Echo-of-the-Day

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AMA Category 1 Credit for Physicians Only.
ASRT CME is not available.

Echo-of-the-Day Information

The Case-of-the-Week is a presentation of 8 or more video loops to present an important topic in echocardiography. Please reveiw the image or video loops and then answer the questions below. After you have answered the questions you can view the explanation and obtain CME credit (if available).

You can change the size and the format of the image or video loops by using the links below the image or video loop.

= Windows Media Video	= MP4 Video
= QuickTime	= WebM Video
= Flash	= Ogg Video
= JPG Image	= GIF Image
Image/Video Sizes
1X = 200x150 pixels 2X = 400x300 pixels	3X = 600x450 pixels 4X = 800x600 pixels

Loop Text Key
Preop	Preop TEE or TTE
Intraop	An Intraop TEE
IntraopPreOp	Intraop TEE or TTE before Operation
IntraopPostOp	Intraop TEE or TTE after Operation
IntraopEnd	Intraop TEE or TTE at End of Anesthesia
Post Op	Postop TEE or TTE
	= Legacy/Old Video Formats

Case of the Month Information Table

IntraopEnd is usually a TEE after the Operation and after some event occured to show a change in the TEE

Heart feels flat.

Case#: 205

AMA CME Units: 0.25 Units
Estimated Time: 15 minutes.

Presentation:
A patient presented with the following echo loop:

Loop(s):

Case Discussion

The septum is flattening during diastole and is maximal at the end of diastole. Ventricular septal flattening can occur with right ventricular overload (ie. TR) where the ventricular septum flattening is maximal at the end of diastole. Diastolic septal flattening can occur with ASD and VSD repairs. Diastolic septal flattening can also occur with constrictive pericarditis. Diastolic septal flattening can also occur in primary pulmonary hypertension, although it is preceded by systolic flattening (paradoxial septal motion) and the diastolic septal flattening occurs only in early diastole.

CME Section

Please answer the following questions correctly to obtain your CME.

Web Links/References

Clinically Suspected Constrictive Pericarditis: MR Imaging Assessment of Ventricular Septal Motion and Configuration in Patients and Healthy Subjects1
Echocardiographic analysis of ventricular geometry and function during repair of congenital septal defects
Right Ventricular Overload and the Ventricular Septum
Comparison of interventricular septal motion studied by ventriculography and echocardiography in patients with atrial septal defect.
Ebstein anomaly of the tricuspid valve
atrial septal defect
and severe right ventricular dysfunction in an adult: transesophageal echocardiographic images.
Echocardiographic Predictors of an Adverse Response to a Nifedipine Trial in Primary Pulmonary Hypertension* Diminished Left Ventricular Size and Leftward Ventricular Septal Bowing

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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of University of Nebraska Medical Center, Center for Continuing Education and JLS Interactive, LLC.

The University of Nebraska Medical Center, Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This activity is approved by the American Society of Radiologic Technologists (ASRT) as sonography-related continuing education (CE). Credit(s) issued for successful completion of ASRT-approved CE activities are accepted by the American Registry of Diagnostic Medical Sonography, American Registry of Radiological Technologists, Cardiovascular Credentialing International and Canadian Association of Registered Diagnostic Ultrasound Professionals. Contact the applicable registry for additional information / restrictions on their acceptance of ASRT CE credit.