Download Table of Contents - International College of Health Sciences

Date
Course Title
Echocardiography
Pathology II/Advance
Studies with Lab
Pre-requisite (s) HSC 1000, BSC 1085/
BSC 1085L, ENC 1101,
PHY 2053, DMS 1020,
MAC 1105, BSC 2085/
BSC 2085L, PSY 1012,
SPC 1017, STA 2003,
DMS 1030, EKG 1010,
CPR 1010, HAE 1000,
ECH 1020, ECH 1040,
DMS 1050, DMS 2060
Hours
105 theory hours/30 Lab
hours (135 clock hours)
Note: Subject to change
Credits
Course Number
8 Credits
ECH 2030
Co-requisite (s)
None
Place and Time of Class Meeting
International College of Health Sciences
2300 South Congress Ave, Suite 105
Boynton Beach, Florida 33426
Name and Contact Information of Instructor
Instructor: Juan Carlos Zamora CCT, RCS, RDCS, RVT
E-mail: [email protected]
Office Hours: 9.00 am to 5.00 pm
Campus Telephone: 561-202-6333
Delivery Method: On Campus
Books required
Textbook of Clinical Echocardiography:
5th Edition, Catherine M. Otto MD
The Echocardiographer’s Pocket Reference
4th Edition, Terry Reynolds, BS, RDCS
Attendance Policy
Failure to maintain regular attendance may lead to a failing grade. The attendance policy at ICHS
is as follows:
 Students must attend 80 percent (80%) of the total didactic class hours per semester and
100 percent (100%) of clinical externship hours. A student may have the opportunity to
make up absences; however, this is only available at the discretion and approval of a lead
instructor and can only be completed outside of scheduled classroom hours, if available.
In the event that the student will be absent from his or her clinical externship, the student
must call the assigned site and ICHS in advance. All absences must be justified in writing
(i.e. doctor’s excuse). Students are not excused from attending the clinical externship
except for grave emergencies or serious illness, and the student must call the assigned site
and ICHS in advance. Additionally, these hours must be made up within a student’s
scheduled dates for the course, the term, the semester or the scheduled clinical rotation.
Instructors, in their discretion, may base a percentage of the grade on attendance.

Termination may occur for any of the following attendance situations:
1. Eight (8) consecutive absences per semester.
2. Absence in excess of 20 percent (20%) of available course hours.
3. Absence in excess of 20 percent (20%) of externship hours.

Tardiness for didactic or clinical education will not be tolerated. Anytime beyond the
scheduled reporting time will be considered late or tardy. When attending clinical
externship, if a student is to be late, he or she must notify the clinical instructor at the
facility and the program clinical coordinator. If a student must miss class, he or she must
contact the program director or instructor at least 30 minutes prior to the class beginning.
For didactic education, four episodes of tardiness or leaving ICHS early per semester will
result in an absence.

If a student is more than 15 minutes late, he or she must obtain the instructor’s
permission to attend the class. Four late arrivals will result in the equivalent
“consequence” as one unexcused absence. Any student who has been excessively tardy in
arriving to class or absent will receive a written advisement and guidance report by a
faculty member. A student, who has more than one unexcused absence during clinical
externship, may be removed from the site.
DISTANCE EDUCATION ATTENDANCE POLICY
Students must log into their online course prior to the third day of the course as dictated by the
drop/ad policy of ICHS. Failure to log in by the end of the third day will result in the student
being dropped from the course. Attendance in online courses is defined as active participation in
the course. Active participation is defined as completion of all expectations outlined in the online
course as contained in the lesson plan, syllabi and other course related documents within the
course. These expectations may include but are not limited to participation in discussion forums,
submission of completed assignments, and completion of quizzes and exams.
VETERAN'S ATTENDACE POLICY
Excused absences will be granted for extenuating circumstances only. Excused absences must be
substantiated by entries in students' files. Early departures, class cuts, tardies, etc., for any
portion of a class period will be counted as absence. Students exceeding 3 unexcused absences in
a 7 day period for non-degree programs and 5 unexcused absences in a semester for degree
granting programs will be terminated from their VA benefits for unsatisfactory attendance. The
student's attendance record will be retained in the veteran's file for USDVA and SAA audit
purposes.
