Podcast
Questions and Answers
What type of imaging does echocardiography primarily utilize?
What type of imaging does echocardiography primarily utilize?
- X-ray imaging
- Computed tomography (CT)
- Ultrasound imaging (correct)
- Magnetic resonance imaging (MRI)
The term 'echocardiography' is best described as which of the following?
The term 'echocardiography' is best described as which of the following?
- Electrical activity mapping of the heart
- Ultrasound imaging of the heart (correct)
- Sound waves causing echoes in the body
- The study of cardiology using only external methods
Why is echocardiography a valuable tool in veterinary and human medicine?
Why is echocardiography a valuable tool in veterinary and human medicine?
- It provides real-time assessment of cardiac function (correct)
- It completely eliminates the need for operator skill
- It is invasive, providing direct access to the heart
- It allows for direct visualization of extracardiac structures
Which of the following is a limitation of echocardiography?
Which of the following is a limitation of echocardiography?
What information does the 'Brightness mode' (B-mode) in 2D echocardiography provide?
What information does the 'Brightness mode' (B-mode) in 2D echocardiography provide?
Which echocardiographic mode is primarily used to assess the function and timing of cardiac events?
Which echocardiographic mode is primarily used to assess the function and timing of cardiac events?
Hemodynamic information is best obtained using which echocardiography technique?
Hemodynamic information is best obtained using which echocardiography technique?
What is the primary benefit of using standardized imaging planes in 2D echocardiography?
What is the primary benefit of using standardized imaging planes in 2D echocardiography?
In echocardiography, what does the acronym 'BART' stand for in color Doppler imaging?
In echocardiography, what does the acronym 'BART' stand for in color Doppler imaging?
Which echocardiographic view is often referred to as the 'five-chamber view'?
Which echocardiographic view is often referred to as the 'five-chamber view'?
Which of the following best describes the purpose of Doppler echocardiography?
Which of the following best describes the purpose of Doppler echocardiography?
What is the key advantage of the left apical view in Doppler echocardiography?
What is the key advantage of the left apical view in Doppler echocardiography?
In M-mode echocardiography of the left ventricle, what does LVIDd represent?
In M-mode echocardiography of the left ventricle, what does LVIDd represent?
What does 'aliasing' refer to in the context of Doppler echocardiography?
What does 'aliasing' refer to in the context of Doppler echocardiography?
What is the primary clinical significance of assessing the 'E' and 'A' waves in M-mode echocardiography?
What is the primary clinical significance of assessing the 'E' and 'A' waves in M-mode echocardiography?
What does the Doppler shift measure in echocardiography?
What does the Doppler shift measure in echocardiography?
How does the 'right parasternal long axis' view aid in echocardiographic assessment?
How does the 'right parasternal long axis' view aid in echocardiographic assessment?
Which statement accurately contrasts Pulsed-Wave (PW) and Continuous-Wave (CW) Doppler?
Which statement accurately contrasts Pulsed-Wave (PW) and Continuous-Wave (CW) Doppler?
How does understanding the Doppler Effect contribute to echocardiography?
How does understanding the Doppler Effect contribute to echocardiography?
Which echocardiographic approach is MOST affected by patient-related factors like body size and shape?
Which echocardiographic approach is MOST affected by patient-related factors like body size and shape?
The term 'interrogation angle' is defined as:
The term 'interrogation angle' is defined as:
In the context of the heart, where would you expect to visualize papillary muscles?
In the context of the heart, where would you expect to visualize papillary muscles?
What cardiac chambers are visualized from the 'Right Parasternal Short Axis' view at the 'Heart base with AV and LA'?
What cardiac chambers are visualized from the 'Right Parasternal Short Axis' view at the 'Heart base with AV and LA'?
In 'Right Parasternal Short Axis', what 2 structures form the 'Heart base with Ao and PA'?
In 'Right Parasternal Short Axis', what 2 structures form the 'Heart base with Ao and PA'?
When performing 2D echocardiography via 'Left Apical Four-Chamber' view, what are the 4 heart structures that visualized?
