Echocardiography

General Goals: The goal of the echo lab rotation is to develop competence in the performance and interpretation of all the different modalities of echocardiography. This should be achieved in a logical step-wise approach of increasing complexity and depth of knowledge. This specific curriculum outlines the hands-on training requirements and the cognitive skills required, citing reading sources for achieving this knowledge. A clear reading curriculum is outlined for the fellows to follow and to be supplemented by attending Cardiologists as pertinent cases arise. This rotation, with others, also will serve to allow the fellow to achieve competence in stress testing procedures. Core training involves 3-4 months in the MMC echo lab. As an elective (additional months in the 2nd or 3rd year), the goal of these rotations is to achieve level 2 or 3 competency in echocardiography.

Objectives:

First and Second Year Core 3 Month Requirement:

Transthoracic echocardiography

  • Understand the physics involved in image acquisition and blood velocity measurement.
  • Understand and be able to properly use echocardiographic equipment.
  • Acquire a working knowledge of cardiac anatomy, physiology, hemodynamics, and pathology relevant to echocardiography.
  • Understand fluid dynamics and cardiovascular blood flow.
  • Understand the role of these procedures in clinical practice, including: diagnostic and prognostic utility, cost, and limitations.

 

Transesophageal echocardiography and stress echocardiography (2nd and 3rd month)

  • Understand the indications, contraindications, and risks of transesophageal echocardiography.
  • Gain experience in esophageal intubation, probe passage, acquisition, and interpretation of transesophageal echocardiography.
  • Understand the indications, contraindications, and risks of stress echocardiography.
  • Gain experience in the analysis of images and interpretation of stress echocardiography.
  • Elective (for level 2 or 3 training; see ACC COCATS guidelines):
  • Gain sufficient experience to acquire and interpret echocardiograms independently (level 2 or 3). This includes transthoracic, transesophageal, and stress echocardiography studies.
  • Learn the indications, contraindications, and limitations of all stress testing modalities (exercise and pharmacologic).
  • Obtain proficiency in producing an accurate written report.
  • Understand digital image analysis and processing.
  • Understand the risks, benefits, and mechanism of echo contrast agents.
  • Be able to perform this procedure under supervision.