Transoesophageal Echocardiography—Study Guide and Practice MCQs
Transoesophageal Echocardiography—Study Guide and Practice MCQs. A. Roscoe. Published by Cambridge University Press, Cambridge, UK. Pp. 154 ; indexed; illustrated. Price £23.99. ISBN 13 978-0-521-68960-1.Since 2003, there has been an accreditation scheme in the UK for perioperative transoesophageal echocardiography run jointly by the British Society of Echocardiography and the Association of Cardiothoracic Anaesthetists. This comprises a multiple choice examination on both echocardiography images and theory, together with a log book of reports of 125 transoesophageal echocardiography examinations. The log book has to be supported by stored images of representative examinations. Similar accreditation qualifications in the USA preceded the UK scheme, and a European accreditation has since followed.
This new study guide and practice MCQs seeks to assist those preparing for the accreditation process by presenting factual information that is required by the syllabus. This is not a book for the absolute beginner. The only narrative appears in the introduction and the foreword. After six pages of translation of abbreviations, it is straight into 39 pages of the physics of ultrasound. However, the lists of facts are well laid out, interspersed with explanatory line diagrams, and proceed in a logical order.
The following chapters summarize guidelines, normal anatomy, and function. There are then chapters on abnormal ventricle function, valve pathology, and cardiac masses. The book concludes with congenital heart disease, extra cardiac anatomy, and haemodynamic calculations.
The information is concise and unequivocal. It has a certainty found only elsewhere in accreditation examinations. However, the factual background it provides will help guide decisions in the less clear cut world of acquiring images in clinical practice. For someone who has learned to obtain the standard views and can use the colour and Döppler flow controls, this guide will provide a portable and concise summary and reference of the normal ranges in adult practice.
The line diagrams have a similar appearance to that obtained when tracing around a Döppler flow envelope. A trackball on a digital machine gives a jagged outline rather than the smooth curve of the tissue border or blood flow it seeks to represent. In a way, this emphasizes that the image is a digital representation of a structure rather than the real structure itself. Examinations drive learning and this study guide will add a premium to the cost of the examination. However, as a concise portable reference or as an accompaniment on a practical echocardiography course, it will make it easier to read and re-read the information sufficient times for it to stick in the memory.
Leeds, UK E-mail: d.j.r.duthie{at}leeds.ac.uk
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