Noninvasive Assessment With Transthoracic Echocardiography in End-Stage Heart Failure

Published:January 05, 2023DOI:
      Heart failure is a common cardiac condition that carries a substantial risk of morbidity and mortality despite advances in management. Echocardiography plays a central role in its diagnosis, elucidation of mechanisms, and detailed hemodynamic analysis. In this E-Challenge, the authors review a few transthoracic echocardiographic findings that yield insights into the hemodynamics.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Cardiothoracic and Vascular Anesthesia
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Traube L.
        Ein fall von pulsus bigeminus nebst bemerkungen tiber die lebershwellungen bei klappenfehlern und uber acute leberatrophic.
        Berl Klin Wochenschr. 1872; 9: 185-188
        • Perk G
        • Tunick PA
        • Kronzon I.
        Systolic and diastolic pulsus alternans in severe heart failure.
        J Am Soc Echocardiogr. 2007; 20 (905.e5-7)
        • White P.
        Alternation of the pulse: A common clinical condition.
        Am J Med Sci. 1915; 150: 82
        • Ryan JM
        • Schieve JF
        • Hull HB
        • et al.
        The influence of advanced congestive heart failure on pulsus alternans.
        Circulation. 1955; 12: 60-63
        • Mountfort K.
        Acute cardiac unloading and recovery.
        Interv Cardiol. 2017; 12: 1
        • Rossi A
        • Cicoira M
        • Florea VG
        • et al.
        Chronic heart failure with preserved left ventricular ejection fraction: Diagnostic and prognostic value of left atrial size.
        Int J Cardiol. 2006; 110: 386-392
        • Rossi A
        • Temporelli PL
        • Quintana M
        • et al.
        Independent relationship of left atrial size and mortality in patients with heart failure: An individual patient meta-analysis of longitudinal data (MeRGE Heart Failure).
        Eur J Heart Fail. 2009; 11: 929-936

      Linked Article

      • Every Beat Counts!
        Journal of Cardiothoracic and Vascular Anesthesia
        • Preview
          Nāḍīparīkṣā (नाडीपरीक्षा), the ancient medical science of detecting early signs of disease based on palpation of the radial artery, was mentioned nearly a millennia ago in the Ayurvedic treatise in Sharangadhara Samhita.1 Nadipariksa is still widely practiced today in India and Nepal. Interpreting a patient's pulse is no less important to practitioners of “Western” medicine. For example, the clinical significance of pulsus paradoxus is clear to all of us. In the operating room, plethysmography, arterial lines, right- and left-heart catheters, esophageal Doppler, and echocardiography are all different ways of capturing and measuring a patient's pulse that guide daily practice.
        • Full-Text
        • PDF