Course Description
After completion of Echocardiography Pathology One, the course will be focusing on
Pathology, Dysfunction, and the Disease process. Echo Pathology II covers Ischemic Heart
Disease, Hypertension, Pericardial Disease, Cardiac Masses, Prosthetic Valves, Stress
Testing, Congenital Heart Disease, and other Pathologies, Signs and Symptoms, 2-D,
M-Mode, Doppler findings will be quantitated , Differential Diagnosis, Murmurs related
to the disease, EKG findings, Treatment, Prognosis, Medical and Surgical Treatment,
among other subjects will be covered in the course. Coordination of the Patient’s history,
Physical findings and Sonographic images are evaluated for presentation. Discussions will
be both detailed and concise for understanding and comprehension. Students will be
provided with scan lab demonstration and techniques that will allow them to apply what
they learn in class to a real medical setting.
Upon successful completion of this course, the student will be able to:
1.
Understand Ischemic Heart Disease
2. Understand Systemic and Pulmonary Hypertension
3.
Understand Pericardial Diseases and Non-Cardiac Chest
4.
Understand Cardiac Masses, Endocarditis, Intracardiac Thrombus
5. Understand Prosthetic Valves and Transcatheter Aortic Valve Replacement
6. Understand Diseases of the Great Vessels
7. Understand Stress Testing, Tissue Doppler, 3-D and Transesophageal Echo
8. Understand Intraoperative Echo and the Role of the Sonographer
9. Understand Congenital Heart Disease in Adults and Children
10. Integration of data
Topical Outline and Schedule
DATE
WEEK 1
Distribute and review Syllabus
SPECIFIC
OBJECTIVES Describe the course.
Discuss Presentations, Quiz, Test, and Lab Criteria
Introduction to ischemic heart disease
Review walls and corresponding views
At the end of this chapter, the student will be able to:
• Define ischemic heart disease and etiology
• Understand the difference between Atherosclerosis and Arteriosclerosis
• Describe complications, symptoms, 2-D, M-Mode and Doppler findings
• Describe normal and abnormal values
• Describe follow up, treatment, and prognosis
• Understand coronary imaging
• Describe ischemia vs infarction
• Understand aneurysm and pseudoaneurysm
• Describe other methods of assessing coronary artery disease
TOPIC (S)
Ischemic Heart Disease
LEARNING Discussion of Syllabus
ACTIVITIES Power Point Presentation
Review of Coronary Distribution and Segmental Wall Motion Abnormalities
Lab: Maximizing Endocardial Definition
Discussion of Wall Thickening, Hypokinesis, Akinesis and Dyskinesis and
Aneurysmal Wall Motion
Report on Diastolic and Systolic Dysfunction
OUTSIDE
Homework: Complete Key Terms
WORK &
ASSIGNED
Read: Chapter 8th Coronary Artery Disease Otto (page # 190)
READINGS
Echo Pocket Book (page 138)
DATE
WEEK 2
At the end of this chapter, the student will be able to:
SPECIFIC
OBJECTIVES • Define systemic and pulmonary heart disease and etiology
• Describe complications, symptoms, 2-D, M-Mode and Doppler findings
• Describe murmurs, normal and abnormal values
• Describe follow up, treatment, and prognosis
• Describe calculations used to determine severity of systemic and
pulmonary hypertension
• Describe Eisenmenger’s Syndrome
TOPIC (S)
Systemic and Pulmonary Heart Disease
LEARNING Power Point Presentation
ACTIVITIES Describe the Importance of properly calculating Velocities and Pressure
Changes with in Cardiac Chambers and Great Vessels
Lab: Students will work in Doppler Calculations and Ejection Fraction
Review Power Point
OUTSIDE
WORK &
Study for Quiz # 1
Homework: M-Mode Findings
ASSIGNED
READINGS
Read: Chapter 9th Hypertensive and Pulmonary Heart disease
Otto (page # 245), Echo Pocket Book (page 100)
DATE
WEEK 3
At the end of this chapter, the student will be able to:
SPECIFIC
OBJECTIVES • Define pericardial disease and etiology
• Define pericarditis
• Describe pericardial effusion and tamponade
