|• Guidelines for the clinical application
of echocardiography have been formulated by the American College
of Cardiology and the American Heart Association in collaboration
with the American Society of Echocardiography.|
Disease in the Newborn
• To monitor normally occurring physiologic changes
during the transitional circulation of the newborn.
• Helps define structural anomaly, if present.
• Helps determine hemodynamics and ventricular function.
• To assess the presence and degree of pulmonary artery hypertension
in premature infants with respiratory failure related to lung disease.
• Doppler echocardiography can show ductal patency as well as amount
and direction of shunting.
• Cyanosis in newborns without evidence of severe lung disease
but whose chest radiograph, ECG, and extremity blood pressures are
• Arrhythmias, nonimmune hydrops, and sepsis.
• Chromosomal abnormalities and certain extracardiac anomalies.
Murmurs in Infants
• Innocent heart murmurs do not warrant echocardiography.
• Still’s murmur.
• Flow murmur of the pulmonary artery.
• Peripheral pulmonic stenosis.
• Supraclavicular murmur.
• Systolic flow murmur.
• Maintain low threshold for obtaining echocardiogram in children
with a murmur and abnormal results on accompanying studies (eg,
ECG, chest radiograph).
• Diastolic murmur or gallop.
• Examples include Kawasaki disease, rheumatic
fever, myocarditis, and endocarditis.
• Provides important information regarding the following:
• Chamber sizes.
• Valve and ventricular function.
• Pericardial involvement.
• Presence of intracardiac masses.
• Can also be used for serial evaluation throughout the disease
process and to determine whether therapy is effective.
• To evaluate patients with connective tissue diseases,
such as Marfan syndrome and Ehlers-Danlos syndrome, which are associated
with valve prolapse, aortic root dilation, and dissection.
• To assess ventricular function in patients with certain neuromuscular
disorders, such as Duchenne’s muscular dystrophy, that
can affect the heart muscle.
• To assess left ventricular hypertrophy and dysfunction in children
with chronic renal disease and long-standing systemic hypertension.
• To obtain baseline and serial echocardiograms to assess for cardiomyopathy
in patients receiving chemotherapeutic agents, which can be cardiotoxic.
• Useful in additional disease processes including HIV, serial assessment
for rejection in cardiac transplant patients, and screening of patients
with a family history of cardiomyopathy.
• Newly diagnosed thromboembolic disease.
• Searches for sources of thrombus and potential intracardiac
• Routine transthoracic echocardiogram is often inconclusive and
therefore, a contrast study may be necessary.
• If either study is inconclusive, a transesophageal echocardiogram
may be necessary.
• Determines whether there is associated structural
heart disease (eg, Ebstein’s anomaly, mitral valve prolapse,
and cardiac tumors).
• Evaluates cardiac function (ie, myocarditis, cardiomyopathy).
• If tachycardia has been present for an extended period of time,
an echocardiogram may help determine whether an intracardiac thrombus
is present and if ventricular ...
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