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Basics of Echocardiography

Basics of Echocardiography. Mostafa Eladawy MD,AFSA. Ultrasound principles. Penetration depth and resolution. Factors affecting ultrasound transmission: cycle length: (wavelength λ [mm]) frequency: (frequency f [Hz]) Speed: (propagation velocity c [m/s]) in the respective medium

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Basics of Echocardiography

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  1. Basics ofEchocardiography • Mostafa Eladawy MD,AFSA

  2. Ultrasound principles

  3. Penetration depth and resolution Factors affecting ultrasound transmission: cycle length: (wavelength λ [mm]) frequency: (frequency f [Hz]) Speed: (propagation velocity c [m/s]) in the respective medium The relationship of these parameters is described by the wave equation: c = λ × f λ = c / f longer wavelengths penetrate further than shorter wavelengths Image resolution cannot be greater than one wavelength the higher the ultrasound frequency, the better the image resolution

  4. Types of resolution • Axial resolution • Lateral resolution • Elevational resolution

  5. Modes1-A mode2-B mode3-M mode4-2DEchogenicity

  6. Doppler principlesChristian Doppler

  7. The difference between the emitted frequency and the received frequency is called: Doppler shift (fd ) • Blood flow V = fd × c/2 × f0 × cos α • For practical application in Doppler echocardiography: the emitted frequency (f0) is known and the velocity of sound (c/2) is constant at 1540 m/s. Therefore, the velocity causing the Doppler shift can be calculated by: V = fd × cos α

  8. PRF (or scale)

  9. Nyquist limit • Nyquist Limit = Pulse Repetition Frequency / 2

  10. 1-PW2-CW3-CFMAngle of beam

  11. Pressure or pressure gradient?

  12. ∆P = P2-P1 = 4(V22 – V12)

  13. Transducers

  14. Transducers

  15. Manipulation of TEE probe

  16. The ASE/SCA 20 Views for a Comprehensive TEE Exam .

  17. Left Ventricle function • FS = EDD-ESD EDD • FAC = EDA-ESA EDA • EF = EDV-ESV EDV

  18. Left ventricle functionSimpson modeM-mode2D Eye ballingTEI index

  19. Regional wall motion

  20. ME 4 chamber view

  21. Trans gastric view

  22. Right ventricleSize Contractility

  23. Rt Atrium

  24. LT atrium

  25. LV filling pressure

  26. Mitral valve leaflets

  27. Mitral valveStenosis1-gradient 2-planimetry3-pressure half time

  28. Regurgitation1-PISA2-vena contracta3-jet area4-Regurgitant fraction5-Indirect indices

  29. Aortic valve Stenosis1-gradient 2-planimetry

  30. Regurgitation1-PISA2-jet area3- vena contracta4-Indirect indices

  31. Tricuspid valveStenosisRegurgitation

  32. Pulmonary valveStenosisRegurgitation

  33. Pulmonary pressure

  34. Pulmonary veins

  35. Shunts

  36. Ascending aorta and LVOT

  37. Descending aorta

  38. IVC and hepatic veins

  39. Recent adavances3D echo (live and offline)

  40. TDI • Speckle Tracking: non-Doppler, angle-independent quantification of myocardial deformation, by tracking the displacement of the speckles during the cardiac cycle, strain and the strain rate can be measured offline.

  41. Recommended books1-Practical approach to transesophageal echocardiography(Perrino)2-Core topics in echocardiography (Rob Fenneck)3-Atlas of multiplane transesophageal echocardiography (Martin Dunitz)4-transesophageal echocardiography in anesthesia and intensive care (BMJ)5-Pocket atlas of echocardiography (Thieme)5-Essential echocardiography (Humana press)

  42. Questions??

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