When performing 2D echocardiography via 'Left Apical Four-Chamber' view, what are the 4 heart structures that visualized?
Which of the following statements accurately describes the 'M-mode'?
Which of the following statements accurately describes the 'M-mode'?
The Doppler shift principle enables the assessment of:
The Doppler shift principle enables the assessment of:
How does Color Doppler assist in evaluating blood flow in the heart?
How does Color Doppler assist in evaluating blood flow in the heart?
During a CW(continuous-wave) Doppler assessment, what does the spectral display show?
During a CW(continuous-wave) Doppler assessment, what does the spectral display show?
When acquiring a Pulsed-Wave (PW) Doppler signal, what does the spectral display illustrate?
When acquiring a Pulsed-Wave (PW) Doppler signal, what does the spectral display illustrate?
If the ultrasound beam is aligned parallel to the direction of blood flow during Doppler echocardiography, how does it affect velocity measurement and accuracy?
If the ultrasound beam is aligned parallel to the direction of blood flow during Doppler echocardiography, how does it affect velocity measurement and accuracy?
What characterizes the aortic outflow profile in normal systolic flow when assessed by Doppler echocardiography?
What characterizes the aortic outflow profile in normal systolic flow when assessed by Doppler echocardiography?
How does the mitral inflow profile typically appear during diastole on Doppler echocardiography?
How does the mitral inflow profile typically appear during diastole on Doppler echocardiography?
Which parameter does NOT impair the accuracy of hemodynamic assessment using echocardiography?
Which parameter does NOT impair the accuracy of hemodynamic assessment using echocardiography?
Which echocardiographic view is optimal for aligning the ultrasound beam parallel to the direction of blood flow, particularly for assessing mitral valve flow?
Which echocardiographic view is optimal for aligning the ultrasound beam parallel to the direction of blood flow, particularly for assessing mitral valve flow?
An echocardiographer adjusts the pulse repetition frequency (PRF) to correct aliasing on a spectral Doppler display. Which of the following best describes the effect of this adjustment?
An echocardiographer adjusts the pulse repetition frequency (PRF) to correct aliasing on a spectral Doppler display. Which of the following best describes the effect of this adjustment?
In a patient with suspected aortic stenosis, which Doppler modality provides the MOST accurate assessment of the peak systolic velocity across the aortic valve?
In a patient with suspected aortic stenosis, which Doppler modality provides the MOST accurate assessment of the peak systolic velocity across the aortic valve?
What are the advantages or disadvantages of M-mode?
What are the advantages or disadvantages of M-mode?
By performing Doppler Echocardiography on Moving objects, what does this determine?
By performing Doppler Echocardiography on Moving objects, what does this determine?
Which of the following best explains why modern cardiology relies heavily on echocardiography?
Which of the following best explains why modern cardiology relies heavily on echocardiography?
When performing echocardiography via the right parasternal short axis view at the heart base with the aorta (Ao) and pulmonary artery (PA), which anatomical relationship is MOST accurate?
When performing echocardiography via the right parasternal short axis view at the heart base with the aorta (Ao) and pulmonary artery (PA), which anatomical relationship is MOST accurate?
During Doppler echocardiography, what does the term 'aliasing' refer to?
During Doppler echocardiography, what does the term 'aliasing' refer to?
In the formula $V = \frac{C \times f_d}{2(f_0) \times cos \theta}$ used in Doppler echocardiography, what does the $\theta$ (theta) represent?
In the formula $V = \frac{C \times f_d}{2(f_0) \times cos \theta}$ used in Doppler echocardiography, what does the $\theta$ (theta) represent?
Which of the following is a limitation of echocardiography that is directly related to patient characteristics?
Which of the following is a limitation of echocardiography that is directly related to patient characteristics?
Which of the following is a primary goal of introductory echocardiography lectures?
Which of the following is a primary goal of introductory echocardiography lectures?
What is the underlying principle of echocardiography?
What is the underlying principle of echocardiography?
Why is echocardiography considered advantageous compared to older methods of assessing the heart?
Why is echocardiography considered advantageous compared to older methods of assessing the heart?
