2d echo
-dr. mg

Basics

Image echo

Doppler echo

2d

M (motion) mode

Continuous wave

superimposition of simultaneously reflected dots, builds
up a real-time image on the display screen

useful to evaluate the anatomy of the heart and
the relationship between different structures

motion of the walls of ventricles
and cusps of valves is visualized.

Measures wall thickness, C.O., E.F., S.V.,chamber dimensions

tracing, ultrasound is transmitted and received
along only one scan line

displayed as a continuous tracing with two axes

Vertical is distribution btn transducer and structure

Horizontal is time

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only one scan line is imaged,so more sensitive to study motion of moving structures

transmits and receives ultrasound continuously

can measure high velocities without any upper limit

used for rapid scanning of the heart
in search of high velocity signals and abnormal flow patterns.

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cannot precisely localize the returning signal which may originate from anywhere along the length or width of usg beam

grading the severity of valvular
stenosis and assessing the degree of valvular regurgitation

Quantifying intracardiac left-to-right shunt

tricuspid valve, pulmonary
artery pressure can be calculated.

Pulse wave

transmits ultrasound in pulses and waits to
receive the returning ultrasound after each pulse

it cannot detect high velocities.due to time delay

At velocities over 2 m/sec, there occurs a reversal of flow
known as the phenomenon of aliasing

provides a better spectral tracing than
CW Doppler, which is used for calculations

aortic valve outflow signal is used for the calculation of
stroke volume and cardiac output

mitral valve inflow signal is used for the assessment of
left ventricular diastolic dysfunction.

Views of transthorasic

Methods

Transthorasic

Trans esophageal

Parasternal long axis (PLAX)

Apical 4 chamber

Apical 5 chambers

Subcoastal

Suprasternal

Rt parasternal

left sternal edge; 2nd–4th space

dot direction: points towards right shoulder

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Structures seen: prox aorta
AV
LA
LV
MV
RV
IVS
POST WALL
PERICARDIUM

Parasternal short axis

dot direction: points towards left shoulder
(90° clockwise from PLAX)

Structures: PA
PV
RV OUTFLOW TRACT
AV
LA
IAS
TV
MV
IVS

position: apex of the heart

dot direction: points towards left shoulder

Structures: RA RV
LA LV
MV TV
IAS IVS
LT APEX AND LAT WALL
RV FREE WALL

left sternal edge; 2nd–4th space

After the 4 chamber view just tilt probe downward

5th chamber added
is the left ventricular outflow tract (LVOT).

Structures: additional are aortic valve
Proximal aorta
LV OUTFLOW TRACT

subject lies in the semi￾recumbent position on the right side.

position: right sternal edge; 2nd–4th space

dot direction: points towards left shoulder

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Structures seen: AV
AORTIC ROOT

lies supine with the head held slightly low, feet
planted on the couch and the knees slightly flexed.

the abdomen relaxed and
during the phase of inspiration.

position: under the xiphisternum

dot position: points towards left shoulder

Structures: IAS
IVC
PERICARDIAL EFFUSION
DESC AORTA

Lies supine with neck hyperextension by pillow under shoulder and head rotated slight left

position: suprasternal notch

dot direction: points towards left jaw

Structures: ASCENDING AORTA
PULM ARTERY