what is echocardiography(1)

8/7/2019 What is echocardiography(1)

http://slidepdf.com/reader/full/what-is-echocardiography1 1/18



E chocardiographyE chocardiographyE chocardiography is a relatively painlessE chocardiography is a relatively painlesstest that uses sound waves to create imagestest that uses sound waves to create imagesof the heart.of the heart.

Probe rotations allow the sonographer toProbe rotations allow the sonographer toacquire multiple images, assessing it fromacquire multiple images, assessing it frommultiple views and windowsmultiple views and windows



E cho windows and viewsE cho windows and views



E cho assessmentE cho assessment

Allows the assessment of:Allows the assessment of:Left ventricular size and function, includingLeft ventricular size and function, includingregional wall motion abnormalitiesregional wall motion abnormalitiesRight ventricular size and functionRight ventricular size and functionThe heart valvesThe heart valves ± ± Mitral, Aortic, TricuspidMitral, Aortic, Tricuspidand Pulmonary (stenosis, regurgitationand Pulmonary (stenosis, regurgitationetc)etc)Intracardiac pressuresIntracardiac pressuresLung pressuresLung pressures



Indications for E choIndications for E cho

MYOCARDIAL INFARCTIONMYOCARDIAL INFARCTION±± Ex tent and location of area of infarctionEx tent and location of area of infarction

±± Assessment of overall systolic function (E

F)Assessment of overall systolic function (E

F)±± Assessment of right ventricular involvementAssessment of right ventricular involvement±± Detection of complications of MIDetection of complications of MI



RegionalRegionalwall motionwall motion




CH ES T PAINCH ES T PAIN±± Useful when E CG is indeterminateUseful when E CG is indeterminate

±± Detection of myocarditis / pericarditisDetection of myocarditis / pericarditis±± Detection of aortic dissection (TO E oftenDetection of aortic dissection (TO E often

indicated)indicated)±± Ex clusion of aortic stenosis, hypertrophicEx clusion of aortic stenosis, hypertrophic

cardiomyopathy, mitral valve prolapsecardiomyopathy, mitral valve prolapse




MURMUR SMURMUR S

±± Aortic or pulmonary stenosis ( ES M)Aortic or pulmonary stenosis ( ES M)

±± Mitral or tricuspid regurgitation (PS

M)Mitral or tricuspid regurgitation (PS

M)±± Aortic or pulmonary regurgitation (diastolicAortic or pulmonary regurgitation (diastolic

murmur)murmur)±± Ex clusion of shuntsEx clusion of shunts ± ± VS D, AS D, PDAVS D, AS D, PDA±± Detection of hypertrophic obstructiveDetection of hypertrophic obstructive

cardiomyopathy ( ES M)cardiomyopathy ( ES M)



Aortic S tenosis




HE ART FAILUR EHE ART FAILUR E

±± Ischaemic vs nonIschaemic vs non- -ischaemic cardiomyopathyischaemic cardiomyopathy

±±Ex

clude diastolic dysfunction as causeEx

clude diastolic dysfunction as cause±± Ex clude valvular dysfunctionEx clude valvular dysfunction



Ischaemic cardiomyopathy

Dilated cardiomyopathy




Ex clude pericardial effusion / tamponadeEx clude pericardial effusion / tamponadeDetection of endocarditisDetection of endocarditis

Assessment of pulmonary pressures inAssessment of pulmonary pressures insuspected pulmonary hypertensionsuspected pulmonary hypertension



Interpreting an E cho ReportInterpreting an E cho Report

Left ventricleLeft ventricle±± S izeS ize

±±S

ystolic function (E

F, regional wall motion)S

ystolic function (E

F, regional wall motion)±± Diastolic function (rela x ation)Diastolic function (rela x ation)±± Wall thickness (LVH)Wall thickness (LVH)



S egmental Model: LVS egmental Model: LV

3 Levels3 Levels 17 segments 17 segments(1)(1) Basal LevelBasal Level ± ± MV annulus to papillaryMV annulus to papillary

muscle tipsmuscle tips(2)(2) Mid LevelMid Level ±± Pap muscle tips to base of Pap muscle tips to base of

pap musclepap muscle(3)(3) Apical LevelApical Level ±± Base of pap muscle toBase of pap muscle to

ape x ape x



17 Segment Model



Coronary artery distributionCoronary artery distribution



What are Regional Wall MotionWhat are Regional Wall MotionAbnormalities?Abnormalities?

N ormalN ormal -- > 40% increase> 40% increase in systolic wallin systolic wallthicknessthickness

HypokinesisHypokinesis -- < 40% increase< 40% increase in systolic wallin systolic wallthicknessthickness

AkinesisAkinesis ±± negligiblenegligible systolic thickeningsystolic thickening

DyskinesisDyskinesis ±± OutwardOutward systolic e x pansionsystolic e x pansion

AneurysmalAneurysmal ±± Diastolic deformationDiastolic deformation withwithassociated outward systolic e x pansionassociated outward systolic e x pansion



LV diastolic functionLV diastolic function

Indicates LV rela x ation and complianceIndicates LV rela x ation and complianceDiastolic dysfunction occurs early in theDiastolic dysfunction occurs early in thedisease processdisease process

Four key echocardiographicFour key echocardiographicmeasurements to assess diastolemeasurements to assess diastole

1.1. Mitral inflow velocity profileMitral inflow velocity profile2.2. Pulmonary vein inflow profilePulmonary vein inflow profile3.3. Mitral annular velocity or E¶Mitral annular velocity or E¶

4 .4 . Left atrial size / volumeLeft atrial size / volume

what is echocardiography(1)

Documents