Sharek Abdul Nazir, Subrata Kumar Singha, Anil Gupta, Gade Sandeep, T C Arun
{"title":"Intraoperative Transesophageal Echocardiographic Detection of Interatrial Septal Band in Ostium Secundum Atrial Septal Defect with Deficient Rims: A Clinical Image.","authors":"Sharek Abdul Nazir, Subrata Kumar Singha, Anil Gupta, Gade Sandeep, T C Arun","doi":"10.4103/jcecho.jcecho_77_25","DOIUrl":"10.4103/jcecho.jcecho_77_25","url":null,"abstract":"<p><p>Ostium secundum atrial septal defect (ASD) is the most common form of interatrial shunt, and its management depends on defect size, shunt direction, and adequacy of surrounding rims. Device closure is not feasible when inferior vena cava (IVC) or posterior rims are deficient, and such cases require surgical repair. We describe a 19-year-old female with a 28 mm ostium secundum ASD, deficient IVC and posterior rims, and right heart chamber dilation who was scheduled for minimally invasive surgical closure. Intraoperative transesophageal echocardiography (TEE) revealed a linear band within the left atrium adjacent to the deficient septum. Surgical inspection confirmed an interatrial band traversing the defect from the coronary sinus to the superior vena cava. Partial excision of the band was carried out along with ASD repair. The postoperative recovery was uneventful, with no arrhythmias or conduction disturbances, and the patient was discharged in stable condition. This case underscores the value of intraoperative TEE in delineating both expected anatomy and rare anomalies such as interatrial septal bands, which may influence surgical planning and outcomes.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 4","pages":"400-402"},"PeriodicalIF":1.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Giacomo Ingallina, Antonella Moreo, Paola Enrica Colombo, Francesca Casadei, Francesca Spanò, Oriana Belli, Riccardo Colombi, Leone Giovanni Musci, Matteo Cameli, Maurizio Cusmà-Piccione, Antonio De Luca, Roberta Manganaro, Eustachio Agricola
{"title":"Radioprotection for Interventional Echocardiographers: A Consensus Statement of the Italian Society of Echocardiography and Cardiovascular Imaging.","authors":"Giacomo Ingallina, Antonella Moreo, Paola Enrica Colombo, Francesca Casadei, Francesca Spanò, Oriana Belli, Riccardo Colombi, Leone Giovanni Musci, Matteo Cameli, Maurizio Cusmà-Piccione, Antonio De Luca, Roberta Manganaro, Eustachio Agricola","doi":"10.4103/jcecho.jcecho_140_25","DOIUrl":"10.4103/jcecho.jcecho_140_25","url":null,"abstract":"<p><p>The interventional echocardiographer (IE) plays a crucial role in structural heart interventions, yet faces significant risks from ionizing radiation, often greater than those encountered by the primary interventional cardiologist (IC). This elevated exposure is due to the IE's close proximity to the patient's head and, consequently, to the X-ray source, combined with a general lack of dedicated protective equipment designed for their position. Despite growing awareness of radiation safety in the catheterization lab, the specific protection needs of IEs remain under-recognized. Recent studies have shown that IEs can receive up to 11 times more radiation than ICs during procedures guided by transesophageal echocardiography (TEE), such as transcatheter edge-to-edge repair or left atrial appendage closure. These findings, together with the recent reduction in recommended dose thresholds for deterministic effects like cataract formation, emphasize the urgent need to implement effective protective measures. Radiation exposure can be significantly reduced by following the core principles of radiation safety: time, distance, and shielding. Key strategies include optimizing the IE's position based on expected fluoroscopic projections, using dedicated mobile or ceiling-mounted shields, adopting lightweight personal protective equipment, and encouraging the use of low-dose imaging protocols. Ongoing education and training, targeted not only at IEs but also at ICs, is essential to reinforce safe practices and promote a culture of radiation awareness. Technological innovations offer promising solutions. New shielding systems like the Eggnest® and Rampart<sup>®</sup> have demonstrated effective protection for staff near the patient's head. Disposable radiation-reducing drapes and the development of robotic systems for remote TEE manipulation may further enhance safety without compromising workflow or image quality. Advances in imaging hardware and software also support dose reduction without sacrificing clinical effectiveness. Finally, computational dosimetry methods may soon allow for more accurate and individualized exposure monitoring, overcoming the limitations of conventional dosimeters. In summary, improving radiation protection for IE must become a priority. A combination of strategies is necessary to ensure long-term safety and sustainability in this rapidly evolving field.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 4","pages":"427-433"},"PeriodicalIF":1.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Concetta Pastore, Elvira Delcuratolo, Riccardo Agostini, Francesco Becherini, Elisa Cerone, Elisabetta Corsi, Maria Grazia D'Alfonso, Iacopo Fabiani, Giosuè Falcetta, Lorenzo Nesti, Marco Solari, Matteo Cameli, Valentina Barletta
