Imaging (Echocardiography) —
Training activity: 27

Details

Adapt protocol and report to cater for pericardial 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 the different types of pericardial disease (e.g., pericardial effusion, constrictive pericarditis) and their echocardiographic features?
• How does the imaging protocol need to be adapted to assess the pericardium?
• What specific views and techniques are important in evaluating pericardial disease and its haemodynamic consequences?
• What key elements should be included in the echo report when focusing on pericardial disease?

In action

• How are you modifying the standard echo protocol to assess for features of pericardial disease (e.g., pericardial effusion, tamponade, constrictive pericarditis)? Which specific views and measurements are you prioritising? How are you planning to structure your report to clearly document any findings related to the pericardium and their haemodynamic impact? Are you carefully assessing for the presence, size, and distribution of any pericardial effusion? Are you looking for echocardiographic signs of cardiac tamponade (e.g., right atrial and ventricular diastolic collapse)? Are you evaluating for features suggestive of constrictive pericarditis (e.g., septal bounce, respiratory variation in inflow velocities)? Are you familiar with the echocardiographic findings in different types of pericardial disease? Are you consciously applying specific criteria for diagnosing tamponade or constrictive pericarditis?

• Are you successfully visualising the pericardium and assessing for effusions or thickening? Are you obtaining the necessary Doppler measurements to evaluate for haemodynamic compromise? Are you gaining a better understanding of the echocardiographic spectrum of pericardial disease and its haemodynamic consequences? Are you learning to differentiate between different types of pericardial abnormalities? Are you applying your knowledge of pericardial anatomy and physiology, the pathophysiology of pericardial diseases, and echocardiographic techniques for assessing the pericardium and cardiac haemodynamics?

• Would M-mode imaging be particularly helpful in assessing for septal bounce in constrictive pericarditis? Is there a role for other imaging modalities like CT or MRI in evaluating pericardial disease? If you identify findings suggestive of tamponade or constrictive pericarditis, would you immediately discuss them with a senior colleague? Are the protocol adaptations and the interpretation of findings related to pericardial disease within the scope of your current training?

On action

• Describe the specific considerations for imaging a patient with suspected or known pericardial disease. Outline how you adapted the standard echo protocol, including specific views and assessments (e.g., for effusion, tamponade, constriction). Note the key features you focused on in the report.
• Reflect on your understanding of the echocardiographic assessment of pericardial disease. Did you gain a better understanding of the specific imaging features of different pericardial 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 aspects of pericardial disease imaging where you need to enhance your knowledge of 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 patients with various forms of pericardial disease (e.g., pericardial effusion, constrictive pericarditis) requiring specific adaptations to the echo protocol and reporting? Have your subsequent experiences broadened your understanding of the echocardiographic assessment of pericardial pathology?
• How has your ability to tailor echo protocols to assess for pericardial effusion, tamponade, and constrictive physiology improved? Are you now more proficient in obtaining and interpreting the specific measurements and qualitative assessments relevant to pericardial disease?
• How will your understanding of echocardiography in pericardial disease inform your role in the diagnosis and management of these conditions, potentially in collaboration with other specialties such as rheumatology? How will this experience support your ability to differentiate between different types of pericardial disease based on echocardiographic findings?

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.