Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions.
Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
The ESC Councils' goal is to share knowledge among medical professionals practicing in specific cardiology domains.
Authors: Dr. Julia Grapsa, Dr. Andreas Kalogeropoulos, Dr. Grigorios Karamasis, Mr. Benjamin F Smith, Mr. David Dawson, Prof. Petros NihoyannopoulosHammersmith HospitalImperial College NHS TrustContact : Julia Grapsa: EACVI ambassador for GreeceOn behalf of the EACVI club 35 for Greece
63 years old lady with known metastatic carcinoid submitted for follow up echocardiogram
Parasternal long axis view – the left ventricle has normal size while the right ventricle is dilated and volume loaded. The mitral and aortic valves are structurally normal.
Parasternal long axis: measurement of left ventricular dimensions: we measure the wall thickness, the end-diastolic and end-systolic diameter of the left ventricle as well as the left atrial diameter.
Parasternal right ventricular inflow focused on the tricuspid valve. Tthe leaflets are thickened and shortened suggesting carcinoid disease affecting the tricuspid valve. There is also lack of coaptation between the leaflets.
Parasternal short axis of the right ventricular outflow tract: the pulmonary valve is affected by the carcinoid disease and the pulmonary cusps are thickened and shortened. There is severe pulmonary regurgitation with free regurgitant flow.
Apical 4 chamber view. The right ventricle is dilated and volume loaded due to the free flow tricuspid regurgitation. The right atrium is also markedly dilated.
Apical 4 chamber view with colour Doppler. The right ventricle is dilated and volume loaded due to the free flow tricuspid regurgitation. The right atrium is also markedly dilated.
Subcostal view. The inferior vena cava and the hepatic veins are dilated with no respiratory collapse. There is flow reversal (not showed in the hepatic veins indicating severe tricuspid regurgitation. Right atrial pressure is estimated as being greater than 20 mmHg.
Tissue Doppler Imaging on the RV free wall: The systolic S wave is measured as 19 cm/sec which represents good overall performance of right ventricular function. However, tissue doppler imaging may be influenced by volume loading.
Real time 3D echocardiography of the tricuspid valve : the view has been obtained from the parasternal right ventricular inflow.
Real time 3D echocardiography of the tricuspid valve: the view is obtained from the parasternal right ventricular inflow view and the image is rotated towards the atrial view for a better view of the tricuspid valve: the leaflets are restricted in motion and there is a large coaptation gap.
The study main findings were
These echocardiographic findings with severe thickening and rigidity of leaflets leading to free regurgitation in both tricuspid and pulmonary valves is the typical pattern of cardiac carcinoid disease.
Our mission: To reduce the burden of cardiovascular disease
© 2017 European Society of Cardiology. All rights reserved