echocardiography examination

7/25/2019 Echocardiography Examination

1/73

EchocardiograpEchocardiograp

hyhy

ExaminationExaminationRudy A.Taruli MDRudy A.Taruli MD

Husada HospitalHusada HospitalJakartaJakarta

20052005


2/73

HistoryHistory A mode EchoA mode Echo M mode EchoM mode Echo B mode Echo ( 2D B mode Echo ( 2D Doppler Echo ( !" # $"% !R& Doppler Echo ( !" # $"% !R& $o'trast Echo$o'trast Echo $olor Doppler Echo ( $& $olor Doppler Echo ( $& Tissue DopplerTissue Doppler Harmo'ic ma)i')Harmo'ic ma)i') Di)ital Echo% * D + , D EchoDi)ital Echo% * D + , D Echo


3/73

TransducerTransducer

InterrogationInterrogation

Tra'sthoracic Echo (TTETra'sthoracic Echo (TTE

Tra'sesopha)eal Echo (TEETra'sesopha)eal Echo (TEE 'traoperati-e Echo'traoperati-e Echo

'tracardiac Echo'tracardiac Echo

Epicardiac EchoEpicardiac Echo 'tra-ascular Echo (/'tra-ascular Echo (/


4/73

Using B mode, M mode,Using B mode, M mode,

Color doppler & DopplerColor doppler & Doppler

"e ca' e-aluate 1"e ca' e-aluate 1

AAT3M4% &/$T3 #AAT3M4% &/$T3 #

HEM3D4AM$HEM3D4AM$

$o'trast echo still useul (perusio'$o'trast echo still useul (perusio'

tress echo (myocardial -ia6ilitytress echo (myocardial -ia6ility


5/73

How to er!ormHow to er!orm

EchoEcho

examinationexamination


6/73

Three componentsThree components

7.7. 3perator3perator

2.2. 'strume't'strume't

*.*. !atie't!atie't

3perator 13perator 1

7.7. $o)'iti-e skill ( k'o8led)e o physical$o)'iti-e skill ( k'o8led)e o physicalpri'ciple% 'ormal+patholo)ic cardiacpri'ciple% 'ormal+patholo)ic cardiac

a'atomy% cardiac auscultatio'% E$9% :uida'atomy% cardiac auscultatio'% E$9% :uid

dy'amic a'd 'ormal 6lood :o8 etcdy'amic a'd 'ormal 6lood :o8 etc


7/73

2. Tech'ical skill ( operatio' o /92. Tech'ical skill ( operatio' o /9

e;uipme't a'd all co'trols% positio'e;uipme't a'd all co'trols% positio'o tra'sducer% perorm completeo tra'sducer% perorm complete

sta'dard e


8/73

'strume't 1'strume't 1

hould e;uipped 8ith the 6asichould e;uipped 8ith the 6asicre;uireme't o M@mode% 2D sectorre;uireme't o M@mode% 2D sectorsca''i')% Doppler% color :o8 ima)i')sca''i')% Doppler% color :o8 ima)i')

&re;ue'cy o at least 2%0 = 2%5 Mh&re;ue'cy o at least 2%0 = 2%5 Mh(adult% *%0 = 5%0 Mh (pediatric%(adult% *%0 = 5%0 Mh (pediatric%harmo'ic ima)i')harmo'ic ima)i')

$o'trolled )ray scale% )ai'% depth o$o'trolled )ray scale% )ai'% depth oeld (oom% lter% color :o8 )ai'eld (oom% lter% color :o8 )ai'a'd ltera'd lter


9/73

!atie't 1!atie't 1

9i-es ull i'ormatio'% patie'tCs9i-es ull i'ormatio'% patie'tCspositio'%positio'%

Hemody'amic status% E$9% limiti')Hemody'amic status% E$9% limiti')

actors (o6ese% emphysematousactors (o6ese% emphysematous

mporta't mporta't patial 3rie'tatio' # Ha'd eyepatial 3rie'tatio' # Ha'd eye

coordi'atio'coordi'atio'


10/73

How to per!orm "How to per!orm "

'strume't preparatio' ( D'strume't preparatio' ( D 'ormed patie't'ormed patie't >et lateral decu6itus>et lateral decu6itus

2 = D Echo $olor &lo8 mappi') (o-er-ie82 = D Echo $olor &lo8 mappi') (o-er-ie8 M = Mode (Aorta@>A% M% > ca-ity%M = Mode (Aorta@>A% M% > ca-ity%

calculatio'% !calculatio'% ! till rame (systolic@diastolic% !>AF #till rame (systolic@diastolic% !>AF #

!AF!AF Doppler Echo (M + > i':o8% A + >3T%Doppler Echo (M + > i':o8% A + >3T%

T%!T%!


