Echocardiography in adults

Abstract

Transthoracic echocardiography is the primary non-invasive modality for anatomical and functional cardiac assessment. All one-, two-dimensional and Doppler modes use the same phenomenon, i.e. the piezoelectric effect, to visualize mobile cardiac structures and blood flow in cardiac cavities. Novel techniques for myocardial imaging, such as tissue Doppler and acoustic marker tracing, allow for the assessment of regional myocardial contractility of the left and the right ventricle. Cardiac assessment is performed in standard views characterized by an optimal acoustic window. The goal of each cardiac echo is to assess cardiac function and morphology using all available imaging modes. The evaluation of acquired valvular heart diseases should include morphological and functional changes indicative of the type (stenosis, regurgitation, complex defect) and the mechanism (Carpentier's classification of mitral regurgitation) of the defect, as well as its stage (mild, moderate, severe). The assessment of left and right ventricular function should involve the measurement of global and regional parameters. An echocardiographic report should also include information on septal continuity and the presence of additional structures or intracardiac masses.

Transthoracic echocardiography is the primary non-invasive modality for anatomical and functional cardiac assessment. All one-, two-dimensional and Doppler modes use the same phenomenon, i.e. the piezoelectric effect, to visualize mobile cardiac structures and blood flow in cardiac cavities. Novel techniques for myocardial imaging, such as tissue Doppler and acoustic marker tracing, allow for the assessment of regional myocardial contractility of the left and the right ventricle. Cardiac assessment is performed in standard views characterized by an optimal acoustic window. The goal of each cardiac echo is to assess cardiac function and morphology using all available imaging modes. The evaluation of acquired valvular heart diseases should include morphological and functional changes indicative of the type (stenosis, regurgitation, complex defect) and the mechanism (Carpentier’s classification of mitral regurgitation) of the defect, as well as its stage (mild, moderate, severe). The assessment of left and right ventricular function should involve the measurement of global and regional parameters. An echocardiographic report should also include information on septal continuity and the presence of additional structures or intracardiac masses.

Fig. 1.

A three-dimensional view of mitral and tricuspid valves. Leaflet morphology is visualized. The three-dimensional view allows for the assessment of the tricuspid valve in a transverse plane. TV – tricuspid valve, MV – mitral valve

Fig. 2.

A cross-section of the aortic valve in 2D imaging, short-axis (vascular) parasternal projection. Three closed cusps are displayed

Fig. 3.

Aortic stenosis. Flow spectrum in continuous wave Doppler. Peak velocity (Vmax), peak gradient (max PG) measurements, and aortic valve area (AVA) measurement using the equation of continuity are displayed

Fig. 4.

Normal biphasic inflow into the left ventricle through the mitral valve in PWD in apical 4-chamber view

Fig. 5.

A two-dimensional view of mitral regurgitation jet in color Doppler imaging in apical 4-chamber view. Altered color scale (Nyquist limit) and the PISA phenomenon along with the measurement of its radius (MS radius) and calculations of mitral effective regurgitant orifice area (MR ERO) and mitral regurgitant volume (MR volume)