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Relatório de estágio em ultrassonografia cardíaca
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Introdução: O ecocardiograma transtorácico de repouso é o meio complementar de diagnóstico de imagem mais utilizado na prática clínica em cardiologia. Para além de permitir uma avaliação morfológica e funcional do coração, avalia também a sua hemodinâmica de forma não invasiva. Por vezes, pode ser necessário recorrer a outras modalidades ecocardiográficas, como o ecocardiograma transesofágico e ecocardiograma transtorácico de sobrecarga, destinadas a indicações clínicas mais específicas.
Objetivos: Realização de estágio na área de ultrassonografia cardíaca, no âmbito do Mestrado em Fisiologia Clínica, na Unidade Local de Saúde de Matosinhos – Hospital Pedro Hispano, E.P.E.
Métodos: Análise estatística descritiva de variáveis demográficas e ecocardiográficas e exposição de dois casos clínicos de interesse abordados no período de estágio, durante o normal funcionamento do laboratório de ecocardiografia.
Resultados: Num total de 382 exames de ecocardiografia, 349 corresponderam a ecocardiogramas transtorácicos de repouso, 23 a ecocardiogramas transesofágicos e 10 a ecocardiogramas transtorácicos de sobrecarga. Foram também analisados dois casos clínicos de interesse: o primeiro caso clínico aborda um paciente com doença coronária isquémica conhecida, que realiza ecocardiograma de sobrecarga para estratificação de risco após enfarte agudo do miocárdio do tipo 2; o segundo caso clínico aborda um paciente com diagnóstico de miocardiopatia hipertrófica que realizou um ecocardiograma transtorácico de repouso para cálculo de score de risco de morte súbita cardíaca e, posteriormente, um ecocardiograma transesofágico por endocardite infeciosa de prótese valvular em posição mitral.
Conclusões: O ecocardiograma possibilita, por diversos motivos clínicos, sejam eles motivados por patologias cardíacas e/ou sistémicas, a recolha de uma variedade de dados de forma rápida, por vezes com a necessidade de recorrer a técnicas mais avançadas. Assim, é considerado como um meio complementar de diagnóstico de imagem de primeira linha na estratificação de risco, auxílio e tomada de decisão terapêutica.
Introduction: Transthoracic echocardiography is the most widely used complementary imaging diagnostic method in clinical practice. In addition to providing a morphological and functional assessment of the heart, it also assesses its hemodynamics noninvasively. Occasionally, it may be necessary to use other echocardiographic modalities, such as transesophageal echocardiography and stress echocardiography, for more specific clinical reasons. Objectives: Internship in cardiac ultrasound, within the scope of the master’s degree in Clinical Physiology, at the Matosinhos Local Health Unit – Hospital Pedro Hispano, E.P.E. Methods: Descriptive statistical analysis of demographic and echocardiographic variables and presentation of two clinical cases of interest addressed during the internship period in the normal operation of the echocardiography laboratory. Results: A total of 382 echocardiography exams were performed, 349 were resting transthoracic echocardiograms, 23 were transesophageal echocardiograms and 10 were stress transthoracic echocardiograms. Two clinical cases of interest were analyzed: the first clinical case involves a patient with known ischemic coronary disease who underwent stress echocardiography for risk stratification after a type 2 acute myocardial infarction; the second clinical case involves a patient diagnosed with hypertrophic cardiomyopathy who underwent a resting transthoracic echocardiography to calculate a sudden cardiac death risk score and, subsequently, a transesophageal echocardiogram for infective endocarditis of a mitral prosthetic valve. Conclusions: For various clinical reasons, whether caused by cardiac and/or systemic pathologies, echocardiography can quickly detect a wide range of information, sometimes using advanced techniques. This makes it a first-line complementary imaging diagnostic tool for risk stratification, assistance, and faster therapeutic decision-making.
Introduction: Transthoracic echocardiography is the most widely used complementary imaging diagnostic method in clinical practice. In addition to providing a morphological and functional assessment of the heart, it also assesses its hemodynamics noninvasively. Occasionally, it may be necessary to use other echocardiographic modalities, such as transesophageal echocardiography and stress echocardiography, for more specific clinical reasons. Objectives: Internship in cardiac ultrasound, within the scope of the master’s degree in Clinical Physiology, at the Matosinhos Local Health Unit – Hospital Pedro Hispano, E.P.E. Methods: Descriptive statistical analysis of demographic and echocardiographic variables and presentation of two clinical cases of interest addressed during the internship period in the normal operation of the echocardiography laboratory. Results: A total of 382 echocardiography exams were performed, 349 were resting transthoracic echocardiograms, 23 were transesophageal echocardiograms and 10 were stress transthoracic echocardiograms. Two clinical cases of interest were analyzed: the first clinical case involves a patient with known ischemic coronary disease who underwent stress echocardiography for risk stratification after a type 2 acute myocardial infarction; the second clinical case involves a patient diagnosed with hypertrophic cardiomyopathy who underwent a resting transthoracic echocardiography to calculate a sudden cardiac death risk score and, subsequently, a transesophageal echocardiogram for infective endocarditis of a mitral prosthetic valve. Conclusions: For various clinical reasons, whether caused by cardiac and/or systemic pathologies, echocardiography can quickly detect a wide range of information, sometimes using advanced techniques. This makes it a first-line complementary imaging diagnostic tool for risk stratification, assistance, and faster therapeutic decision-making.
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Ultrassonografia cardíaca ecocardiografia diagnóstico cardiologia Cardiac ultrasound echocardiography diagnosis cardiology