Textbook of Echocardiography for Intensivists and Emergency Physicians, 2nd ed

Abstract

More than ever, echocardiography has become an important diagnostic and monitoring tool for physicians in various specialties. Critically ill patients in the intensive care unit (ICU) and emergency room are routinely being evaluated by focused ultrasound examination to assist clinicians with medical decisions. This broader application of echocardiography requires educational resources that focus on relevant information for the clinician. The Textbook of Echocardiography for Intensivists and Emergency Physicians, second edition, provides a broad review of the fundamentals of bedside echocardiography and ultrasound for rapid assessment and diagnosis. The second edition of the popular first textbook is completely revised, with additional illustrations, tables, figures, and 10 entirely new chapters. This edition begins with fundamentals and the standard echocardiographic examination, followed by cardiac/vascular/valvular anatomy and ultrasound. There are several sections dedicated to the application of echocardiography for specific disease states, such as myocardial ischemia, making it easier to browse the text for patient care. Most chapters begin with key points and conclude with suggestions for further reading. Although some chapters reference other textbooks for suggested reading, there are several primary resource papers highlighted. The textbook is divided into 5 parts, with the first section providing a brief overview of ultrasound physics. The second section focuses on patient and probe positioning for transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). In this section, there is a concise table listing the standard views, landmarks, and angling of the probe required to achieve the views. Recognizing that ICU patients have unique challenges to performing a TTE examination, there is a chapter dedicated to showing how to optimize views in patients who may be difficult to examine. A practical section on “utilizing echocardiographic indexes that are less dependent on image quality” has also been added. Applications of 3-dimensional echocardiography and speckle tracking are also discussed in one chapter; however, the emphasis throughout the textbook is on 2-dimensional echocardiography. Section 3 is dedicated to functional anatomy, with a discussion on diastolic dysfunction, tissue Doppler imaging, and valvular and ventricular function. Within this section, echocardiographic findings and concepts are discussed as they pertain to patient care. Compared with other current texts on echocardiography, Section IV proves to be unique in that each chapter focuses on echocardiography and ultrasound by specific disease states. The supplementary section V covers essential topics for intensive care professionals, such as ultrasound for venous thrombosis, lung and pleura, percutaneous tracheostomy, transcranial Doppler, and regional analgesia. This textbook serves as a useful study guide for critical care physicians interested in competency and certification in echocardiography. It covers specific content for the new Examination of Special Competence in Critical Care Echocardiography, such as dynamic evaluation of hemodynamics, whole body ultrasonography, diagnosis of disease, and placement of central/peripheral lines. The book could be improved by the addition of chapters focusing on extracorporeal membrane oxygenation and ventricular assist devices. Online video content on TTE and ultrasonography techniques would be valuable additions as well. There is some overlap and repetition of concepts and content between chapters; however, that allows the reader to access the chapters independently without referring to previous chapters. Authors throughout the text have a varied style of writing, with different levels of complexity in describing the concepts. The progression of the content throughout the textbook is easy to follow, and in many cases, difficult ideas are simplified. The corresponding illustrations are not necessarily unique; in fact, similar examples can be found in other textbooks, but they are on point and correspond nicely to the content. An electronic version is also available, and proves to be easy to navigate and search. The editors have managed to capture the essence of echocardiography as it applies to the diagnostic care for critically ill patients. This textbook is a great reference for physicians looking to incorporate echocardiography and ultrasound into routine practice for patient management, but it is not comprehensive and not an essential buy. As a practicing cardiac anesthesiologist in academic medicine, I would buy this book as a teaching adjunct for fellows and residents. This textbook helps to bridge the gap between diagnostic echocardiography and pragmatic clinical care. Richa Dhawan, MD, MPHMark Chaney, MDDepartment of Anesthesia and Critical CareUniversity of Chicago HospitalsChicago, Illinois[email protected]