intro to echo_class_05262015
TRANSCRIPT
TRAINING INSTITUTE
Introduction to Echocardiography
Presented by Clifford Thornton, RDCS, B.S.
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GOALS FOR COURSE• Develop a basic understanding of the
purpose, application, and key findings of an echocardiogram in the clinical setting
• Gain a fundamental understanding of the anatomy of the heart and its perspective in the standard 2D Echo views
• Gain a fundamental understanding of 2D imaging, M-Mode, spectral doppler, and color-flow doppler and how it pertains to a standard 2D Echo
• Learn and apply key 2D, M-Mode, sprectral doppler, and color-flow
• Learn and apply the standard echo protocol• Learn and apply cardiac hemodynamic
concepts• Learn and apply knobology and image
optimization
Echo Book we’ll be using
• Textbook of Clinical Echocardiography– Otto, 3rd Edition
– Elsevier Saunders publishing
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What I expect from you:
• Your full attention when speaking (please turn cell phones off or put on vibrate)
• Courtesy and respect to your fellow students
• Participation – let me know if I’m going too fast/slow, respond to questions, Be engaged!
• Focus – use active listening when concepts are being presented
• Hands-on scanning – again focus on obtaining the views as instructed and applying learnings from lectures
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Why perform an Echo?• Key reasons to perform an echo:
– Abnormal EKG (i.e. bradycardia, tachycardia, arrhythmia, atrial-fibrillation, aortic stenosis, valvular regurgitation/murmur)
– Assess ejection fraction (EF%) (% of blood ejected from the left ventricle every heart beat)
– Post Myocardial infarction (MI)/heart attack• Check changes in heart wall motion/assess damage
– Cardiac assessment pre-operation– Stroke – assess cardiac changes– Valvular lesions (i.e. regurg, MV prolapse, etc.)
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Key Findings from an Echo:
• Ejection Fraction (%) – Normal between (50-75%)• Size of heart chambers
– Left ventricle (in diastole and systole)– Right ventricle (in diastole)– Left/Right atriums– Aortic root, Inferior Vena Cava, Pulmonary artery
• Assessment of valvular structures– Mitral valve, aortic valve, pulmonic valve and tricuspid
valves• Assessment of regurgitation for all valves (i.e. mild,
moderate, severe regurg)• Doppler – blood velocities through valves and
pressure gradients
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Components of Echo:• 2D imaging
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Components of Echo• M-Mode
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Components of Echo:• Spectral Doppler
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Components of Echo• Doppler Color-Flow:
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Basic Cardiac Anatomy
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Basic Cardiac Anatomy
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Basic Cardiac Anatomy –Anterior view -normal
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Cardiac Chambers
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Heart Anterior View Coronal Section
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Heart Cadaver
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Heart Oblique
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Heart – Coronary Territories
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Cardiac Anatomy & Standard Echo Views
• Parasternal Long-Axis
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Parasternal long-axis view:
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Parasternal Short Axis:
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Short Axis- Left Ventricle:
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Perspective – LV Short Axis
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Short Axis
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Short Axis – Aortic level
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Short Axis-Aortic Level
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Apical 4 Chamber (A4C)
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Apical 4 Chamber
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Left Ventricle – Outflow track
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Right-Heart Anatomy
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Apical 2-Chamber (A2C)
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Apical 2-Chamber (A2C)
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Apical 3-Chamber View (A3C)
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Subcostal view
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Abnormalities – Left Ventricular
Hypertrophy
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Abnormalities – Left Ventricular Aneurysm
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Abnormalities – Left Ventricular Aneurysm
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Abnormalities – Anterior Wall Scar
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Heart - Electrophysiology
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Electrophysiology
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Electrophysiology
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Right Ventricle
Right Atrium
Left Atrium
Left Ventricle
Cardiac Cycle
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Cardiac Cycle
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Wiggers Diagram
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Wiggers Diagram
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Wiggers Diagram
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Pressures
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Pressures:Right Atria (2)Right Ventricle (30/6)Pulmonary Artery(25/8)Left Atria (8)Left Ventricle (130/10)Aorta (130/80)