Cardiology Point-of-Care Ultrasound Solutions: Integrating Hardware, Software, Artificial Intelligence, Education, and Training: The EchoScope Project
Joined May 2011
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16 Jan 2022
"For the heart to effectively pump, it must first effectively fill."
Ventricular Diastolic Function: FEATURES: 351 pages, > 2,000 Illustrations and Images. Publication date: Jan 16, 2022.
LOOK INSIDE: amazon.com/dp/B09QFJ4S4W?ref…
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Bernard E Bulwer retweeted
Jun 11
Most echocardiography laboratories have adopted the 2016 diastolic guidelines. With the release of the 2025 update, an important question arises:
What are the key conceptual differences between the 2016 and 2025 approaches to diagnosing diastolic dysfunction?
academic.oup.com/ehjcimaging…
@JGrapsa
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Bernard E Bulwer retweeted
Our 6th Advanced Imaging Techniques: Virtual Experience will be held August 29-30! 🫀
Sign up: bit.ly/4mzI1za
Attendees will gain a systematic approach to the evaluation of MR and TR using 3D technology, providing the precision required for modern clinical practice.
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Bernard E Bulwer retweeted
Check out this excellent @CardioBusiness article by @DaveFornell about our new #ASEGuideline, "Guidelines for the Intraprocedural Imaging for Mitral Valve Transcatheter Edge-to-Edge Repair (M-TEER)!"
Read it: bit.ly/4eeaVBn
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Bernard E Bulwer retweeted
We've released a #new State-of-the-Art Review, "The Effect of General Anesthesia and Mechanical Ventilation on the Echocardiographic Evaluation of Cardiac Function!"
Read it now: bit.ly/4eokgaT
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Bernard E Bulwer retweeted
🫀PRODUCT OF THE MONTH🫀
#AdvancedEcho 2026 online course is a comprehensive program designed to update cardiology and imaging professionals on the forefront of cardiovascular ultrasound.
Sign up: bit.ly/4tzfWKr
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Bernard E Bulwer retweeted
Great point @NephroP 🌟
Yes - in acute PE the septal shift is often most pronounced in late systole and early diastole rather than uniformly throughout systole.
👉 adult and pediatric patients with acute PE #echofirst
👉 TG mid SAX
May 21
Since you’re clearly not a beginner, that part is too easy for you!
But I do have a question for advanced users like you who have likely seen a lot of acute PE cases.
When exactly does septal flattening occur in acute pulmonary embolism, assuming the patient does not have chronic pulmonary hypertension with RV hypertrophy? My understanding is that for septal flattening throughout systole, the RV pressure would need to exceed LV pressure, which seems less likely in an acute event. So wouldn’t the flattening be more prominent during late systole and early part of diastole instead?
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Bernard E Bulwer retweeted
May 22
#CardioNuggets™
TEE views for fellows starting out🫀
Your FIRST view should usually be the mid-esophageal 4 chamber (~0–20°).
Why?
Because it helps orient you to:
• RA vs LA
• RV vs LV
• Mitral vs tricuspid valve
• Septum
• Overall probe position
Everything else builds from this view.
ProTip:
• The UMN TEE Simulator app is incredibly helpful for understanding how probe movement changes anatomy in real time
#CardioNuggets™ #CardioTwitter #TEE #EchoFirst
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Bernard E Bulwer retweeted
May 22
What is best formula to estimate mPAP on #echofirst?
📝 finds minimal end-diastolic PR pressure best correlation (R = 0.92) & diagnostic accuracy AUC 0.96 bit.ly/4nQrzvm in almost 600 pts referred for RHC for PH dx, integrates both PR & TR signals
At 24.5 mm Hg cutoff, mPAPDPmin 89% sensitivity, 94% specificity
At 20 mm Hg, mPAPDPmin sensitivity⬆️99% w/ net reclassification driven by more accurate downgrading of pts w/o PH
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Bernard E Bulwer retweeted
We quantitatively assessed the degree of echogenicity in the proximal and mid segments of both coronary arteries to determine its additional diagnostic value in 109 patients with clinically suspected Kawasaki disease.
Read our @JournalASEcho article: bit.ly/4dzdHkg
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Bernard E Bulwer retweeted
How many cusps does this aortic valve have?
1️⃣ Unicuspid
2️⃣ Bicuspid
3️⃣ Quadricuspid
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May 7
Artifacts in Echocardiography: Complementary charts and infographics. References: Echocardiography Illustrated: Ultrasound Physics: B-Mode Echocardiography and Introduction to Doppler (Echocardiograhy Illustrated Vols 9 and 10; 590 pages).
Vol 9: lnkd.in/eVcjSZcR
Vol 10: lnkd.in/eGU3n5WU
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Bernard E Bulwer retweeted
In the fourth 👶, when a markedly dilated coronary sinus is seen : think about associated PLSVC, which can coexist with D-TGA. @iamritu @ASE360 @CASivaram1 @alex1708ander
@loomba_rohit @SIwa23288585 @CardioNeo @WithAScalpel @AEPCcongenital @swatigar @sujithsp
21 Aug 2025
In the first 👶 - just one great vessel is seen (normal)
In the second 👶 - two great vessels in parallel are seen (this usually occurs in TGA), the anterior one being the aorta
In the third 👧 - just one great vessel overriding 🏇the IVS is seen (this usually occurs in TOF)
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Bernard E Bulwer retweeted
This video provides a structured approach for healthcare professionals to teach patients the Instructed Valsalva maneuver while identifying and correcting common imaging artifacts.
Learn more about our new "Goal Directed Valsalva Education Series!" bit.ly/4lR9MmF
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Bernard E Bulwer retweeted
During intraoperative TEE in a septuagenarian undergoing aortic valve replacement and coronary artery bypass grafting, eccentric mitral regurgitation is identified. Which echocardiographic parameter should be relied upon to accurately quantify its severity?#echofirst
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Bernard E Bulwer retweeted
In prosthetic MVR, a comet-tail artifact is a classic form of complex reverberation artifact caused by the highly reflective metallic components of the valve. @ASE360 @iamritu @CASivaram1 @alexsfelixecho @loomba_rohit @alex1708ander @SIwa23288585 @WithAScalpel @swatigar
This document provides a uniform & structured approach to managing ultrasound artifacts, including the appearance of the artifact, the mechanism behind the artifact generation, the clinical impact of the artifact on the diagnosis, & examples of real cases. bit.ly/4tKDSvf
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Bernard E Bulwer retweeted
We evaluated and compared the diagnostic performance of 5 echocardiographic formulas for estimating mPAP in a large cohort of consecutive patients undergoing both RHC & TTE, applying the updated hemodynamic PH definition.
Read our @JournalASEcho article: bit.ly/3R5gqu5
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Bernard E Bulwer retweeted
This document provides a uniform & structured approach to managing ultrasound artifacts, including the appearance of the artifact, the mechanism behind the artifact generation, the clinical impact of the artifact on the diagnosis, & examples of real cases. bit.ly/4tKDSvf
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Bernard E Bulwer retweeted
Standard echocardiographic imaging planes and the standard 17-segment model.😍
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Bernard E Bulwer retweeted
Comprehensive tricuspid valve TEE analysis (mid-esophageal & transgastric views) @iamritu @OungSavly @CASivaram1 @NMerke @DrRajeshG1 @alexsfelixecho @WithAScalpel
1️⃣ ME 4Ch
2️⃣ ME RV in-out
3️⃣ ME bicaval
💚 anterior TV leaflet
💛 septal TV leaflet
💙 posterior TV leaflet
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Bernard E Bulwer retweeted
Which all parameters to decide severity of MR in such jets?
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