BASICS OF

ECHOCARDIOGRAPHY
• Cardiac anatomy – structures
• Diseases of the heart
• Echo and its various modes
• Features and it’s utility
• Product positioning and pitch
 CARDIAC ANATOMY FROM THE
LUNGS
4 PULMONARY
SUPERIOR VEINS
VENACAV
INFERIOR A
VENACAV
A
RIGHT LEFT ATRIUM
ATRIUM LA
RA
FROM TRICUSPID MITRAL
THE VALVE VALVE
BODY TV MV
RIGHT LEFT
VENTRICLE VENTRICLE
RV LV ( PUMP )
2
PULMONARY PULMONIC VALVE / AORTIC VALVE / AV
ARTERIES PV
AORTA
LUNGS
REMEMBER : IT’S ALWAYS 4!!
4 CHAMBERS, 4 VALVES TO THE 2

BODY
 DISEASES OF THE HEART

CORONARY HEART VALVULAR HEART CONGENITAL HEART

DISEASE DISEASE DISEASE

• “Heart attacks” Diseases affecting either Diseases due to

of the 4 valves : developmental
• High bp abnormality of the fetal
• Stenosis or
• High cholesterol heart :
‘narrowing’
• Diabetes • ‘Holes’ in the heart –
• Regurgitation or ASD, VSD
‘leak’
• Abnormal
connections

A fourth type is called ‘Disorders of Rhythm’

also exists – pertaining to rhythm and rate
abnormalities, where ECG is the main
diagnostic tool; little use of Echo
 Wh
ECHO + CARDIO + GRAPHY at i
sE
?? c ho
US + HEART +
RECORDING
REFLECTIONS

Heart 4
ECHOCARDIOGRAPHIC ‘WINDOWS’
Unlike the liver or kidneys, the Heart is covered by
bones (ribs). Bones hinder US penetration, hence the
heart can be seen from only some areas called
‘Windows’ – as they allow us to visualize the heart.

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 Trans-Thoracic
SUPRASTERNA
Echo Windows
L

PARASTERNA
L

APICA REMEMBER:
L 4 CHAMBERS,
SUBCOSTAL 4 VALVES,
4 WINDOWS !
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PARASTERNAL WINDOW

PARASTERNAL
LONG AXIS :

LONGITUDINAL
SECTION OF THE
HEART

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 PARASTERNAL WINDOW

PARASTERNAL SHORT AXIS :

CROSS-SECTIONAL VIEWS
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APICAL WINDOW – 1. APICAL 4
CHAMBER

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APICAL WINDOW – 2. APICAL 5
CHAMBER

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APICAL WINDOW – 3. APICAL 2
CHAMBER
APICAL WINDOW – 4. APICAL 3
CHAMBER

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OTHER WINDOWS
SUBCOSTAL WINDOW SUPRASTERNAL
WINDOW
• Most useful in kids
• Mainly used for ASD • Used to see the aorta

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Basics of Echocardiography 01/23/2024
ECHOCARDIOGRAPHY MODES
1. 2D / B-MODE
2. M-MODE / MOTION MODE
3. COLOUR DOPPLER
4. SPECTRAL DOPPLER – PW AND CW DOPPLER
5. TISSUE DOPPLER IMAGING
6. PARAMETRIC IMAGING – TVI, TT, TSI, STRAIN,
AFI
7. 3D / 4D ECHO

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EJECTION FRACTION ( EF )
• Tells us about the Systolic function or
contractility of the heart
• If 100 ml blood is present in LV, out of which 55
ml of blood is pumped into the Aorta, then the
EF is 55%
• Normal is upto 55 – 60 %
• Most important result in any Echo report
• Many ways of assessing EF – eyeballing, M-
mode and AMM, Simpson’s, AutoEF, 4D EF
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Basics of Echocardiography
M - MODE

• Used to make
measurements

• EF calculation

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Basics of Echocardiography
COLOUR DOPPLER

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Basics of Echocardiography
SPECTRAL DOPPLER
PW (PULSED WAVE) DOPPLER: CW (CONTINUOUS WAVE)
DOPPLER:
• Measures a point sample
• Measures a line sample
• Used for low velocities
• Used for high velocities

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 TISSUE DOPPLER IMAGING

• PW Doppler
technique
• Used to
assess
diastolic
function
(relaxation)

