Stress Echocardiography

Details

Title

Stress Echocardiography

Type

Stage Two

Module code

HPS145

Requirement

Optional

Module objective

By the end of this module the Clinical Scientist in HSST, with respect to stress echocardiography, will be able to critically analyse, synthesise, evaluate and apply knowledge, and develop advanced skills in stress echocardiography, including reporting. They will be able to take a leadership role in a stress echocardiogram service, including the quality assurance and training of other staff, while demonstrating the attitudes and behaviours necessary for the role of a Consultant Clinical Scientist in a patient-focused service.

Knowledge and understanding

By the end of this module training period the Clinical Scientist in HSST will critically analyse, synthesise, evaluate and apply their expert knowledge of stress echocardiography, including:

• the principles, indications and clinical role of stress echocardiography;
• the pathophysiology and biochemical and mechanical changes associated with hibernation, infarction and ischaemia;
• different stressors, including dobutamine, exercise, pacing, atropine, adenosine and dipyridamole;
• the physical properties and side effects of intravascular contrast agents for opacification of the LV cavity and myocardial perfusion;
• the effects of flow on the left ventricle, the heart valves and the right heart in patients with valve disease;
• the methods of reporting a stress echocardiogram, including wall motion analysis, contrast assessment and long axis function;
• the evidence for stress echocardiography in the detection of coronary disease, coronary risk stratification and the detection of viable myocardium;
• the use of stress echocardiography in valve disease;
• the cost-effectiveness of stress echocardiography;
• the comparison of echocardiography with other techniques;
• the principles of myocardial contrast;training and supervision
• national and international recommendations and guidelines for the following: (i) indications for echocardiography; (ii) standards for performing and reporting of echocardiograms; (iii) institutional accreditation for echocardiography departments;(iv) e roles of clinical and technical leadership in echocardiography departments; (v)training and supervision.

Technical and clinical skills

application to the performance, adaptation and mastery of a range of clinical and communication skills and will:

• prepare and administer pharmacological stressors safely;
• prepare and administer contrast agents safely;
• manage complications, including allergic reactions and arrhythmias, and be able to resuscitate in the event of cardiac arrest;
• set up an echocardiography machine appropriately for stress echocardiography;
• record echocardiograms during a stress study;
• recognise subtle abnormalities of wall motion and differentiate wall thickening and wall motion;
• perform stress studies in patients with valve disease;
• reflect on the challenges of applying research to practice in relation to an aspect of stress echocardiography and suggest improvements, building on a critique of available evidence.

Attitudes and behaviours

By the end of this module the Clinical Scientist in HSST will be expected to critically evaluate their own response to both normal and complex situations, consistently demonstrating the professional attributes and insights required of a Clinical Scientist in HSST working within the limits of professional competence, referring as appropriate to senior staff, and will:

• adequately explain the procedure to a patient and maintain trust;
• work with sonographers, cardiac surgeons and interventional cardiologists;
• collaborate with specialists in other imaging modalities;
• integrate the stress study with the clinical context to produce recommendations;
• critically reflect on your practice;
• audit results;
• compare different techniques, including cardiac magnetic resonance and nuclear perfusion imaging;
• integrate results from a variety of techniques, including coronary angiography, to produce an appropriate synthesis;
• develop leadership role in organisation and administration;
• develop leadership skills in training and clinical supervision;
• work collaboratively with cardiologists, cardiac surgeons, other medical staff, healthcare science practitioners, echocardiographers and nurses.