1. Principles of Ultrasound |
a. Nature of ultrasound: compression and rarefaction |
b. Frequency,wavelength, tissue propagation velocity |
c. Properties of ultrasound waves |
d. Ultrasound/tissue interactions |
e. Tissue characterization |
2. Transducers |
a. Piezoelectric effect |
b. Crystal thickness and resonance |
c. Damping |
3. Sound Beam Formation |
a. Focusing |
b. Axial and lateral resolution |
c. Arrays |
4.Equipment, Infection Control, and Safety |
a. Clinical dosimetry |
b. Biological effects of ultrasound |
c. Electrical and mechanical safety |
d. Infection control |
e. TEE probe insertion and manipulation |
f. Contraindications to transesophageal echocardiography |
g. Complications of transesophageal echocardiography |
5. Imaging |
a. Instrumentation |
b. Displays |
c. B-mode,M-mode, and two-dimensional echocardiography |
d. Signal processing and related factors |
6. Principles of Doppler Ultrasound |
a. Doppler effect |
b. Doppler equation |
c. Doppler shift frequencies and influencing factors |
d. Nyquist limit |
e. Spectral analysis and display characteristics |
f. Pulsed-wave Doppler |
g. High pulse repetition frequency pulsed-wave Doppler |
h. Continuous-wave Doppler |
i. Color-flow Doppler |
j. Color M-mode |
7. Quantitative M-Mode and Two-Dimensional Echocardiography |
a. Edge recognition |
b. Edge components |
c. Temporal resolution |
d. Referencing centroids, fixed and floating axes |
e. Center-line method |
f. Global function; measurements and calculations |
g. Geometric, spectral, and other methods |
8. Quantitative Doppler |
a. Types of velocity measurements |
b. Volumetric measurements and calculations |
c. Valve gradients, areas, and other measurements |
d. Cardiac chamber and great vessel pressures |
e. Tissue Doppler |
9. Doppler Profiles and Assessment of Diastolic Function |
a. Tricuspid valve and right ventricular inflow |
b. Pulmonary valve and right ventricular outflow |
c. Mitral valve and left ventricular inflow |
d. Aortic valve and left ventricular outflow |
e. Non-valvular flow profiles |
10. Cardiac Anatomy |
a. Imaging planes |
b. Cardiac chambers and walls |
c. Cardiac valves |
d. Cardiac cycle and relation of events relative to ECG |
11. Pericardium and Extracardiac Structures—Anatomy and Pathology |
a. Pericardium and pericardial space |
b. Pulmonary arteries |
c. Pulmonary veins |
d. Vena cavae and hepatic veins |
e. Coronary arteries |
f. Aorta and great vessels |
i. Anatomy |
ii. Atherosclerosis |
iii. Aneurysm |
iv. Dissection and traumatic injury of the aorta |
g. Pleural space |
12. Pathology of the Cardiac Valves |
a. Acquired valve diseases |
i. Endocarditis |
ii. Rheumatic |
iii. Myxomatous |
iv. Calcific/degenerative |
v. Traumatic |
b. Tricuspid |
c. Pulmonary |
d. Mitral |
i. Mitral regurgitation |
ii. Ischemic mitral valve dysfunction |
iii. Mitral stenosis |
iv. Systolic anterior motion of mitral valve (SAM) |
e. Aortic |
i. Aortic regurgitation |
ii. Aortic stenosis |
13. Intracardiac Masses and Devices |
a. Tumors |
b. Thrombi |
c. Devices and foreign bodies |
14. Global Ventricular Systolic Function |
a. Normal left ventricular systolic function |
b. Abnormal left ventricular systolic function |
i. Etiologies including ischemia |
ii. Assessment/ejection fraction |
iii. Confounding factors |
c. Right ventricular systolic function |
d. Cardiomyopathies |
i. Hypertrophic |
ii. Restrictive |
iii. Dilated |
15. Segmental Left Ventricular Systolic Function |
a. Myocardial segment identification |
b. Coronary artery distribution and flow |
c. Normal and abnormal segmental function |
i. Assessment and methods |
ii. Differential diagnosis |
iii. Confounding factors |
d. Left ventricular aneurysm |
e. Left ventricular rupture |
16. Assessment of Perioperative Events and Problems |
a. Hypotension and causes of cardiovascular instability |
b. Cardiac surgery: techniques and problems |
i. Assessment of bypass and cardioplegia |
ii. Cannulae and devices commonly used during cardiac surgery |
iii. Circulatory assist devices |
iv. Intracavity air |
v. Minimally invasive cardiopulmonary bypass |
vi. Off pump cardiac surgery |
c. Coronary surgery: techniques and assessment |
d. Valve surgery: techniques and assessment |
i. Valve replacement: mechanical, bioprosthetic, and other |
ii. Valve repair |
e. Transplantation surgery |
i. Heart |
ii. Lung |
iii. Liver |
17. Congenital Heart Disease |
a. Identification and sites of morphologically left and right structures |
b. Atrial septal defects |
c. Ventricular septal defects |
d. Pulmonary valve and infundibular stenosis |
e. Left atrial and mitral valve conditions |
f. Aortic valve and left ventricular outflow tract abnormalities |
g. Coronary artery anomalies |
h. Patent ductus arteriosus |
i. Coarctation of the aorta |
j. Ebstein anomaly |
k. Persistent left superior vena cava |
l. Tetralogy of Fallot |
m. Transposition of great arteries |
n. Atrioventricular septal defect—“AV canal” |
o. Conditions with single ventricle physiology |
18.Artifacts and Pitfalls |
a. Imaging artifacts |
b. Doppler artifacts and pitfalls |
c. Structures mimicking pathology |
19. Related Diagnostic Modalities |
a. Stress echocardiography |
b. Myocardial perfusion imaging |
c. Epicardial scanning |
d. Contrast echocardiography |
e. Utility of TEE relative to other diagnostic modalities |