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RE: [echocardiography] LV diastolic Dysfunction

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  • Kishore Shetty
    You may find this document interesting. Consensus document on how to diagnose diastolic heart failure. As you can see TDI is important in assessing diastolic
    Message 1 of 6 , Oct 31, 2008
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      You may find this document interesting. Consensus document on how to diagnose diastolic heart failure.
      As you can see TDI is important  in assessing diastolic function.
       
        http://www.escardio.org/communities/hfa/documents/diastolic_hf_consensus_doc.pdf
       
      Kishore Shetty
      Sunderland UK





      To: echocardiography@yahoogroups.com
      From: leftytck@...
      Date: Fri, 31 Oct 2008 06:15:56 -0700
      Subject: Re: [echocardiography] LV diastolic Dysfunction


      Hi Dr. Udaya kumar,
         Bingo, I think that's a good start on the trail of diastolic dysfxn. The other thing you might add is a valsalva to try and provoke that issue of  E to A  reversal.
         I don't suppose that these ultrasound machines have the capability of Tissue doppler? That might be another piece of the puzzle.
         It depends how much information you believe is sufficient to answer the diastolic dysfunction question. The rule is that diastolic dysfunction precedes systolic dysfunction.
                                                                   Sincerely,
                                                                 Tom K. RDCS

      --- On Thu, 10/30/08, Udaya kumar <drudaya2002@ yahoo.co. in> wrote:
      From: Udaya kumar <drudaya2002@ yahoo.co. in>
      Subject: [echocardiography] LV diastolic Dysfunction
      To: echocardiography@ yahoogroups. com
      Date: Thursday, October 30, 2008, 8:28 PM


      Hi, I am new to this group.
      This is my first post .
      Doppler waveforms at the LV inflow should normally show an E wave that is taller than the A wave.  If A is taller than E in a person less than 50y old we infer LV Diastolic dysfunction.
      I use a portable machine to perform bedside ECHO studies.  No doppler. Only 2D and M mode for these bedside studies.  Would it be possible to diagnose LV diastolic Dysfunction without doppler.?  Say for eg. from the M mode tracings of Mitral valve leaflets.?
      I do use a Wipro GE pro500 and Toshiba Nemio XG too...these have CW and PW doppler and colour. No problem when I use these.

      ..Dr.Udayakumar ( Chennai, India)


      From: Tam Doan <huytamped@yahoo. com>
      To: echocardiography@ yahoogroups. com
      Sent: Friday, 31 October, 2008 2:37:30 AM
      Subject: Re: [echocardiography] seeking a position

      Cliff,
       
      First, thank so much for your tips, regards, and sharing the experience you had with the people from other countries.
       
      I've been searching and will soon send out my applications to some of the cardiology practices around. I've also looked at ARDMS web site and learnt that I need a sort of letter of recommendation from an ARDMS-certified sonographer besides the verification of my outside US MD degree and another letter from my former employer. I wander if anybody would take the risk to offer me a job without knowing me, so did not feel strongly if I should call and talk to the people. Given your advice, I will be more comfortable to call them up and ask for their job availabilities.
       
      Again, thanks a lot
      I will keep you posted
       
      Tam


      --- On Thu, 10/30/08, Clifford Thornton <cmt51597@yahoo. com> wrote:
      From: Clifford Thornton <cmt51597@yahoo. com>
      Subject: Re: [echocardiography] seeking a position
      To: echocardiography@ yahoogroups. com
      Date: Thursday, October 30, 2008, 8:23 AM

      You clearly have a lot of valuable experience and I'm sure it would be put to good use here. 
       
      Have you attemped to apply for or sit for any of the ARDMS or CCI exams?  Things have changed here and there is a big push to have ultrasound techs registered (Canada as well).
       
      In the meantime, it is possible for you to secure a position if a lead tech is available to cover for you.  If you have transcripts, diplomas, etc....I would start working on getting them translated if necessary as that will need to be done if you apply for a cardiovascular program here and/or you apply to sit for the registry exams. 
       
      As far as the job search there are so many options.  I have been seeing a lot more echo jobs on careerbuilder. com lately as the healthcare recruiters are getting smart and utilizing the web more.  Or just type in google "echo" and your city "Fresno" and see what comes up.  Also, just search for cardiology practices in the area, find their phone number, call them, ask to speak to the practice manager, and ask him/her if they can use your experience or have an ultrasound position open and explain your situation.  Also, check-out
       
      When I went through my cardiovascular program here there were several foreign trained physicians in my class (i.e. India, Dominican Republic, Egypt) and they excelled in their class.  Unfortunately I lost touch and not too sure how they fared, but I'm sure they passed their registries. 
       
