure 33.12 Myocarditis in a 26-year-old man. Note the subepicardial white ...

      32 Chapter 34Figure 34.1 RCA course and branches. The intersection of the AV groove and t...Figure 34.2 (a) Left coronary system on LAO cranial view. (b) LV walls on cr...Figure 34.3 The top two rows show the difference in morphology between stabl...Figure 34.4 LAO view, cranial. Note the diaphragm overlapping with the heart...Figure 34.5 Shallow RAO view, cranial. Note the diaphragm overlapping with t...Figure 34.6 Illustration of the difference between caudal and cranial views. Figure 34.7 View orthogonal to a segment vs. view foreshortening a segment....Figure 34.8 Heart in an anteroposterior view. Imagine how you look at the co...Figure 34.9 RAO caudal view (25°, 25°).Figure 34.10 RAO caudal view. Distal LM bifurcation area is well seen; if no...Figure 34.11 RAO caudal view. The ribs are looking down towards the right-ha...Figure 34.12 RAO caudal view in a patient with a vertical heart. Note that, ...Figure 34.13 (a) RAO caudal with a large diagonal and a totally occluded LAD...Figure 34.14 AP caudal view. Similarly to RAO caudal view, the AP caudal vie...Figure 34.15 LAO caudal view (40°, 30°). Catheter tip is at the center of he...Figure 34.16 LAO caudal view of a vertical heart. The catheter tip (star) is...Figure 34.17 LAO caudal view of a horizontal heart. Note that the catheter t...Figure 34.18 (a) Vertical heart. LAO caudal is not orthogonal to the LM bifu...Figure 34.19 Shallow RAO cranial view (5°, 35°).Figure 34.20 Shallow RAO cranial view. Note the overlap of the distal LM, pr...Figure 34.21 LAO cranial view (40°, 30°). The LCx and OMs run on the border ...Figure 34.22 LAO cranial view. Note the overlap at the level of the distal L...Figure 34.23 LAO cranial view showing a dominant LCx. The distal PLBs and PD...Figure 34.24 LAO cranial view. If there is too much overlap in the proximal ...Figure 34.25 RAO caudal view. One gets the impression that the LAD is patent...Figure 34.26 LAO cranial view of the patient from Figure 34.25. What seems l...Figure 34.27 RAO cranial view (30°, 30°). The circled area is the area where...Figure 34.28 Best views for ostial left main, and best views for distal left...Figure 34.29 RCA views: LAO straight vs. LAO cranial. LAO cranial opens the ...Figure 34.30 Note how the LAO cranial opens the distal RCA branches (arrows)...Figure 34.31 AP cranial view. Note how the distal RCA is well laid out.Figure 34.32 The true RCA has two distal bends on the LAO and AP cranial vie...Figure 34.33 (a) LAO cranial view. It may seem that the RCA continues down a...Figure 34.34 (a) LAO cranial view of the RCA. Try to identify the true RCA, ...Figure 34.35 RAO straight (30°) looks at the AV groove from the side rather ...Figure 34.36 AP cranial view properly showing the SVG-to-RCA anastomosis and...Figure 34.37 On this LAO cranial view, the grafted artery is at the left rat...Figure 34.38 AP caudal view showing sequential SVG to OM2 and OM3. In this v...Figure 34.39 RAO cranial view (diaphragm is seen over the heart shadow, ribs...Figure 34.40 (a) Occluded SVG to RCA on LAO view (catheter at the left of th...Figure 34.41 Sequential and split grafts (RAO caudal view). Graft anastomose...Figure 34.42 Left lateral view showing the LIMA-to-LAD anastomosis.Figure 34.43 Top figure: Illustration of how the RAO and LAO views “look” at...Figure 34.44 LAO straight vs. LAO cranial view. LAO cranial better opens the...Figure 34.45 Left ventriculogram on LAO straight view vs. LAO cranial view....Figure 34.46 Left ventriculogram performed in LAO straight view.Figure 34.47 (a) Illustration of how the RAO and LAO views look at the mitra...Figure 34.48 RAO view of the LV. Look how the aorta overlaps with the LA. Go...Figure 34.49 Steep RAO view shows severe MR with full delineation of the LA,...Figure 34.50 Axial cuts across the aortic cusps and the PA, showing the cour...Figure 34.51 Anomalous origin of LM as visualized on RAO aortography. Always...Figure 34.52 Anomalous RCA engaged with AL1. Two cases (1 and 2) are present...Figure 34.53 Right oblique view of the aorta, iliac and femoral arteries. No...Figure 34.54 Femoropopliteal anatomy. A right lower extremity is shown. Dash...Figure 34.55 Axial CT scan images showing the SFA anatomy. Top: note the...Figure 34.56 OmniFlush or IMA catheter used to selectively engage the left i...Figure 34.57 External iliac occlusion extending into the common femoral arte...Figure 34.58 Totally occluded left SFA from the ostium to the popliteal leve...Figure 34.59 Totally occluded right distal SFA with collaterals mostly origi...Figure 34.60 Differentiate SFA from profunda in the case of SFA occlusion.Figure 34.61 Same patient as Figure 34.60. An almost lateral view (left pane...Figure 34.62 Aortic arch types I, II, and III. The distance between the top ...Figure 34.63 (a) On an LAO view, the JB1 catheter is torqued counterclockwis...Figure 34.64 Simmons catheter used to engage the innominate and carotid arte...

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