Week Six -- Mitch

This week I focused more on my research than clinical shadowing. I did shadow in Echo though. I watched a few trans-esophageal echo-cardiograms, and one stress echo. TEE is a relatively quick and non-risky procedure. The transducer is inserted into the esophagus where it can get a clearer ultrasound of the heart, than if it was on top of the chest. I found it very interesting how clear the pictures were, compared to regular ultrasound. In addition, the doctors can tell a lot from the images, including if there is a thrombus in the heart. This seems to be one of the biggest applications of TEE -- because patients going for cardio-versions need to be thrombus free, to reduce the risk of stroke. I was surprised by the fact that there only seemed to be one TEE procedure room, even though they are very busy and also have to do consults in different services. In addition, I was surprised by the fact that they read the echos right after they take them, unlike MRI or CT, where the image is taken by a technician and the doctors read the images later in the day.

Working on my research, I continued to help my mentor prepare for a clinical trail of the use of the new GE t1 mapping tool in cardiac amyloidosis. This week we got the mapping software from GE and I worked to install it, learn it, and run it on some cases. I also ran a few scans using phantoms with known t1 values, to evaluate the consistency of the reconstruction tool. It works fairly well, but does have some variability. I will cover this in my final report for the class. In addition, I went to pathology this week to see slides from a positive amyloid case, that we had done an MRI on, and then the patient got a biopsy. It was really neat to see the amyloid under the microscope, and how it affects the myocardium.