ECHO SCREENING CLINICAL SESSION RHD Education Workshop 2017 Role of echo in rhd SCREENING TO IDENTIFY PRECLINICAL DISEASE ASSESS VALVE MORPHOLOGY ASSESS DEGREE OF STENOSIS SEVERITY OF REGURGITATION ID: 1031314
Download Presentation The PPT/PDF document "Michael Cursaro – Royal Adelaide Hospi..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1. Michael Cursaro – Royal Adelaide HospitalECHO SCREENING CLINICAL SESSIONRHD Education Workshop 2017:
2. Role of echo in rhdSCREENING TO IDENTIFY PRE-CLINICAL DISEASEASSESS VALVE MORPHOLOGYASSESS DEGREE OF STENOSIS SEVERITY OF REGURGITATIONDETERMINE SUITABILITY FOR VALVULOPLASTYASSIST IN TIMING OF SURGERYMONITOR COMPLICATIONS (such as pulmonary hypertension, thrombus, etc)
3. Screening for rhd:“HAND offers a significant improvement over auscultation forthe diagnosis of RHD…”“Sensitivity and positive predictive value of cardiac auscultation compared with echocardiography is poor…More than 50% of children with abnormal echocardiographyresults did not have a murmur detected, and more than 90% of murmurs heard were false positives.”
4. Screening for rhd:Who to screen?What age?How often?SACRHD (South Australian Rheumatic Heart Disease) PROJECTTargeted echo screening using portable equipmentAPY Lands, Port Augusta, Port Pirie, Coober Pedy, Ceduna and Metropolitan areas1808 Aboriginal children Children identified with a heart condition (Rheumatic and Congenital) were referred for further investigation/treatment.
5. Screening in apy lands
6. Screening in apy landsScreened 292 school children at 8 community schools from Pipalyatjara to Iwantja
7. rhd vS normal echo*Mitral stenosis +/- regurgitation – most common ++Aortic valve involvementTricuspid valve involvement
8. rhd vS normal echo
9. Screening protocolSettings: Harmonics OFFOur protocol included additional images to exclude common CHD.
10. Criteria: definite vs borderline
11. Criteria: definite vs borderline
12. Criteria: definite vs borderline
13. When mitral stenosis present:measure mitral valve area2D/3D PlanimetryDoppler(Only 2D data available in echo screening)
14. When mitral stenosis present:measure mean gradient and pressure half time
15. Measure:Ejection fractionLA volumePulmonary artery pressure
16. LIVE ECHO