BASIC ECHOCARDIOGRAPHY HOW TO DO? Before echocardiography - - PowerPoint PPT Presentation

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BASIC ECHOCARDIOGRAPHY HOW TO DO? Before echocardiography - - PowerPoint PPT Presentation

Jan 14, 2024 321 likes •1.15k views

BASIC ECHOCARDIOGRAPHY HOW TO DO? Before echocardiography Patients clinical data Symptoms - Why do we examine? Chest pain, dyspnea, etc. Blood pressure Past medical history HTN, IHD,

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BASIC ECHOCARDIOGRAPHY – HOW TO DO?

속편한내과 하성일

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Before echocardiography

 Patient’s clinical data

 Symptoms - Why do we examine?

◼ Chest pain, dyspnea, etc.

 Blood pressure  Past medical history

◼ HTN, IHD, cardiac surgery, etc.

 P/Ex

◼ Cardiac murmur, etc.

 EKG  ChestPA  Previous echocardiographic findings

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Before echocardiography

 Patient’s privacy

 Attendants – Nr. or family(mother, etc.)  Appropriate clothing & fitting room  Keep the door open  Keep the ultrasound gel warm

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Patient position

 Which prefer???

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Echo probe

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How to grip your probe?

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TERM

 Transducer motion

 Movement

◼ To a different position on the chest

 Tilting or point

◼ Transducer tip with a rocking motion to image different

structures in the same tomographic plane

 Angulation

◼ Transducer from side to side to obtain different tomographic

planes somewhat parallel to the original image plane

 Rotating

◼ The image plane at a single position to obtain intersecting

tomographic planes

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Manipulation

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Manipulation – overall gain

High Low

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Manipulation – overall gain

High Low

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Manipulation – TGC (time gain compensation)

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Manipulation – TGC (time gain compensation)

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Manipulation – auto gain

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Manipulation – auto gain

High gain Low gain Auto gain

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Manipulation – Color doppler scale

Normal Abnormal

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Manipulation - depth

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Manipulation - depth

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How to get standard echo view?

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Anatomy

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Echocardiographic window

Suprasternal window Parasternal window Apical window Subcostal window

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Standard Echo View

 Parasternal

 Long axis view  Short axis view

 Apical

 4 chamber view  3 chamber view  2 chamber view  5 chamber view

 Subcostal view  Suprasternal view

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Parasternal long axis view

http;//www.jss.org

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Parasternal long axis view

http;//www.jss.org

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Parasternal long axis view

http;//www.jss.org

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Parasternal long axis view

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Parasternal long axis view

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Parasternal short axis view – mitral level

http;//www.jss.org

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Parasternal short axis view – mitral level

http;//www.jss.org

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Parasternal short axis view – aortic valve level

http;//www.jss.org

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Parasternal short axis view – aortic valve level

http;//www.jss.org

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Parasternal short axis view

  • mitral valve level

http;//www.jss.org

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Parasternal short axis view – papillary muscle level

http;//www.jss.org

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Parasternal short axis view – papillary muscle level

http;//www.jss.org

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Parasternal short axis view – apical level

http;//www.jss.org

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Apical view

 4 chamber view  3 chamber view  2 chamber view  5 chamber view

http;//www.jss.org

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Rotation!!!

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Apical view – 4 chamber view

http;//www.jss.org

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Apical view – 4 chamber view

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Apical view – 4 chamber view

Foreshortening Normal

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Apical view

  • 3 chamber view

http;//www.jss.org

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Apical view

  • 2 chamber view

http;//www.jss.org

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Apical view

  • 2 chamber view
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Apical view

  • 5 chamber view
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Subcostal view(4 chamber)

http;//www.jss.org

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Subcostal view(IVC)

http;//www.jss.org

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Subcostal view(Aorta)

http;//www.jss.org

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Suprasternal view

http;//www.jss.org

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Summary view

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Why each standard echo view is important?

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Basal echocardiography

 2D  Valve anatomy and function  Wall motion  Congenital anomaly

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Parasternal long axis view

 2D

DCMP Aortic annuloectasia HCMP Pericardial effusion

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Parasternal short axis view – papillary muscle level

 2D

Pericardial effusion

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Parasternal short axis view – aortic valve level

 2D

Atrial septal aneurysm LA thrombi in afib

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Apical view – 4 chamber view

 2D

Pulmonary thromboembolism Apical HCMP

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Apical view – 5 chamber view

 2D

LA thrombi in MS

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Apical view

  • 2 chamber view

 2D

LAA thrombi in HF d/t Afib LAA thrombi in HF d/t afib

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Subcostal view

 Aorta(2D)

Aortic dissection Aortic dissection AAA with thrombi AAA with thrombi

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Subcostal view

 IVC(2D)

IVC plethora(+) in HF d/t afib

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Parasternal long axis view

 Valve anatomy and function

Mitral stenosis Aortic regurgitation MVP MVP with MR

Infective endocarditis Infective endocarditis

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Parasternal short axis view – aortic valve level

 Valve anatomy and function

Aortic stenosis Aortic regurgitation

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Parasternal short axis view

  • mitral valve level

 Valve anatomy and function

Mitral stenosis

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Apical view – 4 chamber view

 Valve anatomy and function

Mitral stenosis Mitral regurgitation

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Apical view

  • 3 chamber view

 Valve anatomy and function

MR & AR

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Apical view

  • 2 chamber view

 Valve anatomy and function

MVP with eccentric MR

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Parasternal long axis view

 Wall motion

Anterior MI(LAD territory) Posterolateral MI(LCx territory)

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Parasternal short axis view

  • mitral valve level

 Wall motion

Inferior MI(RCA territory)

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Parasternal short axis view – papillary muscle level

 Wall motion

Anterolateral MI(LCx territory)

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Parasternal short axis view – apical level

 Wall motion

Anterior MI(LAD territory)

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Apical view – 4 chamber view

 Wall motion

Anteroseptal MI(LAD territory) Anterolateral MI(LCx territory)

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Apical view

  • 3 chamber view

 Wall motion

Anteroseptal MI(LAD territory) Posterolateral MI(LCx territory)

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Apical view

  • 2 chamber view

 Wall motion

Anterior MI(LAD territory) Inferior MI(RCA territory)

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Parasternal long axis view

 Congenital anomaly

Persistent left superior vena cava

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Parasternal short axis view – aortic valve level

 Congenital anomaly

Bicuspid AV VSD ASD PDA

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Apical view – 4 chamber view

 Congenital anomaly

VSD Cor triatriatum Ebstein anomaly ASD

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Subcostal view

 Congenital anomaly

ASD with L-R shunt

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Suprasternal view

 Congenital anomaly

PDA with L-R shunt

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Which is normal???

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Which is normal???

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Basal echocardiography with 2D is important – your eyeball power!!!

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Reference

 The EAE Textbook of Echocardiography, 2011  Textbook of Clinical echocardiography, 6th ed.  The echo manual, 3rd ed.  Feigenbaum’s echocardiography, 7th ed.  Japanese society of sonographers

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Thank you for your attention!!!