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Practical Echocardiography for the Neonatologist. Nick Evans and Girvan Malcolm (CD ROM; A$250.00). Australia: RPA.
The heart is a deceptively simple structure. Its main function is to power the circulation and it achieves this with only two pumps and only four valves. Most diagrammatic representations of the heart underestimate its true anatomical complexity so that the first contact of the novice with the complex three dimensional anatomy is intimidating. Even the great arteries, which are easy to depict diagrammatically, have a complex changing relationship with each other as they curve through the upper mediastinum. All these problems are compounded by our terminology because the “right” ventricle is in fact anterior to the “left” ventricle and the “left” atrium is posterior.
Neonatologists are interested in echocardiography because it allows assessment of the ductus in prematurity, it provides functional haemodynamic assessment, and it offers recognition or exclusion of structural heart disease although exclusion with confidence often requires expert assessment. The foundation of expertise in echocardiography is a clear understanding of the three dimensional anatomy. This is difficult to teach and time consuming to learn.
This CD provides the neonatologist with a superb introduction to three dimensional cardiovascular anatomy. It then links the anatomical arrangement to the standard echocardiographic views and illustrates the basics of Doppler and colour Doppler assessment of blood flow. The video images are clear and are provided side by side with anatomical diagrams illustrating the plane of the cross sectional image or the orientation of the Doppler probe. This CD will be of interest and of value to all those first learning echocardiography, including technicians and trainee paediatric cardiologists, and not just neonatologists. Obviously, recognition of normality requires familiarity with abnormality and this is due to be presented in a later CD. If that matches the quality of this first CD then between them they will provide a valuable introduction to echocardiographic assessment of the neonate.