An Introduction to the field of echocardiography - for echocardiography technician students, medical residents, and cardiology fellows

1. TRAINING INSTITUTE
Introduction to
Echocardiography
Presented by Clifford Thornton, RDCS,
B.S.

2. ECHOCARDIOGRAPHY2
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

3. Cliff’s contact information
• Mobile:
• Email: cthornton@htinj.edu
ECHOCARDIOGRAPHY3

4. Echo Book we’ll be using
• Textbook of Clinical Echocardiography
– Otto, 3rd Edition
– Elsevier Saunders publishing
ECHOCARDIOGRAPHY4

5. 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
ECHOCARDIOGRAPHY5

6. 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.)
ECHOCARDIOGRAPHY6

7. 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
ECHOCARDIOGRAPHY7

8. Components of Echo:
• 2D imaging
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9. Components of Echo
• M-Mode
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10. Components of Echo:
• Spectral Doppler
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11. Components of Echo
• Doppler Color-Flow:
ECHOCARDIOGRAPHY11

12. Basic Cardiac Anatomy
ECHOCARDIOGRAPHY12

13. Basic Cardiac Anatomy
ECHOCARDIOGRAPHY13

14. Basic Cardiac Anatomy –
Anterior view -normal
ECHOCARDIOGRAPHY14

15. Cardiac Chambers
ECHOCARDIOGRAPHY15

16. Heart Anterior View
Coronal Section
ECHOCARDIOGRAPHY16

17. Heart Cadaver
ECHOCARDIOGRAPHY17

18. Heart Oblique
ECHOCARDIOGRAPHY18

19. Heart – Coronary
Territories
ECHOCARDIOGRAPHY19

20. Cardiac Anatomy & Standard Echo
Views
• Parasternal Long-Axis
ECHOCARDIOGRAPHY20

21. Parasternal long-axis view:
ECHOCARDIOGRAPHY21

22. Parasternal Short Axis:
ECHOCARDIOGRAPHY22

23. Short Axis- Left Ventricle:
ECHOCARDIOGRAPHY23

24. Perspective – LV Short
Axis
ECHOCARDIOGRAPHY24

25. Short Axis
ECHOCARDIOGRAPHY25

26. Short Axis – Aortic level
ECHOCARDIOGRAPHY26

27. Short Axis-Aortic Level
ECHOCARDIOGRAPHY27

28. Apical 4 Chamber (A4C)
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29. Apical 4 Chamber
ECHOCARDIOGRAPHY29

30. Left Ventricle – Outflow
track
ECHOCARDIOGRAPHY30

31. Right-Heart Anatomy
ECHOCARDIOGRAPHY31

32. Apical 2-Chamber (A2C)
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33. Apical 2-Chamber (A2C)
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34. Apical 3-Chamber View
(A3C)
ECHOCARDIOGRAPHY34

35. Subcostal view
ECHOCARDIOGRAPHY35

36. Abnormalities – Left
Ventricular Hypertrophy
ECHOCARDIOGRAPHY36

37. Abnormalities – Left
Ventricular Aneurysm
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38. Abnormalities – Left
Ventricular Aneurysm
ECHOCARDIOGRAPHY38

39. Abnormalities – Anterior
Wall Scar
ECHOCARDIOGRAPHY39

40. Heart - Electrophysiology
ECHOCARDIOGRAPHY40

41. Electrophysiology
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42. Electrophysiology
ECHOCARDIOGRAPHY
42
Right
Ventricle
Right
Atrium
Left Atrium
Left Ventricle

43. Cardiac Cycle
ECHOCARDIOGRAPHY43

44. Cardiac Cycle
ECHOCARDIOGRAPHY44

45. Wiggers Diagram
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46. Wiggers Diagram
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47. Wiggers Diagram
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48. Pressures
ECHOCARDIOGRAPHY48
Pressures:
Right Atria (2)
Right Ventricle (30/6)
Pulmonary Artery
(25/8)
Left Atria (8)
Left Ventricle (130/10)
Aorta (130/80)