Yale: Cardiovascular Medicine: Echocardiography

Section of
Cardiovascular Medicine
Yale University
School of Medicine
333 Cedar Street
PO Box 208017
New Haven, CT 06510
USA
(203) 785-4114

Yale | Cardiovascular Medicine | Echocardiography

Echocardiography Service

Faculty
Five attending cardiologists staff the echocardiography laboratory:

Dr. Robert McNamara, Director
Dr. Farid Jadbabaie
Dr. L. Veronica Lee
Dr. Harlan Krumholz
Dr. Kerry Russell

Location
The Yale University Echocardiography service covers echocardiography performed at the Yale-New Haven Hospital, the West Haven Veterans Hospital, and the Yale University Cardiology Faculty Practice.

Sonographers
Nancy Cavallero, RCDS, heads seventeen registered diagnostic medical sonographers to form the staff of the echocardiographic service at Yale-New Haven Hospital. Many of the sonographers are also cross trained in body ultrasonography. This cross training not only maximizes technician expertise in understanding the full breadth of vascular imaging but enables extensive evening and weekend coverage by fully-certified cardiac sonographers. Maureen O’Connor, RCDS, directs the outpatient echocardiography services for the cardiology faculty practice.

Equipment
Within the hospital, echocardiograms are acquired digitally on four Acuson Sequoia machines and sent to a KinetDx server. Cardiology fellows are given the opportunity to preread studies on two complete digital workstations within the reading room using an electronic reporting system. These studies are then reviewed with an attending cardiologist. A digital archive enables rapid access to previous studies for comparison. A clinical viewstation is located within the Cardiac Care Unit for review by all cardiologists and fellows. The affiliated West Haven Veterans Administration Medical Center uses three state-of-the-art digital machines.

Volume
The adult echocardiography service performs more than 10,000 transthoracic, 500 transesophageal, and 2000 stress examinations per year.

Clinical Training
All cardiology fellows are trained to meet at least the American College of Cardiology Level I requirements, including three months within the first two years in the Yale-New Haven Hospital Echo Lab. Select fellows receive additional training to Levels II and III. Cardiology fellows receive personalized instruction in developing their scanning skills by the experienced technologists who perform the lab's studies. All fellows become proficient in acquisition and interpretation of transthoracic imaging. Experience with transesophageal and stress echocardiography is also an integral part of the echocardiography rotations. Close relations exist with the pediatric cardiac service, including a program of echocardiographic imaging during percutaneous procedures, and the cardiac anesthesia service.

In addition to hands-on clinical training, fellows attend multiple conferences. Biweekly echocardiography conferences are held with active participation by attendings, fellows, and sonographers. Practical sessions for scanning are conducted for the fellows by the Lisa Bevins, RCDS, Director of the Yale-New Haven Hospital Ultrasound School. Echocardiography is displayed prominently in the weekly Cardiology Grand Rounds and thrice-weekly cardiology fellow’s conferences. In addition, fellows can attend monthly cardiac anesthesia conferences and bimonthly regional echocardiography conferences.

Web-based software created by the previous echocardiography director, Dr. C. Carl Jaffe, covering Adult Transthoracic and Transesophageal Echocardiography and Adult Congenital Heart Disease are available for individual learning. Easily available computers contain teaching cases in digital-loop form. The section keeps a large collection (more than 16 hours) of the American College of Cardiology teaching videotapes on echocardiography available for staff use.

Research
Faculty interests in cardiac imaging are broad-ranging. Drs. McNamara, Krumholz, and Radford investigate cardiac outcomes and quality of care. Dr. Russell uses echocardiography on the mouse model to study cellular signaling. Other areas of investigations within the laboratory include atrial fibrillation and diastolic dysfunction.

Last modified: May 11, 2000 (PL)