{"title":"The Role of Cardiac Imaging for the Evaluation of Primary and Secondary Mitral Regurgitation: From Milestones to Novelties.","authors":"Maria Concetta Pastore, Elvira Delcuratolo, Riccardo Agostini, Francesco Becherini, Elisa Cerone, Elisabetta Corsi, Maria Grazia D'Alfonso, Iacopo Fabiani, Giosuè Falcetta, Lorenzo Nesti, Marco Solari, Matteo Cameli, Valentina Barletta","doi":"10.4103/jcecho.jcecho_21_25","DOIUrl":"10.4103/jcecho.jcecho_21_25","url":null,"abstract":"<p><p>Mitral regurgitation (MR) is the second most prevalent valvular heart disease, classified as primary (degenerative) or secondary (functional) based on its underlying etiology. Accurate assessment of MR severity, mechanism, and prognosis is crucial for guiding therapeutic decision-making, including surgical and transcatheter interventions. Cardiac imaging plays a pivotal role in this evaluation, wherein transthoracic and transesophageal echocardiography is considered the first-line modality. Advancements in three-dimensional echocardiography and cardiac magnetic resonance imaging allowed to refine the quantification and characterization of MR, enhancing diagnostic accuracy and risk stratification. This review aims to provide an overview of multimodal cardiac imaging and the most relevant parameters to assess MR, highlighting key milestones, novel techniques, and their implications in clinical practice.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 3","pages":"199-208"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hypertensive Response During Dobutamine Stress Echocardiography: Does it Indicate a Higher Risk of Developing Hypertension?","authors":"Hedieh Alimi, Amirhossein Mirzaei, Maryam Soleimani Farzaghi, Vafa Baradaran Rahimi","doi":"10.4103/jcecho.jcecho_16_25","DOIUrl":"10.4103/jcecho.jcecho_16_25","url":null,"abstract":"<p><strong>Background: </strong>One of the most common complications associated with dobutamine stress echocardiography (DSE) is abnormal blood pressure (BP) responses.</p><p><strong>Aims and objectives: </strong>The current investigation aimed to examine the blood pressure responses during DSE and its potential implications on cardiovascular outcomes.</p><p><strong>Methods: </strong>The study enrolled patients who lacked a history of hypertension and diabetes but demonstrated hypertensive response during DSE (<i>n</i> = 62). An equal number of patients who did not exhibit an increase in BP during the DSE were selected as the control group (<i>n</i> = 55). Throughout the 4-year clinical follow-up, we monitored the incidence of hypertension, myocardial infarction (MI), hospitalization due to heart disease, death, and stroke.</p><p><strong>Results: </strong>Among those who demonstrated a hypertensive response during DSE, baseline systolic BP (<i>P</i> = 0.002) and diastolic BP (<i>P</i> = 0.002) were notably higher compared to the nonhypertensive group. In addition, the hypertensive group received a significantly elevated dosage of dobutamine in comparison to the controls (<i>P</i> = 0.010). However, no statistically significant variances were observed between the two groups concerning death (<i>P</i> = 0.600), acute MI (<i>P</i> > 0.999), chronic hypertension (<i>P</i> = 0.063), diabetes mellitus (<i>P</i> = 0.513), and hospitalization (<i>P</i> = 0.472).</p><p><strong>Conclusion: </strong>In light of our findings, hypertensive responses in patients undergoing DSE do not correlate with subsequent adverse outcomes. While our investigation did not identify a statistically significant difference in hypertension rates, it is essential to note that significance may be achieved with future research involving a larger sample size.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 3","pages":"264-270"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Multidisciplinary Role of Echocardiography: From the Thrombus in Inferior Vena Cava to the Diagnosis of Renal Cell Carcinoma.","authors":"Elif Vraynko, Valentina Andova, Gjulsen Selim, Ljubica Georgievska-Ismail","doi":"10.4103/jcecho.jcecho_101_24","DOIUrl":"10.4103/jcecho.jcecho_101_24","url":null,"abstract":"<p><p>Clear renal cell carcinoma (RCC) represents the most prevalent type of kidney cancer, with a tendency for venous migration and extension into the inferior vena cava (IVC) in 4%-10% of the cases. Herein, we present a case report of a patient with acute coronary syndrome and an incidental echocardiographic finding of a thrombus in the IVC, which contributed to the diagnosis of the RCC. A 67-year-old male patient was transferred to our clinic with high troponin levels and electrocardiogram changes suggestive of myocardial ischemia. Coronary angiography revealed occlusion of the right coronary artery and left anterior descending with normal flow through the graft. During the two-dimensional transthoracic echocardiographic examination, in the subcostal view, a thrombotic formation in the IVC was observed. A computed tomography of the abdomen showed an oval mass on the upper pole of the left kidney. The patient underwent an open radical nephrectomy. Pathological examination confirmed the diagnosis of clear RCC. The patient consulted the oncology department, where no specific oncological therapy was indicated. After a 2-year follow-up, ultrasound of the abdomen was normal, without relapse or metastatic dissemination of the RCC. Detailed echocardiographic assessment can reveal pathological changes even in the surrounding structures, which helps in the timely diagnosis and initiation of treatment in the early stages of the disease.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 3","pages":"285-288"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vitorino Modesto Dos Santos, Taciana Arruda Modesto Sugai, Kin Modesto Sugai, Vitor Ruas Domingues Arruda Modesto
