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 semirecumbent 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