Value of Echocardiography in the Treatment of Patients With Acute Heart Failure

Figures

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  Figure 1. Four cases of acute heart failure. All patients had dyspnea and acute pulmonary edema with systolic blood pressure >140 mm Hg (clinical scenario 1) and preserved left ventricular ejection fraction. (A) 88-year-old female with severe aortic stenosis. Lower panel shows peak velocity of 4.2 m/s and mean pressure gradient of 45.5 mmHg. (B) 78-year-old female with hypertrophic cardiomyopathy. Middle and lower panels show severe mitral regurgitation due to systolic anterior motion of the mitral valve. (C) 64-year-old male with acute mitral regurgitation. Middle and lower panels show severe mitral regurgitation due to posterior leaflet prolapse without left atrial enlargement. (D) 78-year-old female with heart failure with preserved ejection fraction. Middle and lower echocardiographic images show severe left ventricular diastolic dysfunction without structural abnormalities.

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  Figure 2. Echocardiographic images of a 58-year-old man with dilated cardiomyopathy showing response to heart failure therapy. (A) On admission. Upper panel shows severe secondary mitral regurgitation with dilated left ventricle. Middle panel shows restrictive left ventricular inflow pattern and velocity time integral of only 4.7 cm, which suggested low forward cardiac output. (B) After 14 days of hospitalization. Color Doppler echocardiography shows a significant reduction in mitral regurgitation (upper panel). Doppler echocardiography showed decreased left ventricular filling pressure (middle panel) and significantly improved forward cardiac output (lower panel).