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Basics of Echocardiography
PARAMETRIC IMAGING TOOLS –
TVI, TT, TSI, STRAIN, Q-ANALYSIS
AND AFI

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3D / 4D ECHOCARDIOGRAPHY

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ANATOMICAL M-MODE
• For patients with
oblique views

• Helps to rotate the

cursor to obtain
perpendicular cut

• For accurate EF
measurements

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STRESS ECHO
• Done as either Exercise (Treadmill) stress or
Pharmacological (Dobutamine) stress.
• To assess the function of the heart, when the heart is
‘stressed’ due to exercise or medicines.
• Demand v/s Supply

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Basics of Echocardiography
TRANS-ESOPHAGEAL ECHO (TEE)
• TEE probe inserted
via mouth

• To assess posterior
structures of the
heart, not seen in
Trans-thoracic Echo

• In the OT / Cathlab

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LVO CONTRAST
• Injection of
contrast agent

• Helps visualise
LV borders very
well

• Used only by
experts – ask your
Doctor before you
sell !!
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Basics of Echocardiography
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Vivid P3
Value with maximum impact
Value & Performance
• Based on Truscan flexible PC based • Network
architecture • 4x USB
• Virtual Apex, AMM, and onboard Raw • 3x Video
Data analysis (Comp.,
• Spectral Tissue Doppler SVHS, VGA)
• Stress Echo and LVO Contrast • 2x power

Efficient & Reliable

• ATO/ASO and Auto TGC Outputs (backside)
• Large output options: Network, 4x
USB, 3x Video (Comp., SVHS, VGA),
2x power
• Sleek and Streamlined , lightweight
design 80kg
• Premium connectivity: USB Drives and
Network “Quicksave”, MPEGVue, CV
DICOM SR
• Report Designer and flexible USB
HDD based Data Management
• InSite with Express Connection

Multi-Specialist Vivid
• Supports Cardiac /Vascular /Abdominal
/OB/ Gyn Cardio Vascular & Shared Services
• Vascular Compound, Virtual convex, B
Steer, easy 3D OB
Vivid e
High performance quality, low capital investment
Remarkable
• Based on Truscan flexible PC based
architecture
• CV functionalities with Vivid 7 Stress
Echo template, Contrast LVO, TDI,
TEE and antero/Posterior IMT
measurements support, Auto IMT: Anterior and Shared Service and Vascular support
Optimization - ATO, ASO and AMM Posterior
Standard Wall Measurement
• Shared Service functionalities with
work horse 9L and 8C probes
• Comprehensive connectivity and
Mpegvue
TEE (6Tc-RS) support
Portable
• 4.5kg- truly ultra-portable
• Rapid power up time <20sec for
Emergency
• Quick battery re-charge Leverage Vivid 7 Stress
Echo template
• Easy image store/review- eSmart Trainer
• Onboard Raw Data analysis
• Wireless DICOM

Affordable
• Innovative and flexible eSmart Trainer
module
• Special designed Docking Cart

Turn Laptop to Console

Vivid S5 - Signature Class Performance
• TruScan RawData Architecture
• High End Image Quality
• High Frame Rates > 500FpS
• Smart Depth
• Realtime Anatomical M-Mode
• TVI, TT integrated Quantification
• AutoEF quantification
• LVO Contrast
• Adult and Pediatric TEE
• Stress-Echo
• ATO & ASO – Automatic Optimization
• Vascular / Abdominal / Pediatric Applications
High End Cardiac Performance
Bring your patients into focus
Gold Standard Vingmed Doppler

Color Doppler

Spectral Doppler

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High End Cardiac Performance
Advanced functionality

High Frame Rate TVI Tissue Tracking TVI Velocity Quantification

Up to 300 Fps Displacement M-Mode Tissue Tracking Quantification
Quantify in EchoPAC Real Time Up to 8 Cursor / Curves
Event timing with
AVO, AVC, MVO and MVC

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AutoEF
Automatic EF Quantification
• Based 2D Speckle tracking algorithm
• Easy to use
• Quick
Potential Benefits:
• Higher Reproducibility
• Lower Inter-observer variability
Confidence in the AutoEF algorithm:
• Based on (biplane) Simpson
• Has several inherent quality checks
• Is clinically used since > 3 years
• Last responsibility is on the user"
Volumes, EF
Hemodynamic values
CO, SV, HR

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 HAPPY SELLING !!
ALL THE BEST TEAM!