DMS-2602: ECHOCARDIOGRAPHY II

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1 DMS-2602: Echocardiography II 1 DMS-2602: ECHOCARDIOGRAPHY II Cuyahoga Community College Viewing:DMS-2602 : Echocardiography II Academic Term: Fall 2018 Subject Code DMS - Diagnostic Medical Sonography Course Number: 2602 Title: Echocardiography II Catalog Description: Introduction to physical signs symptoms, and indications for an echocardiogram reviewed for each major pathology. History and physical examination, laboratory tests, invasive and non-invasive hemodynamic evaluations used to assess various cardiovascular pathologies. Theory and manipulation of Doppler echocardiography with an introduction to interrogation of technical findings. Determination of blood flow within the normal and diseased heart using Doppler echocardiography and applying principles of hemodynamic effects learned. Color and spectral Doppler techniques discussed as applied to clinical transthoracic and transesophageal echocardiographic examinations as well as stress echocardiography. Credit Hour(s): 4 Lecture Hour(s): 4 Requisites Prerequisite and Corequisite DMS-1602 Echocardiography I; and concurrent enrollment in DMS-2301 Intermediate Sonographic Scanning. I. ACADEMIC CREDIT Academic Credit According to the Ohio Department of Higher Education, one (1) semester hour of college credit will be awarded for each lecture hour. Students will be expected to work on out-of-class assignments on a regular basis which, over the length of the course, would normally average two hours of out-of-class study for each hour of formal class activity. For laboratory hours, one (1) credit shall be awarded for a minimum of three laboratory hours in a standard week for which little or no out-of-class study is required since three hours will be in the lab (i.e. Laboratory 03 hours). Whereas, one (1) credit shall be awarded for a minimum of two laboratory hours in a standard week, if supplemented by out-of-class assignments which would normally average one hour of out-of class study preparing for or following up the laboratory experience (i.e. Laboratory 02 hours). Credit is also awarded for other hours such as directed practice, practicum, cooperative work experience, and field experience. The number of hours required to receive credit is listed under Other Hours on the syllabus. The number of credit hours for lecture, lab and other hours are listed at the beginning of the syllabus. Make sure you can prioritize your time accordingly. Proper planning, prioritization and dedication will enhance your success in this course. The standard expectation for an online course is that you will spend 3 hours per week for each credit hour. II. ACCESSIBILITY STATEMENT If you need any special course adaptations or accommodations because of a documented disability, please notify your instructor within a reasonable length of time, preferably the first week of the term with formal notice of that need (i.e. an official letter from the Student Accessibility Services (SAS) office). Accommodations will not be made retroactively. For specific information pertaining to ADA accommodation, please contact your campus SAS office or visit online athttp:// Blackboard accessibility information is available athttp://access.blackboard.com. Eastern (216) Voice Metropolitan (216) Voice Western (216) Voice Westshore (216) Voice

2 2 DMS-2602: Echocardiography II Brunswick (216) Voice Off-Site (216) Voice III. ATTENDANCE TRACKING Regular class attendance is expected. Tri-C is required by law to verify the enrollment of students who participate in federal Title IV student aid programs and/or who receive educational benefits through other funding sources. Eligibility for federal student financial aid is, in part, based on your enrollment status. Students who do not attend classes for the entire term are required to withdraw from the course(s). Additionally, students who withdraw from a course or stop attending class without officially withdrawing may be required to return all or a portion of the financial aid based on the date of last attendance. Students who do not attend the full session are responsible for withdrawing from the course(s). Tri-C is responsible for identifying students who have not attended a course, before financial aid funds can be applied to students accounts. Therefore, attendance will be recorded in the following ways: For in-person courses, students are required to attend the course by the 15th day of the semester, or equivalent for terms shorter than 5-weeks, to be considered attending. Students who have not met all attendance requirements for an in-person course, as described herein, within the first two weeks of the semester, or equivalent, will be considered not attending and will be reported for non-attendance and dropped from the course. For blended-learning courses, students are required to attend the course by the 15th day of the semester, or equivalent for terms shorter than 5-weeks, or submit an assignment, to be considered attending. Students who have not met all attendance requirements for a blended-learning courses, as described herein, within the first two weeks of the semester, or equivalent, will be considered not attending and will be reported for non-attendance and dropped from the course. For online courses, students are required to login in at least two (2) times per week and submit one (1) assignment per week for the first two (2) weeks of the semester, or equivalent to the 15th day of the term. Students who have not met all attendance requirements for an online course, as described herein, within the first two weeks of the semester, or equivalent, will be considered not attending and will be reported for non-attendance and dropped from the course. At the conclusion of the first two weeks of a semester, or equivalent, instructors report any registered students who have Never Attended a course. Those students will be administratively withdrawn from that course. However, after the time period in the previous paragraphs, if a student stops attending a class, wants or needs to withdraw, for any reason, it is the student's responsibility to take action to withdraw from the course. Students must complete and submit the appropriate Tri-C form by the established withdrawal deadline. Tri-C is required to ensure that students receive financial aid only for courses that they attend and complete. Students reported for not attending at least one of their registered courses will have all financial aid funds held until confirmation of attendance in registered courses has been verified. Students who fail to complete at least one course may be required to repay all or a portion of their federal financial aid funds and may be ineligible to receive future federal financial aid awards. Students who withdraw from classes prior to completing more than 60 percent of their enrolled class time may be subject to the required federal refund policy. If illness or emergency should necessitate a brief absence from class, students should confer with instructors upon their return. Students having problems with class work because of a prolonged absence should confer with the instructor or a counselor. IV. CONCEALED CARRY STATEMENT College policy prohibits the possession of weapons on college property by students, faculty and staff, unless specifically approved in advance as a job-related requirement (i.e., Tri-C campus police officers) or, in accordance with Ohio law, secured in a parked vehicle in a designated parking area only by an individual in possession of a valid conceal carry permit. As a Tri-C student, your behavior on campus must comply with the student code of conduct which is available on page 29 within the Tri-C student handbook, available athttp:// must also comply with the College s Zero Tolerance for Violence on College Property available athttp:// documents/ zero-tolerance-for-violence-policy.pdf Outcomes Course Outcome(s): Evaluate patient for possible cardiovascular diseases. Objective(s): 1. Question patient for clinical history and symptoms in order to determine cardiovascular risk factors. 2. Conclude if patient's signs and symptoms are related to cardiovascular disease. 3. Describe the ausculatory locations and various sounds associated with cardiovascular disease states. 4. Describe the various laboratory tests and their uses with cardiovascular disease. Course Outcome(s): Describe how a thorough echocardiogram is performed in order to determine presence of pathology according to the American Society of Echocardiography standards.

