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By Mary Sheppard, John R. Pepper, Michael Rigby, Michael Y. Henein

The major goal of scientific and educational cardiology actions is to optimize the patient's administration and finally their welfare. pros deal with sufferers in keeping with their very own knowing of affliction procedure; clinicians be aware of assuaging the indicators and echocardiographers on picking the illness. This booklet is helping to 'cross the barrier' and describes the typical floor among physiologic disturbances and their administration which may still preferably shape the shared foundation for figuring out and dealing with all cardiac difficulties.

A sensible assessment of the numerous makes use of of echocardiography in scientific perform, medical Echocardiography is designed to combine and refine the research of cardiac issues in the framework of the pathologic, physiologic and surgical appearances of center illness. it's been universal to contemplate echocardiographic findings individually from the extra actual features of center illness. besides the fact that, with the advance of recent imaging modalities corresponding to 3- and 4-dimensional echocardiography, it has turn into essential to give some thought to this imaging as a window at the center. This publication aids the heart specialist, cardiac general practitioner and echocardiographer to combine their wisdom in the total administration of cardiac affliction in a clinically appropriate manner.

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30 Pathological specimen from a patient with aortic regurgitation secondary to infective endocarditis showing vegetation attached to the valve leaflet Fig. Y. Henein et al. a b Fig. 32 Parasternal long axis view of the LV outflow tract and ascending aorta showing a fusiform aneurysm causing and aortic regurgitation Fig. 33 Pathological section of the aortic root from a patient with aneurysm showing generalized dilatation of the wall with calcification of the aortic valve Fig. 34 (a) Parasternal long axis view from a patient with aneurysmal aortic sinuses with a small clot in the right coronary sinus (cauliflower appearance).

B) Degenerative or senile aortic stenosis: This results from calcium deposition on the aortic surface of the valve [10]. As with the mitral valve, calcification in the elderly affects the base and slowly involves the body of the leaflets whereas with rheumatic disease, the opposite occurs and the commissures fuse with calcification [11]. The calcium is deposited as large lumps within the body of each leaflet. The exact etiology of calcific aortic stenosis is not clear. Y. Henein et al. 2 Apical 5 chamber view from a patient with calcific aortic valve disease atherosclerosis with its known risk factors was thought to be an important mechanism, recent findings and meta-analyses are shedding doubt over this theory [12, 13].

Y. Henein et al. Fig. 21 Septal LV long axis recording from a normal (left) and a patient with significant aortic stenosis before (middle) and after valve replacement (right). Note the normalization of long axis lengthening velocities after surgery Fig. 22 Jugular venous pulse from a patient with aortic stenosis and LV hypertrophy showing Bernheim “a” wave followed by an X descent Fig. TAVI 3D echo during TAVI procedure showing the anatomical structures of the LV outflow tract area and aortic valve as well as the catheter crossing the valve.

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