• Describe constrictive pericarditis vs restrictive cardiomyopathy
• Describe complications, symptoms, 2-D, M-Mode and Doppler findings
• Describe murmurs, normal and abnormal values
• Describe follow up, treatment, and prognosis
• Describe the difference between pericardial and pleural effusion
• Discussion of non-cardiac chest
• Understand ultrasound guided procedures, extrinsic compression,
pneumothorax, pleural effusion
• Understand limitations for non-cardiac chest (artifacts)
TOPIC (S)
Pericardial Disease and Non-Cardiac Chest
LEARNING Power Point Presentation
ACTIVITIES Discuss the importance of properly reporting Pericardial Disease
Discuss Pericardiocentesis
Quiz # 1
Lab: Students will work on Identification of Pericardium, and Locating
Descending Ao from Different Views
Review Power Point
OUTSIDE
Complete Key Terms
WORK &
Homework: Presentation on Non-Cardiac Chest
ASSIGNED
READINGS
Read Chapter: 10 Pericardial Disease Otto (page 254)
Echo Pocket Book (page 100)
DATE
WEEK 4
At the end of the chapters, the student will be able to:
SPECIFIC
OBJECTIVES • Describe the different cardiac masses and etiology
• Describe complications, symptoms, 2-D, M-Mode and Doppler findings
• Describe murmurs, normal and abnormal values
• Describe follow up, treatment, and prognosis
• Define benign and malignant ( primary and secondary) cardiac masses
• Describe differences between endocarditis, thrombus, embolus, and
predisposing factors
TOPIC (S)
Cardiac Masses and Potential Cardiac Source of Embolus
LEARNING • Power point presentation
ACTIVITIES • Video Presentation on Cardiac Source of Embolus
Lab: Students will work on Blood Flow from Apical Five and Three
Chambers
Lab test
Review Power Point
OUTSIDE
Complete Key Terms
WORK &
ASSIGNED
Homework: Study for Quiz # 2
READINGS
Read: Chapters 14 and 15 Otto (page 372 to 417)
Echo Pocket Book (page 159)
DATE
WEEK 5
At the end of the chapter, the student will be able to:
SPECIFIC
OBJECTIVES • Describe types of prosthetic valves
• Describe complications, symptoms, 2-D, M-Mode and Doppler findings
• Describe murmurs, normal and abnormal values
• Describe follow up, treatment, and prognosis
• Mechanisms of prosthetic valve dysfunction
• Understand echo approach to bioprosthetic, and mechanical valves
• Describe microcavitation, valve conduits
• Describe antegrade flow patterns and velocities
• Understand pitfalls in prosthetic valve imaging
• Discuss transcatheter valvular replacement
TOPIC (S)
Prosthetic Valves and TAVR
• Power point presentation
LEARNING
ACTIVITIES • Discuss Lambl’s Excrescences, Pannus Formation, Paravalvular
Regurgitation, Stenosis, and Dehiscence
• Video on TAVR
Quiz # 2
Lab: Practice Aortic Flow and Suprasternal Approach
OUTSIDE
Review for Mid-Term Exam
Complete Key Terms
WORK &
ASSIGNED
Homework: Study for Mid-Term Exam
READINGS
Read: Chapter 13 Prosthetic Valves Otto (page 342)
DATE
WEEK 6
At the end of the chapter, the student will be able:
SPECIFIC
OBJECTIVES • Describe the different diseases of the great arteries and etiology
• Describe complications, symptoms, 2-D, M-Mode and Doppler findings
• Describe murmurs, normal and abnormal values
• Describe follow up, treatment, and prognosis
• Understand aortic dilatation, aneurysm and dissection
• Understand intramural hematoma, traumatic Ao disease
• Understand Sinus of Valsalva aneurysm, atherosclerotic Ao disease
• Understand pulmonary artery abnormalities
• Describe TEE tomographic views, indications and risks
• Understand indications, preoperative procedures, surgical manipulation and
instrumentation, and time constraints
• Understand clinical utility in transcatheter and hybrid procedures
TOPIC (S)
Diseases of the Great Vessels, Transesophageal and Intraoperative Echo
LEARNING • Power point presentation
ACTIVITIES • Discussion on the role of Transesophageal Imaging
• Presentation on Intraoperative Echo
Mid-Term Exam