3 DMS-2602: Echocardiography II 3 Objective(s): 1. Describe and show an understanding of transesophageal echocardiogram, stress echocardiogram and pharmacological stress testing and when to use. 2. List the various imaging modalities used to diagnose cardiovascular diseases and compare their advantages and disadvantages. 3. Describe the correct views, sample placements, Doppler and measurement packages necessary to perform a thorough echocardiogram on a normal or diseased heart. 4. Differentiate between normal and abnormal values for blood flow, valve area, chamber size, function and all other necessary cardiovascular anatomy. 5. Describe the effects of various cardiac lesions on the heart and associated anatomy. 6. Demonstrate knowledge of fetal heart development and congenital diseases that can occur during growth as well as pre and post fetal circulation. Methods of Evaluation: 1. Weekly quizzes 2. Mid term and final examinations 3. Weekly written assignments 4. Homework 5. Oral presentation 6. Article reviews 7. Technical Impressions Course Content Outline: 1. Concepts a. Protocols b. Scope of Practice c. Disease process and affects d. Patient signs, symptoms and risk factors e. Pathophysiology f. Invasive and non-invasive cardiac testing g. Disease appearance h. Normal and abnormal Doppler flow i. Doppler calculations and results j. Critical thinking k. Heart development and congenital variants l. Transesophageal Echocardiography m. Stress Echocardiography 2. Skills a. Preparing patient for exam b. Assessing patient for cardiovascular disease c. Applying knowledge of cardiac tests d. Recognizing pathology by echocardiogram e. Applying knowledge of instruments f. Analyze findings using critical thinking g. Applying knowledge of the various Doppler modalities h. Determining normal versus abnormal anatomy and Doppler i. Differentiating between artifact and anatomical variants 3. Issues a. Knowledge retention b. Scope of practice c. Exam Preparation d. Communication e. Critical thinking f. Medical ethics g. Difficult examinations

4 4 DMS-2602: Echocardiography II Course Outline 1. Medical history and physical examination a. Signs and Symptoms b. Laboratory tests and results c. Risk factors for cardiovascular disease d. Auscultation, phonocardiography and pulse recordings e. Skin color and temperature f. Normal blood pressures and O 2 content g. Blood test and lab results 2. Physical principles and instrumentation a. Doppler types, benefits, and disadvantages b. Color Doppler c. Pulsed wave Doppler d. Continuous wave e. Acoustic windows and optimal angle to flow orientation 3. Equations a. Doppler Equation b. Bernoulli c. Pressure Half Time d. Modified Simpsons e. Qp:Qs f. Diastolic and Systolic g. Pulmonary Hypertension 4. Doppler assessment of the aorta a. Aortic dissection and false lumen b. Sinus of Valsalva aneurysm leakage c. Marfan''s syndrome d. Coarctation e. Affects on the cardiovascular system and great vessels f. 2D, M-Mode and Doppler findings g. Measurements and Calculations h. Therapeutic Modalities i. Echocardiographic changes post therapy 5. Aortic valve stenosis/sclerosis: 6. Aortic regurgitation/ insufficiency

