Imaging (Echocardiography) —
Training activity: 13

Details

Adapt protocol and report to cater for simple adult congenital heart disease

Type

Developmental training activity (DTA)

Evidence requirements

Evidence the activity has been undertaken by the trainee​.

Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.

An action plan to implement learning and/or to address skills or knowledge gaps identified.

Reflective practice guidance

The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.

Before action

• Before this activity, what are some examples of simple adult congenital heart defects (e.g., atrial septal defect, ventricular septal defect) and their typical echocardiographic appearances?
• How does the imaging protocol need to be adapted to visualise these defects and assess their haemodynamic significance?
• What specific views and Doppler techniques are important in evaluating adult congenital heart disease?
• What key elements should be included in the echo report when focusing on simple adult congenital heart disease?

In action

• How are you modifying the standard adult echo protocol to assess for specific features of simple adult congenital heart disease (e.g., atrial septal defect, ventricular septal defect, patent ductus arteriosus)? Which specific views and Doppler techniques are you prioritising? How are you planning to structure your report to clearly describe the anatomy and haemodynamic consequences of the defect? Are you focusing on identifying the location, size, and haemodynamic impact of the congenital defect? Are you deciding which Doppler modalities (e.g., colour flow, continuous wave, pulsed wave) are most appropriate for assessing blood flow patterns and pressure gradients? Are you familiar with the echocardiographic appearances of common simple adult congenital heart defects? Are you consciously applying appropriate imaging planes and Doppler techniques to visualise and quantify the defects?

• Are you successfully visualising the congenital defect and assessing its haemodynamic significance? Are you encountering any technical challenges in optimising your images or Doppler signals? Are you gaining a better understanding of the echocardiographic features of different simple congenital heart defects and their physiological consequences? Are you learning to differentiate between various types of defects and their severity? Are you applying your knowledge of cardiac embryology, congenital heart disease, and echocardiographic assessment techniques?

• Would the use of saline contrast be helpful in visualising certain defects? Is there a role for transoesophageal echocardiography to provide better imaging in specific cases? If you are unsure about the identification or haemodynamic assessment of a specific congenital defect, would you seek advice? Are the protocol adaptations and the interpretation of findings related to simple adult congenital heart disease within the scope of your current training?

On action

• Describe the specific considerations for imaging a patient with simple adult congenital heart disease. Outline how you adapted the standard echo protocol, including any specific views or measurements taken. Note the key features you focused on in the report.
• Reflect on your understanding of the echocardiographic assessment of simple adult congenital heart disease. Did you gain a better understanding of the specific imaging features associated with these conditions? Were there any challenges in adapting the protocol or interpreting the findings? How does this relate to acquiring and interpreting cardiac images for pathological conditions?
• Identify any specific types of simple adult congenital heart disease where you need to enhance your knowledge of imaging protocols and reporting. How will you approach adapting protocols in the future? What resources will you use to further your understanding?

Beyond action

• Have you encountered different types of simple adult congenital heart disease requiring tailored echo protocols (e.g., atrial septal defect, ventricular septal defect)? Have your subsequent experiences enhanced your understanding of the echocardiographic assessment of these conditions in adults?
• How has your ability to adapt echo protocols to assess the specific anatomical and haemodynamic features of simple adult congenital heart disease improved? Are you now more skilled in obtaining and interpreting the necessary views and measurements for these patients?
• How will your understanding of echocardiography in adult congenital heart disease inform your role in the follow-up and management of these patients, potentially in collaboration with specialist congenital heart centres? How will this experience support your recognition of the long-term sequelae of congenital heart defects?

Relevant learning outcomes

#	Outcome
# 1	Outcome Acquire and interpret cardiac images for a range of normal and pathological conditions.
# 2	Outcome Explain imaging results to patients and other health care professionals.
# 3	Outcome Distinguish and justify actions based on clinical and ECG findings.
# 5	Outcome Appraise new guidelines and evidence to inform practice.
# 6	Outcome Demonstrate safe practice in line with local, national and international guidelines and standards.
# 7	Outcome Assess and evaluate a patient’s clinical presentation and make recommendations for cardiac imaging.
# 8	Outcome Evaluate cardiac care pathways.
# 9	Outcome Summarise complex information into a concise and logical reports for specialist and non-specialist audiences.