Introduction to Introduction to EchocardiographyEchocardiography

MOHAMMED R ARAFAHMOHAMMED R ARAFAHMBBS FACP FRCPC FACCMBBS FACP FRCPC FACC

PROFESSOR OF PROFESSOR OF CARDIOLOGYCARDIOLOGY

What is an Echo?What is an Echo?

Simply it is an Simply it is an ultrasound of the heart ultrasound of the heart using an echo machine using an echo machine equipped with a range equipped with a range of probes, each has a of probes, each has a spectrum of spectrum of frequenciesfrequencies

Other names for the Other names for the same modality are, same modality are, transthoracic echo or transthoracic echo or TTE, cardiac Doppler TTE, cardiac Doppler cardiac ultrasound or cardiac ultrasound or ultrasonography, ultrasonography,

What are types of What are types of Echocardiography?Echocardiography?

1.1. M-ModeM-Mode

2.2. 2-D (2 Dimensional) 2-D (2 Dimensional)

3.3. Color DopplerColor Doppler

4.4. TDITDI

5.5. ContrastContrast

6.6. 3-D 3-D

7.7. Strain and strain rateStrain and strain rate

8.8. 4-D4-D

What an Echo can do?What an Echo can do?

Chamber size, thickness and functionChamber size, thickness and function Assess all cardiac valvesAssess all cardiac valves Assess hemodynamicsAssess hemodynamics Congenital heart diseasesCongenital heart diseases Some extracardiac shuntsSome extracardiac shunts

Who can perform it?Who can perform it?

Obviously Echocardiologists as Obviously Echocardiologists as categorized by ASE (American categorized by ASE (American Society of Echocardiography)Society of Echocardiography)

Cardiac Sonographers with proper Cardiac Sonographers with proper and formal training in the fieldand formal training in the field

More Details!More Details!

Echocardiography uses high-frequency sound waves (also Echocardiography uses high-frequency sound waves (also called ultrasound) that can provide a moving picture of your called ultrasound) that can provide a moving picture of your heart. The sound waves are sent through the body with a heart. The sound waves are sent through the body with a device called a transducer. The sound waves bounce off of the device called a transducer. The sound waves bounce off of the heart and return to the transducer as echoes. The echoes are heart and return to the transducer as echoes. The echoes are converted into images on a television monitor to produce converted into images on a television monitor to produce pictures of your heart.pictures of your heart.

One-dimensional or M-mode echocardiography is one beam of One-dimensional or M-mode echocardiography is one beam of ultrasound directed toward the heart. Doctors most often use ultrasound directed toward the heart. Doctors most often use M-mode echocardiography to see just the left side (or main M-mode echocardiography to see just the left side (or main pumping chamber) of your heart.pumping chamber) of your heart.

Two-dimensional echocardiography produces a broader Two-dimensional echocardiography produces a broader moving picture of your heart. Two-dimensional moving picture of your heart. Two-dimensional echocardiography is one of the most important diagnostic echocardiography is one of the most important diagnostic tools for doctors.   tools for doctors.  

Doppler echocardiography measures blood flowing through Doppler echocardiography measures blood flowing through the arteries and shows the pattern of flow through the heart. the arteries and shows the pattern of flow through the heart.

How?How?

By taking the By taking the images from images from different windows different windows such as parasternal such as parasternal long axislong axis

Or parasternal Or parasternal short axisshort axis

Apical 4 chambersApical 4 chambers

Apical 2Apical 2

Apical 3Apical 3

Apical 5 with colorApical 5 with color

S.S.N. S.S.N. (Suprasternal (Suprasternal Notch views)Notch views)

Sub-Xyphoid or Sub-Xyphoid or Subcostal viewsSubcostal views

M-Mode, first echo M-Mode, first echo modality.modality.

Color Doppler Color Doppler (Small ASD or PFO (Small ASD or PFO seen)seen)

Tissue DopplerTissue Doppler

Spectral Tissue Spectral Tissue DopplerDoppler

Contrast Echo, Contrast Echo, apical viewsapical views

Contrast, short axis Contrast, short axis viewsviews

3-D, dilated 3-D, dilated cardiomyopathycardiomyopathy

3-D, Rheumatic 3-D, Rheumatic Mitral valveMitral valve

Strain Imaging Q-Strain Imaging Q-Analysis of Global Analysis of Global HypokinesisHypokinesis

Strain Imaging Q-Strain Imaging Q-Analysis Lateral Analysis Lateral Basal Hypokinesis Basal Hypokinesis

Real time 4D color Real time 4D color full volume imaging full volume imaging

Real time 4D, Real time 4D, parasternal long parasternal long axis, full volume axis, full volume imagingimaging

How fascinating is an echo?How fascinating is an echo?

Well it is hard to say that!Well it is hard to say that! Simply because it might be fascinating for Simply because it might be fascinating for

you but catastrophic for others!!you but catastrophic for others!! And there is a proof to that!!!!!!!!And there is a proof to that!!!!!!!!

OrOr

How about this?How about this?

This one is better!This one is better!

But, I prefer thisBut, I prefer this

Why not this?Why not this?

I like thisI like this

And million thanks for your attention!And million thanks for your attention!