Echocardiography in afya

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Transthoracic for valvular heart disease and ventricular function (cardiomyopathy/pericardial disease)
Transoesophageal for left atrium (source of clot), descending aorta and infective endocarditis (posterior structure)
stress test - looks at function when on treadmill or following dobutamine cf at rest

ejection fraction suggests severity of heart failure (left systolic) and thus prognosis - good predictor of longevity but doesn't correlate with symptomatic limitation. 
stroke volume (amt ejected out) / end diastolic volume (amt in full heart before contraction)
left ventricular ejection fraction - normal is 63-77% male, 55-75% female (<40% is problematic with <25% severe)
Higher fractions may be seen in older less compliant adapted healthy hearts
Note - Diastolic heart failure - Sx but normal EF - drugs help Sx but not survival

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