Carol A. Hirshman, M.D., Editor

The Echo Manual from the Mayo Clinic, By Jae K. Oh, James B, Seward, and A. Jamil Tajik. Boston, Little, Brown and Company, 1994. Pages: 252, Price:$79.95.

Anesthesiologists starting a training program in cardiac echocardiography often need a simple reference text as a guide to imaging specific structures, to explain an equation, or to discuss cardiac correlates of noncardiac disease. The Echo Manual endeavors to be the beginner's guide to echocardiography. It dwells on the practical aspects of examination and diagnosis without a weighty discussion of the theory of ultrasound.

A historical development of cardiac echocardiography introduces the text, followed by chapters illustrating the various merits of transthoracic and tranesophageal imaging. The reviews of basic principles required to analyze left ventricular function or calculate hemodynamics derived from measurements of areas and velocities are clear and easy to follow. Eleven chapters form the body of the book as a presentation of echocardiographic findings associated with specific disease states. The topics range from noncardiac systemic illness (hemochromatosis as an example) to a summary of congenital heart disease. One chapter discusses the use of cardiac echo in the operating room and a guide to echo monitoring of nonsurgical procedures. The text concludes by outlining requirements for a complete examination focused to the referring diagnosis.

The Echo Manual is exactly what it claims to be: a quick reference for either a trainee or a modestly experienced echocardiographer Diagnostic discussions do not attempt to be comprehensive but cover the principal points succinctly and guide the reader toward a rapid diagnosis. References and indexing are adequate, but not exhaustive, in keeping with the brevity of the text. The use of illustrations, particularly the artist's drawings, offers an immediate grasp of the salient anatomy. The emphasis is on the most common and easily acquired planes of section, with a brief introduction to multiple plane imaging. Integration of warnings about common errors of technique or interpretation occurs throughout the text in association with the appropriate pathophysiology.

The strength of The Echo Manual is the breadth of its synopsis in a readable and enjoyable form. Anesthesiologists may prefer less emphasis on transthoracle and more discussion of transesophageal examination. This is a good companion volume for the anesthesiology resident spending a rotation studying basic echocardiography with a cardiology service.

Lex Schultheis, M.D., Ph.D.; Assistant Professor; Department of Anesthesiology; The Johns Hopkins Medical Institutions; Tower 711; 600 North Wolfe Street; Baltimore, Maryland 21287.