      If you are not familiar with the registries here, visit:  www.ardms.org or www.cci-online. org
       
      I think once you have your registries you are going to do great as many employers are looking for your range of abilities and multi-modalities (especially that you have experience in the cath lab and echo, that's unusual for a tech here).  And you can probably apply for a supervisor position after a few years given your background.
       
      Just be positive and be open with people about your situation. 
       
      Hope it helps.
       
      -Cliff

      --- On Wed, 10/29/08, Tam Doan <huytamped@yahoo. com> wrote:
      From: Tam Doan <huytamped@yahoo. com>
      Subject: Re: [echocardiography] seeking a position
      To: echocardiography@ yahoogroups. com
      Date: Wednesday, October 29, 2008, 1:12 PM

      I'm a foreign trained pediatric cardiologist with experiences in cardiac patient care; transthoracic, fetal, transesophageal echocardiography; and cardiac catheterization. I'm looking for a position as either a cardiac ultrasonographer, EKG technician, or cardiac catheterization lab technician in Fresno, California. I believe my experience can benefit a Cardiology practice. I am happy to provide references upon request.
      Thank you very much for your consideration.
       
      Sincerely,
       
       
       






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    • Gerson Lichtenberg
      The only other thing I have to add is a not very sensitive sign from the old M-mode days. Look for a B-bump on the MV tracing, a delay in closure between the
      Message 2 of 6 , Oct 31, 2008
      • 0 Attachment
        The only other thing I have to add is a not very sensitive sign from the old M-mode days. Look for a B-bump on the MV tracing, a delay in closure between the peak of the A-wave and the C point (closure). This is consistent with an end-diastolic pressure over 20mmHg.

        Gershom Lichtenberg, RDCS
        Echocardiographer
        Rambam Healthcare Campus
        Haifa, Israel


        On Fri, Oct 31, 2008 at 3:15 PM, Thomas Kusant <leftytck@...> wrote:

        Hi Dr. Udaya kumar,
           Bingo, I think that's a good start on the trail of diastolic dysfxn. The other thing you might add is a valsalva to try and provoke that issue of  E to A  reversal.
           I don't suppose that these ultrasound machines have the capability of Tissue doppler? That might be another piece of the puzzle.
           It depends how much information you believe is sufficient to answer the diastolic dysfunction question. The rule is that diastolic dysfunction precedes systolic dysfunction.
                                                                     Sincerely,
                                                                   Tom K. RDCS


        --- On Thu, 10/30/08, Udaya kumar <drudaya2002@...> wrote:
        From: Udaya kumar <drudaya2002@...>
        Subject: [echocardiography] LV diastolic Dysfunction
        To: echocardiography@yahoogroups.com
        Date: Thursday, October 30, 2008, 8:28 PM


        Hi, I am new to this group.
        This is my first post .
        Doppler waveforms at the LV inflow should normally show an E wave that is taller than the A wave.  If A is taller than E in a person less than 50y old we infer LV Diastolic dysfunction.
        I use a portable machine to perform bedside ECHO studies.  No doppler. Only 2D and M mode for these bedside studies.  Would it be possible to diagnose LV diastolic Dysfunction without doppler.?  Say for eg. from the M mode tracings of Mitral valve leaflets.?
        I do use a Wipro GE pro500 and Toshiba Nemio XG too...these have CW and PW doppler and colour. No problem when I use these.

        ..Dr.Udayakumar ( Chennai, India)


        From: Tam Doan <huytamped@yahoo. com>
        To: echocardiography@ yahoogroups. com
        Sent: Friday, 31 October, 2008 2:37:30 AM
        Subject: Re: [echocardiography] seeking a position

        Cliff,
         
        First, thank so much for your tips, regards, and sharing the experience you had with the people from other countries.
         
        I've been searching and will soon send out my applications to some of the cardiology practices around. I've also looked at ARDMS web site and learnt that I need a sort of letter of recommendation from an ARDMS-certified sonographer besides the verification of my outside US MD degree and another letter from my former employer. I wander if anybody would take the risk to offer me a job without knowing me, so did not feel strongly if I should call and talk to the people. Given your advice, I will be more comfortable to call them up and ask for their job availabilities.
         
