Posted in Cardiology -Interventional -PCI, cardiology- coronary care, cardiology-Anatomy, Cardiology-Coronary artery disese, Echo library and gallery, echocardiography, great illustrations in cardiology, tagged left main by echo tte, left main coroanry artery, left main ostium, rare echocardiogram images on January 23, 2013| Leave a Comment »
If only . . . we get an image like this , echo can help rule out most left main disease with conviction .
Have a close look at it ! One can get a good image of coronary ostia in short axis view . But , here it is well visualized in long axis .
I tried to put color flow within left main .
What about pulsed Doppler across left main ?
After all it needs 2mm sample volume and this left main was near 4.5mm . So keep trying !
Posted in Cardiology - Clinical, cardiology -Therapeutics, echocardiography, Tutorial in clinical cardiology, tagged aortic cusps, coroanry ostium, coroanry sinus, coronary, coronary artery, coronary artery origin, echocardiography, lcc, left main coroanry artery, left main disease, lmd, ncc, non coronary cusp, rcc, right coroanry cusp, short axis in echocardiography on February 9, 2010| 1 Comment »
Imaging coroanry artery is generally in the domain of interventional cardiologists. MDCT has helped us to change that.
The humble echocardiography can identify the origin* of coronary arteries in most persons. The resolution power of modern day echocardiography is 2mm and the left main ostium is >3.5mm in 99% of population . If some body says one can’t visualise the coronary artery by echo , it can only reflect their ignorance or lack of patience to get an optimal image. Of course technological limitations are there.
* To be emphasised again , only the origin can be identified.
Can we identify ostial leftmain or proximal left main disease by echocardiography ?
It should be possible in few .
Can we place a doppler sample volume within the left main and measure coronary flow velocity ?
When obsterticians are able to assess the uterine artery flow in a bulky uterus , it should be possible to do the same in a coronary artery . Motion artifacts is the issue in the heart. Micro sample voulme (<1mm) are expected in the future that will make a non invasive coronary flow assesment a distinct possibility.
Dr.S.Venkatesan MD 