Manual de técnicas, procedimientos y contribución de enfermería al diagnóstico clínico, dentro de la tecnología no invasiva cardiovascular, en pacientes adultos del Instituto de Cardiología de Corrientes "Juana F. Cabral"

Descripción de las técnicas para realizar el diagnóstico con tecnología no invasiva cardiovascular en adultos. Se describe con detalle formas de aplicar los instrumentos, cuidados con el paciente e interpretación de los trazados en electrocardiografía común y dinámica (Holter) y ergometría, ecocardiografía uni y bidimensional, ecocardiograma Doppler y la presurometria que analiza la presión sanguinea. Señala los aportes de enfermería

Manual de técnicas, procedimientos y contribución de enfermería al diagnóstico clínico, dentro de la tecnología no invasiva cardiovascular, en pacientes adultos del Instituto de Cardiología de Corrientes "Juana F. Cabral"

Descripción de las técnicas para realizar el diagnóstico con tecnología no invasiva cardiovascular en adultos. Se describe con detalle formas de aplicar los instrumentos, cuidados con el paciente e interpretación de los trazados en electrocardiografía común y dinámica (Holter) y ergometría, ecocardiografía uni y bidimensional, ecocardiograma Doppler y la presurometria que analiza la presión sanguinea. Señala los aportes de enfermería

Hypermedia techniques for diagnostic imaging instruction: videodisk echocardiography encyclopedia.

Because of the visual complexity of medical images and the intensive tutorial experience required to develop image recognition expertise, professional training programs have concentrated on educating limited numbers of experts. Videodisk and CD-ROM (compact disk read only memory) image storage media now make it possible for a microcomputer workstation to provide a learning environment substantially equivalent to that of conventional time-consuming tutorial methods. A demonstration hypermedia program on echocardiography was constructed that provides a user-controlled learning environment with instant access to 54,000 video frames encompassing 1,200 clinical items. The instructional module is controlled by a microcomputer, which provides electronic linkage to relevant graphics, animations, text, categorized data bases, and digitized sound. The system has been successfully used in a residency program as the primary instructional tool for achieving an intermediate level of clinical expertise. Hypermedia offer substantial advantages over conventional books as a clinical reference source.

Diagnosis of fetal cardiac abnormality.

Congenital heart disease can now be accurately diagnosed in specialist units from about 18 weeks gestation. By teaching ultrasonographers to examine the four-chamber view of the heart, malformation can be suspected on a routine scan. This will allow a much greater number of pregnancies to be screened effectively for congenital heart disease.

Transesophageal echocardiography: technique, anatomic correlations, implementation, and clinical applications.

The introduction of transesophageal echocardiography has provided a new acoustic window to the heart and mediastinum. High-quality images of certain cardiovascular structures [left atrial appendage, thoracic aorta, mitral valvular apparatus, and atrial septum] can be obtained readily (average examination, 15 to 20 minutes). In this article, we discuss the technique of image acquisition, image orientation, and anatomic validation. In addition, we describe our experience with the first 100 awake patients who underwent transesophageal echocardiography at our institution. The procedure was well accepted by the patients and associated with no major complications. The clinical indications for this procedure have included thoracic aortic dissection, prosthetic cardiac valve dysfunction, detection of an intracardiac source of embolism, endocarditis, cardiac and paracardiac masses, and mitral regurgitation. Transesophageal echocardiography also proved to be useful in assessment of critically ill patients in whom standard transthoracic echocardiographic images did not provide complete assessment. In these patients (who had extensive chest trauma, had undergone an operation, or were in an intensive-care unit), rapid assessment of the cardiovascular status at the bedside was possible with transesophageal echocardiography. On the basis of our initial experience, we conclude that transesophageal echocardiography complements standard two-dimensional Doppler and color flow examinations and will considerably improve the care of patients with cardiovascular disorders by providing high-quality unique images.

Echocardiography performed by emergency physicians: impact on diagnosis and therapy.

Echocardiography is the "gold standard" for diagnosing many cardiac and pericardial abnormalities. It is noninvasive and accurate, but in most emergency departments is only as available as the technician or the cardiologist. We describe our experience in training emergency physicians to perform cardiac ultrasound, and clinical situations in which we have found echocardiography to be useful.

Guidelines for optimal physician training in echocardiography. Recommendations of the American Society of Echocardiography Committee for Physician Training in Echocardiography.

Over the past few years, the clinical use of echocardiography has continued to expand. Echocardiographic techniques are used widely to define normal and abnormal cardiac anatomy, evaluate cardiac chamber sizes and dynamics, assess valvular and pericardial diseases, detect intracavitary masses, measure pressure gradients across discrete stenoses, determine flow volumes, detect and assess the severity of valvular regurgitation, demonstrate and quantitate intracardiac shunts, and measure the timing of cardiac events. These and related applications have led to the increasing use of echocardiography in the diagnostic evaluation of many cardiac disorders. Echocardiography requires considerable theoretical knowledge, technical skill and practical experience to be used in an optimal manner. Previous publications have suggested guidelines for physician training in the techniques of M-mode and 2-dimensional echocardiography. The clinical applications of echocardiography continue to grow, however, and Doppler techniques for evaluating blood flow have become an established component of the echocardiographic evaluation of many disorders. This article presents the current recommendations of the American Society of Echocardiography as to the background knowledge, the nature and amount of practical experience, and the type of training site that are optimal for the training of physicians who take responsibility for the conduct and interpretation of echocardiographic studies.