Chapter 14

» Video 14-1
» Video 14-2
» Video 14-3
» Video 14-4
» Video 14-5
» Video 14-6
» Video 14-7
» Video 14-8
» Video 14-9

Video 14-1. Parasternal long-axis (PLAX) view of severe Dilative CMP (DCMP). Note left ventricular (LV) dilatation, increase separation of the anterior leaflet of the mitral valve and interventricular septum and presence of the spontaneous LV contrast (poor prognostic sign). Small pericardial effusion is present and is not uncommon with DCMP.

Video 14-2. Apical four-chamber view of severe DCMP note increased LV diastolic volume (LVDV) and poor LV ejection fraction (LVEF). LVEF can be determined by biplane Simpson’s method LVEF% = (LVDV - LVSV):LVEDV ' 100. Spontaneous LV contrast is again noted and so is poor separation of the mitral valve leaflets during diastole (likely due to increase LV diastolic pressure).

Video 14-3. Parasternal long-axis (PLAX) view of the patient with hypertrophic CMP/HOCM. Note increased thickness of the interventricular septum and small LVEDV. CMP, cardiomyopathy.

Video 14-4. Patient with hypertrophic CMP/HOCM. Position of the transducer is Apical 4 chamber view but it seems to be tilted some upwards. Note thick interventricular septum, elongated anterior (left on the screen) leaflet of the mitral valve with anterior motion during systole (SAM). CMP, cardiomyopathy; SAM, systolic anterior motion.

Video 14-5. Patient with hypertrophic CMP/HOCM. Apical three-chamber (long-axis) view and obvious SAM of the anterior leaflet of the mitral valve with LV outflow obstruction visualized. Note thick interventricular septum, elongated anterior (right on the screen towards the noncoronary cusp of the aortic valve) leaflet of the mitral valve. Also note during systole (when aortic valve is opened) anterior leaflet of the mitral valve is moving forward, touching thickened interventricular septum (SAM), which result in additional outflow obstruction. CMP, cardiomyopathy; SAM, systolic anterior motion

Video 14-6. Patient with restrictive CMP due to amyloidosis. Parasternal long-axis (PLAX) view. Note thick interventricular septum and inferior wall of the LV with shimmering speckled pattern of the myocardium specific of this illness. Small pericardial effusion and dilated coronary sinus (due to increased right ventricular pressure) are also visible and common for restrictive CMP. Restrictive diastolic filling result in exceedingly low LVDV, and thus stroke volume and cardiac output, with normal or elevated LVEF. CMP, cardiomyopathy; LVDV, LV diastolic volume; LVEF, LV ejection fraction.

Video 14-7. Patient with restrictive CMP due to Amyloidosis. Parasternal short-axis (PSAX) view. Note thick interventricular septum all wall segments of the free LV with shimmering speckled pattern of the myocardium specific of this illness. Anterolateral papillary muscle is clearly visible secondary to its increased thickness. Hemodynamic consequences of this are obvious and described in 14.6. Pericardial effusion is again present, best visible on the bottom of the screen adjacent to the inferior wall (due to accumulation in the dependent position). CMP, cardiomyopathy.

Video 14-8. Apical four-chamber view of the patient with apical ballooning (Takotsubo) syndrome. Note classical apical (dyskinesis) ballooning with preservation or even hyperkinesis of other ventricular segments.

Video 14-9. Computerized tomography angiogram (CTA) of the patient with apical ballooning (Takotsubo) syndrome. Note classical apical ballooning with preservation of other ventricular segments. Also of great importance the lack of the coronary artery disease with widely patent coronary arteries (note), since left anterior descending artery occlusion will result in similar echocardiographic and CTA picture and should be ruled out.