11/73

emi;ua'titati-e% ;ua'titati-eemi;ua'titati-e% ;ua'titati-e

measureme'ts (Re)ur)itatio'%measureme'ts (Re)ur)itatio'%

te'osis% i'tracardiacte'osis% i'tracardiac

pressures% cardiac output%pressures% cardiac output%Gp+GsGp+Gs

9ood ima)e% )ood pri'ter9ood ima)e% )ood pri'ter

ReportsReports


12/73


13/73


14/73


15/73


16/73


17/73


18/73


19/73


20/73


21/73

B-mode (2 D Echo)B-mode (2 D Echo)


22/73


23/73


24/73


25/73


26/73


27/73


28/73


29/73


30/73


31/73


32/73


33/73


34/73


35/73


36/73


37/73


38/73


39/73


40/73

M # modeM # mode

EchoEcho


41/73


42/73


43/73

$dult normal %alues$dult normal %alues

Aortic root 1 20 = * mmAortic root 1 20 = * mm

Ao cusp separatio' 1 75 = 2? mmAo cusp separatio' 1 75 = 2? mm

>et atrial 1 7I = ,0 mm>et atrial 1 7I = ,0 mm

> e'd diast 1 * = 5? mm> e'd diast 1 * = 5? mm

> e'd syst 1 20 = * mm> e'd syst 1 20 = * mm

(diast 1 ? = 77 mm (diast 1 ? = 77 mm

!" (diast 1 ? @ 77 mm!" (diast 1 ? @ 77 mm&ract shorte'i') 1 2 = ,7 K&ract shorte'i') 1 2 = ,7 K

ELect &r. (E& 1 50 = , KELect &r. (E& 1 50 = , K


44/73


45/73


46/73


47/73


48/73

LVH


49/73

LVH

HCM


50/73

HCM


51/73

Thrombus


52/73

Ball thrombus


53/73

EbsteinAnomaly


54/73

Doppler EchoDoppler Echo

Mode 1 pulse 8a-e% co'ti'uousMode 1 pulse 8a-e% co'ti'uous

8a-e8a-e

Applicatio' 1 or -al-ular heartApplicatio' 1 or -al-ular heartdisease% co')e'ital heart disease%disease% co')e'ital heart disease%

;ua'titatio' o -olume :o8%;ua'titatio' o -olume :o8%

assessme't o -e'tricularassessme't o -e'tricularperorma'ceperorma'ce


55/73


56/73


57/73


58/73


59/73


60/73


61/73


62/73

Color lowColor lowImagingImaging

&or -al-ular = co')e'ital&or -al-ular = co')e'ital

heart disease%heart disease%

hemody'amic assessme'themody'amic assessme't


63/73


64/73


65/73

AR

Car.bulb

TEE


66/73


67/73

TEE C A t


68/73

TEE, Cor.Art


69/73

Contrast Echo


70/73

Tissue Doppler


71/73

'EE'E(CE)'EE'E(CE)


72/73

'EE'E(CE)'EE'E(CE)

7.&ei)e'6aum% H. 1 Echocardio)raphy% >ea # &e6i)er% !hiladelphia% ,7.&ei)e'6aum% H. 1 Echocardio)raphy% >ea # &e6i)er% !hiladelphia% ,thth

Ed% 7I?Ed% 7I?

2. 3h J% e8ard JB% TaLik JA 1 The Echo Ma''ual% >ippi'cott "illiams #2. 3h J% e8ard JB% TaLik JA 1 The Echo Ma''ual% >ippi'cott "illiams #"ilki's% !hiladelphia% 2"ilki's% !hiladelphia% 2'd'dEd% 7IIIEd% 7III

*. isslo J% Adams D% Mark DB 1 Basic Doppler Echocardio)raphy%*. isslo J% Adams D% Mark DB 1 Basic Doppler Echocardio)raphy%

$li'ics$li'ics

i' Dia)'ostic /ltrasou'd -ol. 7% $hurchill >i-i')sto'e% 4 7I?i' Dia)'ostic /ltrasou'd -ol. 7% $hurchill >i-i')sto'e% 4 7I?

,. erut E% Mcll8ai' E&% !lot'ick 9D 1 Ha'd6ook o Echo Doppler 'ter@,. erut E% Mcll8ai' E&% !lot'ick 9D 1 Ha'd6ook o Echo Doppler 'ter@ pretatio'% &utura !u6lishi') $o 'c. Armo'k 4% 7II?pretatio'% &utura !u6lishi') $o 'c. Armo'k 4% 7II?

5. Harry JM 1 $ardiac Doppler Hemody'amic "ork6ook% o8a Heart5. Harry JM 1 $ardiac Doppler Hemody'amic "ork6ook% o8a Heart

's@'s@

titute% 7IItitute% 7II

?. "eide'6ach M. et al 1 $omputer 6ased Trai'i') i' T8o Dime'sio'al?. "eide'6ach M. et al 1 $omputer 6ased Trai'i') i' T8o Dime'sio'alEchocardio)raphy usi') a' Echocardio)raphy imulator% J Am ocEchocardio)raphy usi') a' Echocardio)raphy imulator% J Am oc

Echocardio)r% 2005% ,% *?2 = *??Echocardio)r% 2005% ,% *?2 = *??

. 3moto R. 1 $olor Atlas o Real Time T8o Dime'sio'al Doppler Echo =. 3moto R. 1 $olor Atlas o Real Time T8o Dime'sio'al Doppler Echo =

cardo)raphy% hi'da' To $hiryo $o >td. Tokyo% 2cardo)raphy% hi'da' To $hiryo $o >td. Tokyo% 2'd'dEd% 7IEd% 7I

. a'da% $ 1 Te


73/73

echocardiography examination

Documents