Book Review: Essential Echocardiography: A Companion to Braunwald’s Heart Disease

Abstract

The knowledge of echo reflection, the main principle of echocardiography, had its origin in the 18th century when Lazzaro Spallanzani found out that bats were able to navigate using the echo reflection of inaudible sounds. Over the course of the centuries, ‘man-made’ ultrasonic waves, SONAR (Sound Navigation and Ranging) as well as RADAR (Radio Detection and Ranging), were used for military purposes to detect hostile submarines or planes. In the 1930s, the first experiments of using the ultrasonic pulse echo technique for non-military purposes and, soon after, medical examinations in order to visualize the inner organs of the human body were performed. Various attempts, i.e., portraying the ventricle system of the brain or recording the heart’s rhythmic volume variations, were not successful, so W.D. Keidel, a German physicist, concluded, in the late 1940s, that this technique bore “immense technical problems compared with the crude diagnostic possibilities”.1 In 1953, hugely motivated to overcome these technical problems, Inge Edler, head of the Department of Cardiology at the University Hospital of Lund, Sweden, liaised with Carl Hellmuth Hertz, a graduate student at the University’s nuclear physics department studying ultrasound. As a descendant of a famous scientific family – his father Gustav was a Nobel Prize winner in Physics and director of the Siemens Research Laboratory and his uncle Heinrich Hertz, the eponym to the unit of frequency – Carl Hellmuth was able to borrow a Siemens Ultrasonic Reflectoscope, developed for non-destructive materials. Using this device, Edler and Hertz aimed for ameliorating the preoperative assessment of patients undergoing cardiac surgery and soon were able to demonstrate a characteristic shape of a corresponding waveform for the anterior leaflet of the mitral valve in stenosis. Subsequently, Edler and Hertz dramatically enlarged the diagnostic capabilities, demonstrating valvulopathies, impairment of the heart function and other pathological conditions. Evolving from this success, electrocardiography has been much further extended and has become the most commonly used, relatively non-invasive, inexpensive imaging technique in the clinical setting for visualizing the heart and great vessels, providing diagnostic and prognostic value. Besides the great advantages of this technique, one of the main disadvantages is that the quality of the examination is highly dependent on the practitioner’s experience and execution. That is when the 1st edition of “Essential Echocardiography”, one of 18 companion Elsevier books to the 11th edition of “Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine”, comes in handy. This book is conveniently divided into 49 chapters spread over 11 colour-coded sections covering all important aspects of echocardiography from the main principles of ultrasound and instrumentation to a broad range of diseases and pathologies of the heart and vessels. It not only appeals to practitioners such as cardiologist, intensivists, emergency physicians and anaesthetists, but also to young medical students and unexperienced trainees. The book incorporates great illustrations combined with high quality echocardiogram prints which allow understanding of where to put the transducer on the patient’s thorax in order to achieve a specific echo image. Alongside, a huge video content with a total of 489 videos can be accessed via the Expert Consult online version of this book which is, again, included within your purchase. It provides a vast amount of examples for transthoracical/transoesophageal echocardiography (also contrast enhanced) and 3D-imaging. In a nutshell, this book is easily approachable, wellillustrated and full of clinical examples, diagnoses and management tips preparing the reader to become the best echocardiographer possible.