Lab: Mid-Term Lab Competency, Students will practice on Suprasternal
and Supraclavicular Imaging and Doppler
Review Power Point
OUTSIDE
Complete Key Terms
WORK &
Homework: Presentation on Ao Dissection
ASSIGNED
Read: Chapter 16 Diseases of the Great Arteries, Otto (page 418) and
READINGS
Chapter 3 Transesophageal Echocardiography, Otto (page 65
Echo Pocket Book (page 227)
DATE
WEEK 7
At the end of the chapter, the student will be able to:
SPECIFIC
OBJECTIVES • Understand indications and contraindications for stress testing
• Describe protocols
• Describe changes in ventricular function due to stress testing
• Describe dobutamine stress echo
• Understand limitations and technical aspects
• Describe 3-D examination protocol
• Understand three-dimensional echo, quantitation from 3-d images
• Understand tissue Doppler, strain and strain rate
• Understand speckle tracking strain imaging
• Understand contrast echocardiography
TOPIC (S)
Stress Testing, Myocardial Mechanisms (Tissue Doppler, 3-D, Contrast)
LEARNING • Power point presentation
Video on 3-D Echocardiography
ACTIVITIES
Lab: Students will mock a stress test and work on tissue Doppler
Review Power Point
OUTSIDE
Homework: Complete Key Terms
WORK &
ASSIGNED
Read: Chapter 4, Advance Echocardiographic Modalities
READINGS
Chapters 6 Left and Right Ventricular Systolic Function
Echo Pocket Book (pages 280-308)
DATE
WEEK 8
At the end of the chapter, the student will be able to:
SPECIFIC
OBJECTIVES • Define congenital heart disease
• Understand the sonographers approach to pediatric echocardiography
• Describe complications, symptoms, 2-D, M-Mode and Doppler findings
• Describe murmurs, normal and abnormal values
• Describe follow up, treatment, and prognosis
• Understand surgical procedures
• Describe congenital defects seen in adults
TOPIC (S)
Congenital Heart Disease; ASD, VSD, EBSTEIN’S,
TRICUSPID ATRESIA
LEARNING • Power point presentation
ACTIVITIES Lab: Students will practice on Pulmonary Flow from PLAX and PSAX
Visualization of RPA and LPA
Lab test
Review Power Point
OUTSIDE
Homework: Complete Key Terms
WORK &
ASSIGNED
Read: Chapter 17, The Adult with Congenital Heart Disease
READINGS
Otto(page 443)
Study for Quiz # 3
DATE
WEEK 9
At the end of the chapter, the student will be able to:
SPECIFIC
OBJECTIVES • Define endocardial cushion defect, and atrioventricular canal
• Describe Down Syndrome
• Define anomalous venous return
• Define Tetralogy of Fallot
• Describe complications, symptoms, 2-D, M-Mode and Doppler findings
• Describe murmurs, normal and abnormal values
• Describe follow up, treatment, and prognosis
• Describe Fontan physiology
• Understand calculations of shunt ratios
TOPICS
Endocardial Cushion Defect, Abnormal Venous Connections,
Tetralogy of Fallot
LEARNING • Power point presentation
ACTIVITIES • Video on Tetralogy of Fallot and other Congenital Disease
• Discuss Fontan Physiology and Other Available Surgeries
Quiz # 3
Lab: Students will practice Pulmonary Flow
Review Power Point and Normal Values
OUTSIDE
Complete Key terms
WORK &
Homework: Pick a Subject for Final Presentation
ASSIGNED
READINGS
DATE
WEEK 10
At the end of the chapter the students will be able to:
SPECIFIC
OBJECTIVES • Describe transposition of the great vessels (D-TGA, and CC-TGA)
• Describe truncus, coarctation and interrupted Ao Arch
• Describe complications, symptoms, 2-D, M-Mode and Doppler findings
• Describe murmurs, normal and abnormal values
• Describe follow up, treatment, and prognosis
• Understand available surgeries
• Describe arterial switch and atrial switch
TOPIC (S)
Transposition of the Great Vessels, Truncus Arteriosus,
Coarctation of the Ao, Interrupted AO Arch
Power point presentation
LEARNING
Presentation of Fetal Development of Intracardiac Formation
ACTIVITIES
Lab: Assessment of the Great Arteries
Review Power Point
OUTSIDE
Complete Key Terms
WORK &
Homework: Presentation in Conotruncal Abnormalities
ASSIGNED
READINGS
DATE
