: .

• “Echo" refers to sound.

• Echocardiography, also known as an
"echocardiogram" or "diagnostic cardiac
ultrasound," is a test that utilizes sound waves
to create live images of the patient’s heart.
o The transducer makes soundwaves to
penetrate our chest walls going to the
heart.
o Soundwaves would generate images
and this will bounce back.
o It would generate the image of our heart
which will be detected by the transducer
to solar technology
It assesses the heart's structure, including size and
shape, and shows how the heart muscle and valves are
functioning.
• Sonographer: An individual who performs
echocardiography. (It is usually a graduate of
RadTech. After the degree, they could undergo
training the process)
create images that could visualize what happens
• Duration: Typically lasts between 20-30 minutes.
in our heart in real time.
• Procedure Sequence: Usually performed after
an ECG.
3. Integration with Ultrasound Technology:
• Non-invasive
❖ Echocardiography utilizes ultrasound technology,
• No Side Effects
employing ultrahigh frequency sound waves to
create detailed images of the heart in real-time.
PROCEDURE
• WHAT TO EXPECT DURING AN 4. Sound Wave
ECHOCARDIOGRAM ❖ Reflection: As the sound waves encounter the
1. Application of Lubricating Gel heart's structures, they bounce back (echo)
❖ To begin the procedure, a small amount of towards the transducer. This echo phenomenon
lubricating gel is applied to the chest area. This provides valuable information about the size,
gel ensures proper contact between the skin and shape, and movement of the heart chambers,
the transducer, facilitating the transmission of valves, and surrounding tissues.
sound waves. ❖ The main focus are the chambers of the heart
❖ Normal size: is there any blockages?
2. Utilization of Transducers ❖ Detects the abnormal movements
❖ Similar to the echolocation abilities of dolphins,
transducers emit high-frequency sound waves 5. Image Processing
through the chest wall towards the heart. These ❖ The echoes captured by the transducer are
sound waves penetrate the body tissues and processed by a computer in real-time. Through
organs, reaching the heart. The transducers are sophisticated algorithms, the computer converts
carefully positioned at specific locations and these sound waves into visual images of the
angles on the chest, aligning with the heart's heart, resembling a beating heart on the screen.
position within the body. This precise placement ❖ Soundwaves are converted to electrical images
ensures optimal visualization of cardiac
structures and function. WHY DO I NEED AN ECHO TEST?
❖ Detects our soundwaves that are about to bounce These are some of the conditions...
on the heart
• Heart Murmur: To assess abnormal heart
❖ PRINCIPLE: Ultrasound Technology. When
sounds, which can indicate issues like valve
soundwaves that are emitted or detected back
problems.