{"title":"Comment on Lipomatous Hypertrophy of the Atrial Septum.","authors":"Vitorino Modesto Dos Santos, Taciana Arruda Modesto Sugai, Kin Modesto Sugai, Vitor Ruas Domingues Arruda Modesto","doi":"10.4103/jcecho.jcecho_29_25","DOIUrl":"10.4103/jcecho.jcecho_29_25","url":null,"abstract":"","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 3","pages":"301-302"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nondilated Pulmonary Artery on Transthoracic Echocardiography as a Novel Sign of Acute Pulmonary Thromboembolism.","authors":"Satish Rameshrao Chirde, Narendra Prabhakar Bachewar, Amar Shravan Wani, Neha Satish Chirde","doi":"10.4103/jcecho.jcecho_22_25","DOIUrl":"10.4103/jcecho.jcecho_22_25","url":null,"abstract":"<p><strong>Context: </strong>Although computed tomography pulmonary angiography (CTPA) can confirm a diagnosis of acute pulmonary thromboembolism (PTE), its use may not be feasible in hemodynamically unstable patients. Transthoracic echocardiography (TTE) is useful to diagnose such cases but lacks specific, easily identifiable signs for differentiating acute PTE from other causes of right heart strain.</p><p><strong>Aims: </strong>We investigated the effectiveness of the \"SRC\" sign, a nondilated main pulmonary artery with a dilated right atrium (RA) and right ventricle (RV), for diagnosing acute PTE.</p><p><strong>Settings and design: </strong>This was an observational, retrospective, single-center study.</p><p><strong>Subjects and methods: </strong>Patients with acute dyspnea and dilated RA and RV, with or without dilated pulmonary artery (PA), and those suspected of PTE according to the Wells criteria were included. Blood tests, electrocardiography, and CTPA were performed to confirm PTE diagnosis. Patients were divided into a nondilated PA and dilated RA and RV group and a dilated PA, RA, and RV group.</p><p><strong>Statistical analysis used: </strong>Chi-square test with Yates's correction was used for statistical analysis.</p><p><strong>Results: </strong>Forty-one patients (27 men) with suspected PTE were included, with 36 showing a dilated RA and RV on echocardiography. The SRC sign was present in 22 patients, all of whom were confirmed via CTPA to have acute PTE. The SRC sign demonstrated 100% specificity, 100% positive predictive value, and 92.86% negative predictive value.</p><p><strong>Conclusions: </strong>TTE is valuable for assessing patients with acute dyspnea. Although RA and RV dilatation may indicate acute PTE, they are insufficient for diagnosis confirmation. The SRC sign shows high specificity for major acute PTE and may aid in decision-making.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 3","pages":"271-276"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Preventing Sudden Cardiac Death among Athletes Using Echocardiography.","authors":"Saurabh RamBihariLal Shrivastava, Prateek Sudhakar Bobhate, Khalid Khan","doi":"10.4103/jcecho.jcecho_37_25","DOIUrl":"10.4103/jcecho.jcecho_37_25","url":null,"abstract":"","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 3","pages":"303-304"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chandrakant M Bokade, Nisha R Aglave, Milind M Suryawanshi
{"title":"Cardiac Rhabdomyoma in a Neonate.","authors":"Chandrakant M Bokade, Nisha R Aglave, Milind M Suryawanshi","doi":"10.4103/jcecho.jcecho_5_25","DOIUrl":"10.4103/jcecho.jcecho_5_25","url":null,"abstract":"<p><p>Tuberous sclerosis complex has an autosomal dominant pattern of inheritance. Hamartomas are seen in various organs in tuberous sclerosis. Tuberous sclerosis is linked to cardiac rhabdomyomas, which is one of the common heart tumors in children. We present a full-term neonate who was suspected to have the congenital disease due to the presence of pansystolic murmur on examination. Echocardiography revealed multiple rhabdomyomas in the right ventricular (RV) and LV wall and interventricular septum of varying sizes and shapes. The largest rhabdomyoma arising from the lateral wall of RV measuring 16 mm × 18 mm. There was 6 mm × 8 mm rhabdomyoma protruding in the left ventricular outflow tract in nonobstructive manner. There was no inflow or outflow obstruction. Small apical muscular ventricular septal defect noted. Mother had numerous papulonodular lesions on both cheeks, nose, and forehead (adenoma sebaceum). No other neurocutaneous markers were present. Mother had no systemic involvement. In babies born to mothers with suspected tuberous sclerosis, a high degree of suspicion is required to rule out cardiac tumors.</p>","PeriodicalId":15191,"journal":{"name":"Journal of Cardiovascular Echography","volume":"35 3","pages":"289-291"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12530716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}