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Echocardiographic Assessment of Coronary Blood Flow

  • Jarosław D. KasprzakEmail author
  • Piotr Lipiec
  • Karina Wierzbowska-Drabik
Chapter

Abstract

Echocardiography of coronary arteries is challenging, however current high–end systems offer sufficient quality for several clinically relevant applications of the method. Transesophageal echocardiography allows the imaging of proximal coronary arteries with high quality and power to detect stenotic flow. Transthoracic imaging of coronary ostia is feasible to define anomalous coronary arteries and other congenital abnormalities. This approach is also used for recording of distal coronary flow at rest and during vasodilator administration to calculate coronary flow reserve. Transthoracic detection of coronary stenosis is strongly dependent on acoustic window but is very specific based on the finding localized high velocity diastolic flow.

Keywords

Coronary arteries imaging Coronary flow reserve Anomalous coronary arteries 

Abbreviations

2-D

Two-dimensional

CFR

Coronary flow reserve

CFVR

Coronary flow velocity reserve

CX

Circumflex branch of the left coronary artery

LCA

Right coronary artery

LMCA

Left main coronary artery

RCA

Right coronary artery

TEE

Transesophageal echocardiography

TTE

Transthoracic echocardiography

Supplementary material

Video 26.1

Left main coronary artery coursing right-ward with bifurcation site visualized in high esophageal short axis view from trans esophageal window—normal laminar flow. Origin of circumflex branch shown with arrow (AVI 303 kb)

Video 26.2

Proximal right coronary artery seen in trans esophageal echocardiogram. Laminar flow is seen coded in blue (AVI 303 kb)

Video 26.3

Transthoracic imaging of proximal coronary arteries—right coronary artery and proximal left coronary artery seen in long axis parasternal view and short axis parasternal view (AVI 862 kb)

Video 26.4

Left anterior descending artery stenosis demonstrated from the five-chamber transthoracic view (AVI 839 kb)

Video 26.5

Anomalous circumflex originating from the right sinus of Valsalva with retro-aortric course, shown between aortic root and the left atrium in modified (caudal tilt) apical four chamber view and parasternal long axis view (AVI 671 kb)

Video 26.6

Small fistula (arrow) connecting the left coronary artery with pulmonary trunk, 1 cm above the pulmonary regurgitation (seen as a yellow-red retrograde flow)—imaging from short axis parasternal window (AVI 481 kb)

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Jarosław D. Kasprzak
    • 1
    Email author
  • Piotr Lipiec
    • 1
  • Karina Wierzbowska-Drabik
    • 1
  1. 1.Department of CardiologyMedical University of LodzLodzPoland

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