5 DMS-2602: Echocardiography II 5 7. Mitral valve stedrug therapynosis 8. Mitral regurgitation/ insufficiency 9. Tricuspid valve stenosis 10. Tricuspid regurgitation 11. Pulmonic valve stenosis c. 2-D, M-Mode and Doppler findings 12. Pulmonic regurgitation/ insufficiency

6 6 DMS-2602: Echocardiography II 13. Hypertensive Disease a. Systemic Hypertension ii. Affects on the cardiovascular system and great vessels iii. 2D, M-Mode and Doppler findings b. Pulmonary Hypertension ii. Affects on the cardiovascular system and great vessels iii. 2D, M-Mode and Doppler findings 14. Coronary artery disease/ischemic heart disease b. Affects on the cardiovascular system c. 2-D, M-Mode and Doppler findings 15. Cardiomyopathies a. Dilated or congestive ii. Affects on the cardiovascular system b. Hypertrophic ii. Affects on the cardiovascular system

7 DMS-2602: Echocardiography II 7 v. Maneuvers vi. Therapeutic Modalities vii. Echocardiographic changes post therapy c. Infiltrative or Restrictive ii. Affects on the cardiovascular system v. Maneuvers vi. Therapeutic Modalities vii. Echocardiographic changes post therapy 16. Diastolic Function a. Hemodynamics of diastolic dysfunction b. Pulsed Doppler Assessment c. Mitral Valve Inflow d. Pulmonary Vein flow e. Tissue Doppler imaging (TDI) f. Color M-Mode g. Therapeutic Modalities h. Echocardiographic changes post therapy 17. Pericardial diseases a. Pericardial Effusion and Cardiac tamponade ii. Affects on the cardiovascular system (hemodynamics) 1. Cardiovascular surgery b. Pericarditis ii. Affects on the cardiovascular system (hemodynamics) 1. Cardiovascular surgery c. Constrictive Pericarditis ii. Affects on the cardiovascular system (hemodynamics) 1. Cardiovascular surgery 18. Prosthetic valves

8 8 DMS-2602: Echocardiography II a. Types of Prosthetics and failure by type b. Methods of Doppler assessment c. Cardiovascular surgery d. Echocardiographic changes post therapy 19. Tumors, Masses and Missiles b. Affects on the cardiovascular system (hemodynamics) c. 2-D, M-Mode and Doppler findings 20. Artifacts 21. Fetal Heart Development and Congenital Disease a. Bicuspid Aortic Valve b. Subaortic membranes and supraortic ridges c. Coarctation of the aorta d. Cor Triatriatum e. Cleft Mitral Valve f. Epstein''s Anomaly g. Patent Ductus Arteriosus h. Parachute Mitral Valve i. Endocardial Cushion defect j. Pulmonic Stenosis k. Atrial Septal Defects l. Ventricular Septal Defects m. Tetrology of Fallot n. Transposition of the Great Vessels o. Therapeutic Modalities iii. Echocardiographic changes post therapy 22. Other Imaging Modalities for Cardiovascular Assessment a. Transesophageal Echocardiography b. Stress Echocardiography c. Invasive Tests i. Single-photon emission computerized tomography (SPECT) ii. Positron Emission Tomography (PET) Scanning iii. Computerized Tomography (CT)Â Scanning iv. Nuclear Testing 23. Miscellaneous Procedures a. Contrast Studies b. Three-dimensional echocardiography c. Echo-guided procedures Resources Feigenbaum, Harvey.Echocardiography.7th ed. Philadelphia: Lippincott Williams Wilkins, Harry, M. and Behrends, T. (2013)Essentials of Echocardiography and Cardiac Hemodynamics: An Illustrative Guide,Colorado Springs, CO: Mark Harry Cardiac Ultrasound, LLC.

9 DMS-2602: Echocardiography II 9 Pai, R., Varadarajan, P., Chandraratna, P. and Malik, S. (2013)Echocardiography, A Case Based Approach,Burlington, MA: Jones Bartlett. Silverman, D. and Manning W. (2012)The Complete Guide to Echocardiography,Sandbury, MA: Jones Bartlett Learning. McLaughlin, M. (2014)Cardiovascular Care Made Incredibly Easy,Philadelphia, PA: Wolters Kluwer. Top of page Key: 1476

DMS-2981: SPECIALTY REGISTRY REVIEW

DMS-2981: Specialty Registry Review 1 DMS-2981: SPECIALTY REGISTRY REVIEW Cuyahoga Community College Viewing:DMS-2981 : Specialty Registry Review Academic Term: Fall 2018 Subject Code DMS - Diagnostic