Cardiac anatomy

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Cardiac anatomy

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Cardiac anatomy

  1. 1. Echocardiography -why do we need it?
  2. 2. Overview • 90% of echo requests are for LV function assessment – Qualitative and quantitative • Remainder for valvular and structural problems
  3. 3. Function • The Heart is a PUMP & forms part of the Cardiovascular system •Right and left side of the heart •Work in synchrony
  4. 4. Basic Anatomy of the Heart
  5. 5. Chambers • Right Atrium (RA) • Right Ventricle (RV) – Filling Chambers • Left Atrium (LA) • Left Ventricle (LV) – Pumping chambers
  6. 6. Vessels • Vessels: – Aorta (Ao) – Pulmonary artery – Inferior & Superior Vena Cava (IVC & SVC) – Pulmonary Veins (PV)
  7. 7. Valves • Atrioventrucular • Semilunar
  8. 8. Valves • The function of the cardiac valves is to prevent retrograde flow of blood through the heart
  9. 9. Septum • Interventricular septum (IVS) • Interatrial septum (IAS)
  10. 10. Left Ventricular Walls
  11. 11. Coronary Arteries Left Anterior Descending Artery Circumflex Artery Right Circumflex Artery
  12. 12. The Cardiac Cycle • Ventricular filling – DIASTOLE – AV valves are opened – SV are closed • • Ventricular emptying – SYSTOLE – AV valves are closed – SV are opened
  13. 13. The Heart in DIASTOLE
  14. 14. The Heart in SYSTOLE
  15. 15. Two-Dimensional Echocardiography (2D) • Access to the heart can be very difficult • Windows available: – Parasternal – Apical – Subcostal – Suprasternal – Transoesophageal
  16. 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. 17. Parasternal Short Axis (Aortic Valve Level) • Right Ventricle • Left Atrium • Tricuspid Valve • Pulmonic Valve • Pulmonary Artery • Aortic Valve • Right Atrium
  18. 18. Parasternal Short Axis (Mitral Valve Level) • Right Ventricular Wall • Right Ventricle • Interventricular Septum • Left Ventricle • Mitral Valve • Posterior Wall • Pericardium
  19. 19. Parasternal Short Axis (Papillary Level) • Right Ventricular Wall • Right Ventricle • Interventricular Septum • Left Ventricle • Papillary Muscles • Posterior Wall
  20. 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. 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. 22. Apical Two Chamber • Left Ventricular Apex • Left Ventricle • Inferior Wall • Anterior Wall • Mitral Valve • Left Atrium • Pulmonary Veins
  23. 23. Apical Long Axis • Left Ventricular Apex • Left Ventricle • Inferior Wall • Anterior Wall • Mitral Valve • Left Atrium • AO
  24. 24. SUBCOSTAL
  25. 25. SUPRASTERNAL
  26. 26. Hands on!!!!!
  27. 27. • 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 M-Mode echocardiography
  28. 28. • 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 M-Mode echocardiography
  29. 29. • PLAX or PSAX M-Mode AO/LA
  30. 30. • PLAX or PSAX M-Mode MITRAL VALVE
  31. 31. • PLAX or PSAX M-Mode LEFT VENTRICLE
  32. 32. Hands on!!!!!
  33. 33. • 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 DOPPLER
  34. 34. • Blood flow from the LA to the LV • Diastole • Displayed above the baseline FLOW PATTERNS MITRAL VALVE FLOW
  35. 35. • Blood ejected from the LV into the Ao • Systole • Displayed below the baseline FLOW PATTERNS AORTIC VALVE FLOW
  36. 36. • Blood flow from the RA to the RV • Diastole • Displayed above the baseline FLOW PATTERNS TRICUSPID VALVE FLOW
  37. 37. • Blood ejected from the RV into the PA • Systole • Displayed below the baseline FLOW PATTERNS PULMONARY VALVE FLOW
  38. 38. • 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” COLOR FLOW DOPPLER in Echocardiography
  39. 39. AORTIC INSUFFICIENCY
  40. 40. MITRAL STENOSIS/INSUFFICIENCY
  41. 41. Hands on!!!!!
  42. 42. PATHOLOGIESPATHOLOGIES
  43. 43. Ultrasound in Cardiac Assessments 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. 44. Mitral ValveMitral Valve • Disease of the Mitral Valve – Mitral Stenosis – Mitral Regurgitation – Mitral Valve Prolapse
  45. 45. Mitral StenosisMitral Stenosis
  46. 46. Mitral RegurgitationMitral Regurgitation
  47. 47. Aortic ValveAortic Valve • Disease – Aortic Stenosis – Aortic Regurgitation – Bicuspid Valve
  48. 48. Aortic RegurgitationAortic Regurgitation
  49. 49. Tricuspid ValveTricuspid Valve • Disease – Stenosis – Regurgitation
  50. 50. Tricuspid RegurgitationTricuspid Regurgitation
  51. 51. PulmonaryValvePulmonaryValve • Disease – Stenosis – Regurgitation

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