WEEK 11
At the end of the chapter the student will be able to:
SPECIFIC
OBJECTIVES • Describe double outlet RV, hypoplastic left ventricle
• Describe coronary fistulas
• Describe complications, symptoms, 2-D, M-Mode and Doppler findings
• Describe murmurs, normal and abnormal values
• Describe follow up, treatment, and prognosis
• Describe available surgeries
TOPIC (S)
Double Outlet Right Ventricle, Hypoplastic Left Ventricle,
Coronary Fistula
LEARNING • Power Point Presentation
ACTIVITIES • Summary of Congenital Heart Disease
Lab: Practice Protocol
OUTSIDE
Study for Final Exam and Lab Competencies
Homework: Complete Key Terms
WORK &
ASSIGNED
READINGS
DATE
WEEK 12
SPECIFIC
Final Exam
OBJECTIVES Review of Echo Pathologies and the Sonographers Role
TOPIC (S)
Final Exam and Overview of Cardiac Pathology
LEARNING Final Exam
ACTIVITIES Final Lab Competencies
Integration of data: Incorporate outside data (clinical assessment, physical, lab
values, compare with previous exams, provide preliminary reports to
physician)
Review Echocardiography Pathology II
OUTSIDE
WORK &
ASSIGNED
READINGS
Instructional Methods
The following strategies may be used in this class:
1. Class Lectures
2. Sketch drawings
3. PowerPoint Presentation
4. Class Discussion
5. Practice tests
6. Internet research
7. Student evaluation of course
References and Resources
ICHS Virtual Library
Login to the ICHS Virtual Library at http://www.lirn.net, access code 40149 to
online books, journals, and other reference resources selected to support ICHS curricula.
Medline Plus http://www.nlm.nih.gov/medlineplus/
Health information from the National Library of Medicine National Institutes of Health. Easy
access to Medline and Health topics, medical dictionaries, directories, drug information, videos
and more.
PALM BEACH COUNTY LIBRARY ONLINE RESOURCES
You need a free Palm Beach County Library card to access, or register for a free “Temporary
Research Access Code” at http://edb.pbclibrary.org/TRAC/
If you need help using any of the library websites, click on the
“Ask a Librarian” icon and “chat” with a librarian.
Consumer Health
http://www.pbclibrary.org/health.htm
CINAHL® with Full Text - full text articles for more than 610 nursing and allied health journals
(and indexing for an additional 3000 journals) as well as health care books, nursing
dissertations, selected conference proceedings, and more.
http://www.pbclibrary.org/databases/
LearningExpress - (Practice Tests) Contains online learning with skill building modules, test
preparation materials and practice exams; including test preparation E-books. Take practice
tests for Health Careers, Radiography, Registered Medical Assistant and NCLEX-RN for
Nursing. Learn techniques for job searching, resumes, interviewing and workplace skills.
http://www.pbclibrary.org/databases/
Health and Wellness Resource Center http://www.pbclibrary.org/databases/
Assessment Criteria and Methods of Evaluating Students
A
B
C
F
equivalent to
equivalent to
equivalent to
equivalent to
90 – 100
80 – 89
75 – 79
74 and below
4.0
3.0
2.0
0.0
Generally, the grades “A” through “C” are considered passing grades. Grades "W" and "I" indicate that no
grades were earned for the course. A "W" grade indicates that the student withdrew from the course. An
"I" grade indicates that the student was passing the course, but failed to complete all the required course
work. The instructor, in his/her discretion may grant an "I" grade instead of an "F", pending completion of
the course work by the student within a specified time arranged by the instructor and told to the student. It
is the student's responsibility to follow-up with the instructor to complete the course work. If the course
work is not completed by the arranged time, the “I” grade becomes an “F".
Distribution of Grade Elements
Quizzes
25%
Mid-Term
25%
Final
30%
Lab Competencies
20%
Total
100%
Syllabus Revised September 10, 2015