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 • Heart Attack (Myocardial Infarction): To
evaluate heart function and identify areas of
damage.
• Chest Pain (Angina): To assess heart function
and detect any abnormalities contributing to chest
pain.
• Atherosclerosis: To evaluate the degree of
blockage in the arteries and assess overall heart
health.
• Congenital Heart Disease (CHD): To examine
heart structures and function in individuals born
with heart defects.
• Pericarditis: To assess inflammation or infection
of the sac surrounding the heart.
• Cardiomyopathy: To evaluate heart muscle
function and identify any abnormalities affecting
its ability to pump blood effectively.
• Valve Disorders (Stenosis): To assess valve
function and identify abnormalities such as
narrowing or improper opening.
ECHO TECHNIQUES
1. 2-Dimensional (2d) Echocardiography
2. M-Mode
3. Doppler
4. Color Doppler
2-DIMENSIONAL (2D) ECHOCARDIOGRAPHY
• 2D echocardiography, also known as "2D echo,"
provides a cross-sectional view of the heart.
• It enables visualization of the actual motion of
heart structures in real-time.
• The imaging modality offers a dynamic portrayal
of cardiac anatomy and function.
o Allows for the direct observation of the
heart's structures as they move.
o Presents images in a black and white
format, with varying shades of gray
representing tissue density.
o Utilizes a cone-shaped scanning pattern
to capture detailed cross-sectional views
of the heart.
PURPOSE
❖ Any variation inside our chambers can indicate
heart problems
❖ Could not be enlarged 9cyhambers)
• Anatomical Visualization: Enables detailed
examination of cardiac structures, including
chambers, valves, and walls.
• Facilitates assessment of cardiac function, such
as contractility and valve motion, in real-time.
• Aids in the detection and characterization of
various cardiac conditions, including structural
abnormalities, valve disorders, and myocardial
dysfunction.
M-MODE
• Time motion display
• Image produced is similar to a tracing (of ECG)
rather than an actual picture of heart structure.
• Useful for measuring or viewing heart structures
(size, thickness of the heart wall, pumping of
chambers)
• Simplest type of echocardiography
• Has a single ultrasound wave.
• Red Line: Indicates cardiac muscle contraction
(systole), providing insight into the heart's
pumping action.
• Yellow Line: Represents relaxation (diastole) of
the heart muscle, allowing assessment of the
heart's filling phase.
DOPPLER
o Fast and direction of blood flow (if circulates)
• Utilized to estimate the velocity of blood flow
within the cardiovascular system.
• Enables measurement and evaluation of blood
flow through the heart's chambers and valves.
• Effective in identifying abnormal blood flow
patterns within the heart
• Principle: The Doppler effect in
echocardiography functions by analyzing sound
waves reflected by moving objects, such as red
blood cells (RBCs).
o It follows a systematic flow
o Determines the direction of blood flow
o It moves on arteries, veins which is detected to
sound waves
• The variation in sound wave frequency due to the
movement of these objects provides insights into
blood flow dynamics, which may not be directly
proportional to heart motion.
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COLOR DOPPLER
• An enhanced form of Doppler echocardiography.
• Utilizes different colors, typically red and blue, to
represent blood flow dynamics.
• Simplifies interpretation by assigning colors
based on flow direction and velocity.
• Color Representation and Interpretation:
CLINICAL APPLICATIONS
TRANSTHORACIC ECHOCARDIOGRAPHY (TTE)
o Red and Blue Colors:
o RED indicates blood flow towards the
transducer POSITIVE DOPPLER SHIFT
(on the surface)
o BLUE represents blood flow away from
the transducer NEGATIVE DOPPLER
SHIFT (under)
TRANSESOPHAGEAL ECHOCARDIOGRAM (TEE)
• Intensity/Brightness:
o Brighter colors typically signify faster
blood flow velocities.
o INTENSE – Rapid Blood flow
o DULL – Not bright, slower blood flow.
• PURPOSE: Provides a visual representation of
blood flow patterns within the heart and vessels.
• ADVANTAGES:
o Facilitates rapid identification of
abnormal blood flow patterns.
o Improves diagnostic accuracy by
enhancing visualization of blood flow
dynamics.
o “more specific”
• Contrast Echocardiogram:
o Utilizes contrast agents to enhance the
visualization of blood flow, particularly in
color Doppler imaging.
o Produces color-coded images, further
aiding in the interpretation of blood flow
patterns.
• Widely practiced form of echocardiography.
• Involves positioning the transducer on the chest
directly above the heart.
• Non-invasive and painless procedure.
• During the examination, a swishing sound may be
heard, attributed to the ultrasound waves rather
than the device itself.
o The "swishing sound" mentioned
typically refers to the sound of blood flow
within the heart and blood vessels that is
detected and interpreted by the
echocardiography machine. The
machine then converts these signals into
visual images on the monitor for analysis
by the healthcare provider.
o The signal in response to heart rhythm
• Utilized for obtaining detailed views of the
patient's heart.
• Involves inserting a smaller transducer down the
throat via the mouth.
• Anesthesia is typically administered.
• Precautionary measures include fasting for 4-8
hours prior to the test.
• Advantages:
o Provides superior image quality,
incorporating both 2D and Doppler
imaging.
o Procedure duration typically ranges from
20 to 30 minutes.
• Diagnostic Use:
o Used to Diagnose Coronary Artery
Disease (CAD), endocarditis, and
identifying blood clots predisposing to
strokes.
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FETAL ECHOCARDIOGRAPHY
• Employed during weeks 18 to 22 of pregnancy to
assess fetal heart health.
• Involves placing a transducer over the expectant
mother's abdomen.
• Can be performed via transabdominal (often
used) or transvaginal approach.
• Considered a safer alternative to X-rays for
evaluating fetal conditions.
• Advantages:
o Offers a non-invasive and safer means of
examining fetal heart anatomy and
function.
o Allows for early detection of potential
heart abnormalities, facilitating timely
interventions if necessary.
✓ If a women is susceptible to be pregnant, it is
accompanied by a pregnancy test because it is
teratogenic for the child.
3D ECHO
• Either transesophageal or transthoracic
echocardiography to create a 3-D image of your
heart.
• Multiple images from different angles (like a live
image).
• Used prior to heart valve surgery.
• Used to diagnose heart problems in children.
• Stress echocardiography (instead of using ECG,
this uses echocardiography)
o uses a treadmill also.
• Contrast echocardiogram (produces color in color
doppler).
PRINCIPLE OF IMAGE GENERATION
• Phased Array Transducer: This is the key
component of the echocardiography system. It
emits and receives ultrasound waves and is
responsible for capturing images of the heart.
• Piezoelectric Elements: These elements within
the transducer convert electrical energy into
ultrasound waves and vice versa. They play a
crucial role in generating and detecting sound
waves.
• Ultrasound Impulses: These are short bursts of
high-frequency sound waves emitted by the
transducer. These waves travel through the body
and interact with different tissues, producing
echoes that are detected by the transducer.
Image Interpretation in GrayScale:
• Gray scale: indicates intensity of the reflected
ultrasound
• Black: Fluid or Blood
• White: Highly reflective structures (calcifications
on cardiac valves, pericardium)
Tissue Differentiation:
• Tissues:
• Intense Gray: Myocardium
• Muscle Speckle Pattern: Muscular tissues exhibit
a unique speckle pattern
BASIC COMPONENTS OF AN ULTRASOUND
SCANNER
1. Pulse generator (applies high amplitude voltage
to energize the crystals)
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 2. Transducer (converts electrical energy to
mechanical (ultrasound) energy.
o Transducer probe: produces sound
waves and receive echoes back
3. Receiver (detects and amplifies weak signals)
4. Display (displays ultrasound signals in a variety
of modes)
5. Memory (stores video display)

INTERPRETING THE RESULT:

The report should
1. Heart Rate: Within the normal range of 60-100
beats per minute.
2. Heart Size Evaluation: Examining for signs of
dilation in the chambers. Dilation indicates heart
enlargement.
3. Pericardium Description: Providing insights into
the condition of the pericardium.
4. Heart Thickness Assessment: Determining the
thickness of the heart walls.
5. Ventricular Function Conclusion: Offering a
conclusive evaluation of ventricular function,
including any detected abnormalities.
6. Heart Valve Examination: Assessing valve shape
and movement, particularly regarding
regurgitation.
7. Blood Clot Identification: Commenting on the
presence of any blood clots.
8. Unexpected Findings: Highlighting any
unexpected or notable observations.

❖ Drawback of Echocardiography: Limitations in

visualizing coronary arteries or blockages.
❖ Recommend employing angiograms for a more
comprehensive assessment in such cases.

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