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Dr M Shoaib
MD Cardiology
CPEIC Multan
CARDIAC STRUCTURE,
CHAMBER QUANTIFICATIONS
& ARTIFACTS
Echocardiography Machine (GE E95)
Echo transducer
Indication of an Echocardiogram
 To assess pts with SOB
 To assess pts with chest pain, palpitations
 To assess pts with cardiac murmur
 To assess pts with syncope
 For assessment of cardiac risk in pts with family
history SCD,
workup of athletes,
 Pre-op assessment
 Post cardiac surgery assessment
Objectives of an Echocardiogram
 To Assess LV size & systolic function (Ejection Fraction)
 To assess LV diastolic function
 To assess LV wall motion abnormalities
 To assess RV size & systolic function
 To assess cardiac valvular abnormalities, and pressure gradients
 Assessment of vessels : Aorta, pulmonary artery and its
branches. Pulmonary veins, hepatic vein
 Hemodynamic assessments: pulmonary pressures, central
venous pressures, PCWP (E/e’), shunt calculation
 Congenital anomalies, ASD, VSD, PDA, TOF, TGA, Ebstein’s,
etc
 Cardiac Masses. Thrombus, vegetations, tumours primary and
secondary.
 To evaluate pericardial effusion
Stress Echocardiography
For assessment of myocardial ischemia and viability
Cardiac Structure
Four Chambers:
LV, RV, LA, RA
Four Valves:
Mitral, Aortic, Tricuspid, Pulmonary
Great vessels:
Aorta, Pulmonary trunk, IVC
Four walls:
Anterior, Inferior, Septal and Lateral
Hemodynamic Assesments
 Types of Doppler
Color : Assesment of Regurgitation, stenosis,
shunt direction
 Spectral
1.Continuous wave (CW) : Pressure Gradients
across valves, valve area, PHT
2.Pulse wave (PW): Site specific velocity
 Tissue Doppler: Annular velocities, VTI, RVS’TDI
Continous wave Doppler Through
Tricuspid valve
CW through stenosed Mital valve
Pulse wave & Tissue Doppler
Chamber quantifications
LV LINEAR MEASUREMENTS
LEFT ATRIUM
AORTIC ROOT
Aortic Annulus should be measured in peak systole
where as all other measurements are made at end
diastole
LV SEGMENTATION MODELS
RV DIMENSION
RECOMENDATIONS
RV FUNCTION PARAMETERS
NORMAL RV DIMENSIONS
How to minimise aliasing
 Increase the Nyquist limit(increase the velocity
scale)
 Shift the base line to increase the Nyquist limit in
a particular direction
 Activate the high PRF mode.
 Change the Doppler angle to minimise the
Doppler shift.
 Decrease the depth
Increase the transducer frequency
Decrese the depth
Use multiple views
Use contrast agents
Thank You

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Basics of echo Cardiac Structure, Chamber quantifications & Artifacts.pptx

  • 1. Dr M Shoaib MD Cardiology CPEIC Multan CARDIAC STRUCTURE, CHAMBER QUANTIFICATIONS & ARTIFACTS
  • 4. Indication of an Echocardiogram  To assess pts with SOB  To assess pts with chest pain, palpitations  To assess pts with cardiac murmur  To assess pts with syncope  For assessment of cardiac risk in pts with family history SCD, workup of athletes,  Pre-op assessment  Post cardiac surgery assessment
  • 5. Objectives of an Echocardiogram  To Assess LV size & systolic function (Ejection Fraction)  To assess LV diastolic function  To assess LV wall motion abnormalities  To assess RV size & systolic function  To assess cardiac valvular abnormalities, and pressure gradients  Assessment of vessels : Aorta, pulmonary artery and its branches. Pulmonary veins, hepatic vein  Hemodynamic assessments: pulmonary pressures, central venous pressures, PCWP (E/e’), shunt calculation  Congenital anomalies, ASD, VSD, PDA, TOF, TGA, Ebstein’s, etc  Cardiac Masses. Thrombus, vegetations, tumours primary and secondary.  To evaluate pericardial effusion Stress Echocardiography For assessment of myocardial ischemia and viability
  • 6. Cardiac Structure Four Chambers: LV, RV, LA, RA Four Valves: Mitral, Aortic, Tricuspid, Pulmonary Great vessels: Aorta, Pulmonary trunk, IVC Four walls: Anterior, Inferior, Septal and Lateral
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25. Hemodynamic Assesments  Types of Doppler Color : Assesment of Regurgitation, stenosis, shunt direction  Spectral 1.Continuous wave (CW) : Pressure Gradients across valves, valve area, PHT 2.Pulse wave (PW): Site specific velocity  Tissue Doppler: Annular velocities, VTI, RVS’TDI
  • 26. Continous wave Doppler Through Tricuspid valve
  • 27. CW through stenosed Mital valve
  • 28. Pulse wave & Tissue Doppler
  • 32. AORTIC ROOT Aortic Annulus should be measured in peak systole where as all other measurements are made at end diastole
  • 34.
  • 35.
  • 37.
  • 40.
  • 41.
  • 42.
  • 43. How to minimise aliasing  Increase the Nyquist limit(increase the velocity scale)  Shift the base line to increase the Nyquist limit in a particular direction  Activate the high PRF mode.  Change the Doppler angle to minimise the Doppler shift.  Decrease the depth
  • 44. Increase the transducer frequency Decrese the depth Use multiple views Use contrast agents
  • 45.
  • 46.
  • 47.