        Again, thanks a lot
        I will keep you posted
         
        Tam


        --- On Thu, 10/30/08, Clifford Thornton <cmt51597@yahoo. com> wrote:
        From: Clifford Thornton <cmt51597@yahoo. com>
        Subject: Re: [echocardiography] seeking a position
        To: echocardiography@ yahoogroups. com
        Date: Thursday, October 30, 2008, 8:23 AM

        You clearly have a lot of valuable experience and I'm sure it would be put to good use here. 
         
        Have you attemped to apply for or sit for any of the ARDMS or CCI exams?  Things have changed here and there is a big push to have ultrasound techs registered (Canada as well).
         
        In the meantime, it is possible for you to secure a position if a lead tech is available to cover for you.  If you have transcripts, diplomas, etc....I would start working on getting them translated if necessary as that will need to be done if you apply for a cardiovascular program here and/or you apply to sit for the registry exams. 
         
        As far as the job search there are so many options.  I have been seeing a lot more echo jobs on careerbuilder. com lately as the healthcare recruiters are getting smart and utilizing the web more.  Or just type in google "echo" and your city "Fresno" and see what comes up.  Also, just search for cardiology practices in the area, find their phone number, call them, ask to speak to the practice manager, and ask him/her if they can use your experience or have an ultrasound position open and explain your situation.  Also, check-out
         
        When I went through my cardiovascular program here there were several foreign trained physicians in my class (i.e. India, Dominican Republic, Egypt) and they excelled in their class.  Unfortunately I lost touch and not too sure how they fared, but I'm sure they passed their registries. 
         
        If you are not familiar with the registries here, visit:  www.ardms.org or www.cci-online. org
         
        I think once you have your registries you are going to do great as many employers are looking for your range of abilities and multi-modalities (especially that you have experience in the cath lab and echo, that's unusual for a tech here).  And you can probably apply for a supervisor position after a few years given your background.
         
        Just be positive and be open with people about your situation. 
         
        Hope it helps.
         
        -Cliff

        --- On Wed, 10/29/08, Tam Doan <huytamped@yahoo. com> wrote:
        From: Tam Doan <huytamped@yahoo. com>
        Subject: Re: [echocardiography] seeking a position
        To: echocardiography@ yahoogroups. com
        Date: Wednesday, October 29, 2008, 1:12 PM

        I'm a foreign trained pediatric cardiologist with experiences in cardiac patient care; transthoracic, fetal, transesophageal echocardiography; and cardiac catheterization. I'm looking for a position as either a cardiac ultrasonographer, EKG technician, or cardiac catheterization lab technician in Fresno, California. I believe my experience can benefit a Cardiology practice. I am happy to provide references upon request.
        Thank you very much for your consideration.
         
        Sincerely,
         
         
         





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      • kd.horton@comcast.net
        I think this link has been on here before, but this is a great tool for learning the echo findings in the various stages of diastolic function..
        Message 3 of 6 , Nov 3, 2008
        • 0 Attachment
          I think this link has been on here before, but this is a great tool for learning the echo findings in the various stages of diastolic function..
           
           
          Ken
          Salt Lake City
           
          -------------- Original message --------------
          From: "Gerson Lichtenberg" <gershomsl@...>

          The only other thing I have to add is a not very sensitive sign from the old M-mode days. Look for a B-bump on the MV tracing, a delay in closure between the peak of the A-wave and the C point (closure). This is consistent with an end-diastolic pressure over 20mmHg.

          Gershom Lichtenberg, RDCS
          Echocardiographer
          Rambam Healthcare Campus
          Haifa, Israel


          On Fri, Oct 31, 2008 at 3:15 PM, Thomas Kusant <leftytck@yahoo. com> wrote:

          Hi Dr. Udaya kumar,
             Bingo, I think that's a good start on the trail of diastolic dysfxn. The other thing you might add is a valsalva to try and provoke that issue of  E to A  reversal.
             I don't suppose that these ultrasound machines have the capability of Tissue doppler? That might be another piece of the puzzle.
             It depends how much information you believe is sufficient to answer the diastolic dysfunction question. The rule is that diastolic dysfunction precedes systolic dysfunction.
                                                                       Sincerely,
          & nbsp;                                                          Tom K. RDCS


