This document discusses how echocardiography (echo) can be used to assess various systemic diseases. Echo is a noninvasive tool that can examine the heart in real-time and provide information on cardiac structure and function. It discusses how echo is useful in evaluating diseases of the pericardium, valves, and other cardiac manifestations of systemic conditions like hypertension, renal failure, and myocardial infarction. Three-dimensional echo and transesophageal echo allow for detailed assessment of valvular structure and function and are particularly useful for evaluating endocarditis. The document provides an overview of the role of echo in diagnosing and managing common systemic diseases encountered in clinical practice.

1. Echo in systemic diseases.
Phillip D’Amato.
May 24,2014.

2. Echo a unique tool to assess systemic
diseases in the clinical setting.
• Echo is a unique tool to assess all forms of
systemic disease that exist in the healthcare
field.
• Echo is noninvasive and is adeptly suited to
examine the heart in real time versus other
diagnostic alternatives.
• 3D echo and 3D TEE have know come to
forefront in diagnosing structural heart
disease.

3. Systemic Disease overview.
• There are numerous kinds of systemic disease
the clinician will encounter on a daily basis in
the healthcare setting.
• I will attempt in this PowerPoint to touch on
which ones are most prevalent and how echo
can be beneficial in treatment and diagnosis
of systemic disease.

4. Kinds of Systemic disease.
• 1. Infiltrate disease. This can consist of
amyloidal ,sacrcodiosdios, etc that infiltrate
and effect the myocardium.
• 2. Infections that produce disease that
damages endocardial valves.
• 3.Myocardial infarction.
• 4.Hyertension.
• 5.Renal failure.

5. Kinds of systemic disease.
• 8.Obesisty.
• 9.Marfan syndrome.
• 10.Malagincies.
This list is not meant to be
comprehensive in nature its just seeks to
establish the fundamental diseases that a
sonogrpaher will encounter on a daily basis.

6. Echo in the pericardial disease.
• Echo is a wonderful adjunct tool to assess
pericardial disease.
• Echo provides great detail about constrictive
pericardial disease. This is often caused by a
thickened fibrotic pericardium that results in
dense fibrosis calcification and adhesions of
the parietal and visceral pericardium(Yared,
2010).

7. Echo role in assessment of
pericardial disease.
• Septal bounce is often the most consistent
echo sign for this disease state with a
sensitivity of 62% and specificity of 93%
(Yared ,2010).
• Also, slowing the sweep speed down and
using respiratory gating often will provide
clues if there are filling stress on heart.

8. Pericardial Effusion.
• Echo is often considered to be the gold
standard in assessing pericardial effusion.
Echo provides real time hemodynamic data
on filling pressures ,as well as, effusion size.
• However, CCT and CMR can play an important
role in situations in which the hemodynamic
data are atypical and presence or severity of
tamponade are in question (Yared, 2008)

9. Echo in valvular heart disease.
• Echo today plays a large and growing role in
assessing valvular heart disease.
• 3D echo has enabled magnificent
visualization of valves and subvalvular
features from single volume acquisition(Lang
2011).

10. Valve stenosis and Endocarditis.
• 3DE is preferred for assessing the
inflammatory valve process of cardiac valve
stenosis(Lang 2011).
• 3DE has shown conclusively that valve shape
is an important determent of pressure loss in
patients with aortic stenosis(Lang, 2011).

11. Endocarditis.
• 3D TEE has come to the forefront in recent
years in the assessment of endocarditis.
• 3D TEE provides superior imaging planes to
examine valves from all directions.
• Dr.Roberto Lang today continues to strongly
advocate for its expanded use in assessing
vavlular heart disease.

12. Echo in HTN and renal failure .
• Echo plays a huge role in the assessment of
pulmonary htn. Echo is often used to calculate
RVSP and is vital in trying to reduce blood
pressure for cardiologists.
• Quantification of TR by 3D echo color Doppler
is feasible and 3D measurements of VC have
shown great correlation with traditional 2d
echo(Lang 2008).

13. Renal failure.
• Echo also plays a role in assessing both renal
failure and liver failure. The main role is to
assess overall left ventricle function and try to
manage the patients overall hemodynamic
load.
• Cardiac output is vital to assess in these
patients.

14. Myocardial infarction.
• Echo plays a large role in the assessment of
myocardial infarction. Echo plays a role in
trying to keep health costs down by being the
most cost effective method to assess CVD.
• A interesting fact is since 1996 overall
spending on CVD has grown at compound
annual rate 5.7%(Miller ,2011 ).

15. References.
• 1.Yared,Kibar.Baggish,Aaron.Picard,Michael.H
ung,Judy.2010.Multimodality Imaging of
Pericardial Diseases. JACC imaging.3(6)650-
660.
• 2.Miller,George.2011.National Spending on
Cardiovascular Disease.JACC.58.2017 -2019.

16. References.
• 3.Lang,Roberto.Vavular Heart Disease.2011.
JACC 58. 1933-1944.