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Cardiac anatomy

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cardiac anatomy

cardiac anatomy

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  • 1. Echocardiography -why do we need it?
  • 2. Overview• 90% of echo requests are for LV function assessment – Qualitative and quantitative• Remainder for valvular and structural problems
  • 3. Function• The Heart is a PUMP & forms part of the Cardiovascular system •Right and left side of the heart •Work in synchrony
  • 4. Basic Anatomy of the Heart
  • 5. Chambers• Right Atrium (RA)• Right Ventricle (RV) – Filling Chambers• Left Atrium (LA)• Left Ventricle (LV) – Pumping chambers
  • 6. Vessels• Vessels: – Aorta (Ao) – Pulmonary artery – Inferior & Superior Vena Cava (IVC & SVC) – Pulmonary Veins (PV)
  • 7. Valves• Atrioventrucular• Semilunar
  • 8. Valves• The function of the cardiac valves is to prevent retrograde flow of blood through the heart
  • 9. Septum• Interventricular septum (IVS)• Interatrial septum (IAS)
  • 10. Left Ventricular Walls
  • 11. Coronary Arteries Left Anterior Descending Artery Circumflex Artery Right Circumflex Artery
  • 12. The Cardiac Cycle• Ventricular filling • Ventricular emptying – DIASTOLE – SYSTOLE – AV valves are opened – AV valves are closed – SV are closed – SV are opened•
  • 13. The Heart inDIASTOLE
  • 14. The Heart in SYSTOLE
  • 15. Two-Dimensional Echocardiography (2D)• Access to the heart can be very difficult• Windows available: – Parasternal – Apical – Subcostal – Suprasternal – Transoesophageal
  • 16. Parasternal Long Axis• Right Ventricular Wall• Right Ventricle• Interventricular Septum• Left Ventricle• Posterior Wall• Mitral Valve• Papillary Muscles• Chordae Tendinae• Left Atrium• Aortic Valve• Ascending Aorta
  • 17. Parasternal Short Axis (Aortic Valve Level)• Right Ventricle• Left Atrium• Tricuspid Valve• Pulmonic Valve• Pulmonary Artery• Aortic Valve• Right Atrium
  • 18. Parasternal Short Axis (Mitral Valve Level)• Right Ventricular Wall• Right Ventricle• Interventricular Septum• Left Ventricle• Mitral Valve• Posterior Wall• Pericardium
  • 19. Parasternal Short Axis (Papillary Level)• Right Ventricular Wall• Right Ventricle• Interventricular Septum• Left Ventricle• Papillary Muscles• Posterior Wall
  • 20. Apical Four Chamber• Left Ventricular Apex• Interventricular Septum• Right Ventricle• Interatrial Septum• Left Ventricle• Lateral Wall• Mitral Valve• Tricuspid Valve• Papillary Muscles• Chordae Tendinae• Left Atrium• Right Atrium• Pulmonary Veins
  • 21. Apical Five Chamber• Left Ventricular Apex• Interventricular Septum• Right Ventricle• Interatrial Septum• Left Ventricle• Lateral Wall• Mitral Valve• Tricuspid Valve• Aortic Valve• LV Outflow Tract• Left Atrium• Right Atrium• Pulmonary Veins
  • 22. Apical Two Chamber• Left Ventricular Apex• Left Ventricle• Inferior Wall• Anterior Wall• Mitral Valve• Left Atrium• Pulmonary Veins
  • 23. Apical Long Axis• Left Ventricular Apex• Left Ventricle• Inferior Wall• Anterior Wall• Mitral Valve• Left Atrium• AO
  • 24. SUBCOSTAL
  • 25. SUPRASTERNAL
  • 26. Hands on!!!!!
  • 27. M-Mode echocardiography • M-Mode is obtained by placing a cursor through structures of interest in the Heart • Only structures transected by this line are imaged and they are plotted against time to form a tracing
  • 28. M-Mode echocardiography • A graph against time of the position of the reflecting structures of the heart relative to the marker is produced • The M-Mode, or Time Motion, makes accurate measurements of dimensions and velocity of motion
  • 29. M-Mode AO/LA• PLAX or PSAX
  • 30. M-Mode MITRAL VALVE• PLAX or PSAX
  • 31. M-Mode LEFT VENTRICLE• PLAX or PSAX
  • 32. Hands on!!!!!
  • 33. DOPPLER• To assess blood flow VELOCITY and DIRECTION• PWD is used when the exact location of the blood flow sampled needs to be known• CWD is used when we need to determine the peak velocity of blood flow through a particular valve
  • 34. FLOW PATTERNS MITRAL VALVE FLOW• Blood flow from the LA to the LV• Diastole• Displayed above the baseline
  • 35. FLOW PATTERNS AORTIC VALVE FLOW• Blood ejected from the LV into the Ao• Systole• Displayed below the baseline
  • 36. FLOW PATTERNSTRICUSPID VALVE FLOW• Blood flow from the RA to the RV• Diastole• Displayed above the baseline
  • 37. FLOW PATTERNS PULMONARY VALVE FLOW• Blood ejected from the RV into the PA• Systole• Displayed below the baseline
  • 38. COLOR FLOW DOPPLER in Echocardiography• To assign colors to flow direction and show the entire area of any flow, normal or abnormal, within the Heart• Quick visual search of flow anomalies.• Standard practice is “BART”
  • 39. AORTIC INSUFFICIENCY
  • 40. MITRAL STENOSIS/INSUFFICIENCY
  • 41. Hands on!!!!!
  • 42. PATHOLOGIES
  • 43. Ultrasound in Cardiac Assessments• Valve Disease• Cardiomyopathy• Endocarditis• Prosthetic Heart valve assessment• Pericardial effusion• Systemic Hypertension• Pulmonary Hypetension• Ischemic Heart Disease• Septal Defects• Tumours
  • 44. Mitral Valve• Disease of the Mitral Valve – Mitral Stenosis – Mitral Regurgitation – Mitral Valve Prolapse
  • 45. Mitral Stenosis
  • 46. Mitral Regurgitation
  • 47. Aortic Valve• Disease – Aortic Stenosis – Aortic Regurgitation – Bicuspid Valve
  • 48. Aortic Regurgitation
  • 49. Tricuspid Valve• Disease – Stenosis – Regurgitation
  • 50. Tricuspid Regurgitation
  • 51. PulmonaryValve• Disease – Stenosis – Regurgitation