          --- On Thu, 10/30/08, Udaya kumar <drudaya2002@ yahoo.co. in> wrote:
          From: Udaya kumar <drudaya2002@ yahoo.co. in>
          Subject: [echocardiography] LV diastolic Dysfunction
          To: echocardiography@ yahoogroups. com
          Date: Thursday, October 30, 2008, 8:28 PM
           


          Hi, I am new to this group.
          This is my first post .
          Doppler waveforms at the LV inflow should normally show an E wave that is taller than the A wave.  If A is taller than E in a person less than 50y old we infer LV Diastolic dysfunction.
          I use a portable machine to perform bedside ECHO studies.  No doppler. Only 2D and M mode for these bedside studies.  Would it be possible to diagnose LV diastolic Dysfunction without doppler.?  Say for eg. from the M mode tracings of Mitral valve leaflets.?
          I do use a Wipro GE pro500 and Toshiba Nemio XG too...these have CW and PW doppler and colour. No problem when I use these.

          ..Dr.Udayakumar ( Chennai, India)


          From: Tam Doan <huytamped@yahoo. com>
          To: echocardiography@ yahoogroups. com
          Sent: Friday, 31 October, 2008 2:37:30 AM
          Subject: Re: [echocardiography] seeking a position

          Cliff,
           
          First, thank so much for your tips, regards, and sharing the experience you had with the people from other countries.
           
          I've been searching and will soon send out my applications to some of the cardiology practices around. I've also looked at ARDMS web site and learnt that I need a sort of letter of recommendation from an ARDMS-certified sonographer besides the verification of my outside US MD degree and another letter from my former employer. I wander if anybody would take the risk to offer me a job without knowing me, so did not feel strongly if I should call and talk to the people. Given your advice, I will be more comfortable to call them up and ask for their job availabilities.
           
          Again, thanks a lot
          I will keep you posted
           
          Tam


          --- On Thu, 10/30/08, Clifford Thornton <cmt51597@yahoo. com> wrote:
          From: Clifford Thornton <cmt51597@yahoo. com>
          Subject: Re: [echocardiography] seeking a position
          To: echocardiography@ yahoogroups. com
          Date: Thursday, October 30, 2008, 8:23 AM

          You clearly have a lot of valuable experience and I'm sure it would be put to good use here. 
           
          Have you attemped to apply for or sit for any of the ARDMS or CCI exams?  Things have changed here and there is a big push to have ultrasound techs registered (Canada as well).
           
          In the meantime, it is possible for you to secure a position if a lead tech is available to cover for you.  If you have transcripts, diplomas, etc....I would start working on getting them translated if necessary as that will need to be done if you apply for a cardiovascular program here and/or you apply to sit for the registry exams. 
           
          As far as the job search there are so many options.  I have been seeing a lot more echo jobs on careerbuilder. com lately as the healthcare recruiters are getting smart and utilizing the web more.  Or just type in google "echo" and your city "Fresno" and see what comes up.  Also, just search for cardiology practices in the area, find their phone number, call them, ask to speak to the practice manager, and ask him/her if they can use your experience or have an ultrasound position open and explain your situation.  Also, check-out
           
          When I went through my cardiovascular program here there were several foreign trained physicians in my class (i.e. India, Dominican Republic, Egypt) and they excelled in their class.  Unfortunately I lost touch and not too sure how they fared, but I'm sure they passed their registries. 
           
          If you are not familiar with the registries here, visit:  www.ardms.org or www.cci-online. org
           
          I think once you have your registries you are going to do great as many employers are looking for your range of abilities and multi-modalities (especially that you have experience in the cath lab and echo, that's unusual for a tech here).  And you can probably apply for a supervisor position after a few years given your background.
           
          Just be positive and be open with people about your situation. 
           
          Hope it helps.
           
          -Cliff

          --- On Wed, 10/29/08, Tam Doan <huytamped@yahoo. com> wrote:
          From: Tam Doan <huytamped@yahoo. com>
          Subject: Re: [echocardiography] seeking a position
          To: echocardiography@ yahoogroups. com
          Date: Wednesday, October 29, 2008, 1:12 PM

          I'm a foreign trained pediatric cardiologist with experiences in cardiac patient care; transthoracic, fetal, transesophageal echocardiography; and cardiac catheterization. I'm looking for a position as either a cardiac ultrasonographer, EKG technician, or cardiac catheterization lab technician in Fresno, California. I believe my experience can benefit a Cardiology practice. I am happy to provide references upon request.
          Thank you very much for your consideration.
           
          Sincerely,
           
           
           





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