Simultaneous examination of the aorta in echocardiography of patients with coronary artery disease
Simultaneous examination of the aorta in echocardiography of patients with coronary artery disease
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冠心病患者超声心动图同步检查主动脉
DOI：
10.1007/s12574-010-0041-1
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发表时间：
2010
影响因子：
1.6
通讯作者：
K. Nishigami
中科院分区：
文献类型：
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作者：
K. Nishigami
大多数主动脉瘤是无症状的，并且是在常规体格检查或其他适应症的成像研究中偶然发现的[1]，尽管主动脉瘤破裂可引起不受控制的出血和快速循环衰竭。动脉粥样硬化被认为是主动脉瘤的根本原因，并且可以经常观察到主动脉瘤和冠状动脉疾病的伴随疾病[2]。超声心动图是评估冠状动脉疾病患者的基本方法，可用于主动脉瘤的筛查。我想推荐在冠心病患者的超声心动图中同步检查主动脉，并提出以下主动脉瘤的筛查方法。(1)上级肋间切面（图1）：左胸骨旁入路是左心室、心房和近端升主动脉长轴切面的标准方法。从上级肋间隙入路可显示升主动脉近端至中段。(2)小比例尺长轴切面（图2）：在超声心动图胸骨旁切面上，通过调整窗深可在左心房后看到降主动脉。(3)剑突下切面：经剑突下和腹部入路均可看到腹主动脉。(4)胸骨上观（图3）：在“嗅”和仰卧位，从胸骨上入路可以照亮主动脉弓到降主动脉近端。这些方法可以被称为“四个S”。超声心动图常规评价主动脉必须缩短主动脉回声所需时间。采用四S方法的快速主动脉超声心动图不仅在寻找主动脉瘤方面，而且在急诊室评估急性主动脉夹层中也将发挥重要作用。
The majority of aortic aneurysms are asymptomatic and are discovered incidentally on routine physical examination or on imaging studies for other indications [1], although the rupture of the aortic aneurysm can cause uncontrolled hemorrhage and rapid circulatory collapse. Atherosclerosis has been considered the underlying cause of aortic aneurysms, and the concomitant disorder of aortic aneurysm and coronary artery disease can be frequently observed [2]. Echocardiography is a basic modality to assess patients with coronary artery disease and can be used for the screening of aortic aneurysm. I would like to recommend the simultaneous examination of the aorta in the echocardiography of patients with coronary artery disease and propose the following screening method for aortic aneurysms.(1) Superior intercostal view (Fig. 1): left parasternal approach is a standard method for the long-axis view of the left ventricle, atrium, and proximal ascending aorta. The approach from the superior intercostal space can visualize the proximal to mid-portion of the ascending aorta.(2) Small-scale longaxis view (Fig. 2): the descending aorta can be seen behind the left atrium in the parasternal view of echocardiography by adjusting the window depth.(3) Subxiphoid view: abdominal aorta can be seen from subxiphoid and abdominal approaches.(4) Suprasternal view (Fig. 3): aortic arch to proximal descending aorta can be illuminated from the suprasternal approach on the ‘‘sniff’’and supine position. These approaches may be recalled as the ‘‘four Ss’’. The routine evaluation of the aorta in echocardiography must make the time required for aortic echo shorter. Quick aortic echo using the four S approaches will be able to play an important role not only in the search for aortic aneurysm, but also in the evaluation of acute aortic dissection in the emergency room.