What is the function of the multiple ultrasound units within an echocardiography probe?
What is the function of the multiple ultrasound units within an echocardiography probe?
What information is uniquely provided by echocardiography that is difficult to obtain from standard X-rays?
What information is uniquely provided by echocardiography that is difficult to obtain from standard X-rays?
What makes the heart such a fascinating organ, requiring advanced imaging techniques like echocardiography?
What makes the heart such a fascinating organ, requiring advanced imaging techniques like echocardiography?
Which of the following is a major limitation of echocardiography?
Which of the following is a major limitation of echocardiography?
What is a key factor to consider when attempting to acquire echocardiographic images?
What is a key factor to consider when attempting to acquire echocardiographic images?
In the context of echocardiography, what does 'standardized views' refer to, and why are they important?
In the context of echocardiography, what does 'standardized views' refer to, and why are they important?
What is the purpose of the 'tomographic brain' analogy when learning echocardiography?
What is the purpose of the 'tomographic brain' analogy when learning echocardiography?
In the 'Right Parasternal Long Axis Inflow-Outflow View' (five-chamber view), which cardiac structure might not always be visible?
In the 'Right Parasternal Long Axis Inflow-Outflow View' (five-chamber view), which cardiac structure might not always be visible?
When acquiring a 'Right Parasternal Four-Chamber View,' what anatomical structure is excluded from the image compared to the five-chamber view?
When acquiring a 'Right Parasternal Four-Chamber View,' what anatomical structure is excluded from the image compared to the five-chamber view?
What anatomical landmark is characteristic of the 'Right Parasternal Short Axis Left Ventricle View' at the mid-ventricular level?
What anatomical landmark is characteristic of the 'Right Parasternal Short Axis Left Ventricle View' at the mid-ventricular level?
In the 'Right Parasternal Short Axis View,' what structure is described as resembling a 'fish mouth'?
In the 'Right Parasternal Short Axis View,' what structure is described as resembling a 'fish mouth'?
In the 'Right Parasternal Short Axis View at the Heart Base,' what structure is visualized that is critical for assessing chamber size?
In the 'Right Parasternal Short Axis View at the Heart Base,' what structure is visualized that is critical for assessing chamber size?
For what purpose is the 'Right Parasternal Short Axis View at the Heart Base with the Aorta and Pulmonary Artery' primarily used?
For what purpose is the 'Right Parasternal Short Axis View at the Heart Base with the Aorta and Pulmonary Artery' primarily used?
When performing echocardiography from the 'Left Apical Window,' how does the orientation of the heart appear on the image, and why?
When performing echocardiography from the 'Left Apical Window,' how does the orientation of the heart appear on the image, and why?
What key information does M-mode echocardiography provide?
What key information does M-mode echocardiography provide?
When using M-mode to assess the mitral valve, what does the early opening of the mitral valve during diastole represent?
When using M-mode to assess the mitral valve, what does the early opening of the mitral valve during diastole represent?
What causes the change in pitch (frequency) of a sound as a fire truck passes by, according to the Doppler effect?
What causes the change in pitch (frequency) of a sound as a fire truck passes by, according to the Doppler effect?
During Doppler echocardiography, what component of blood primarily reflects sound waves back to the ultrasound probe?
During Doppler echocardiography, what component of blood primarily reflects sound waves back to the ultrasound probe?
Why is it difficult to accurately detect blood flow when the direction of flow is perpendicular to the ultrasound beam?
Why is it difficult to accurately detect blood flow when the direction of flow is perpendicular to the ultrasound beam?
In Doppler echocardiography, what does the X-axis on the spectral display represent?
In Doppler echocardiography, what does the X-axis on the spectral display represent?
What does the location of the signal above or below the baseline on a Doppler spectral display indicate?
What does the location of the signal above or below the baseline on a Doppler spectral display indicate?
What is the BART acronym used for in Color Doppler imaging?
What is the BART acronym used for in Color Doppler imaging?
Which type of Doppler displays a 'hollow' profile on the spectral display?
Which type of Doppler displays a 'hollow' profile on the spectral display?
What is a key difference between Pulsed-Wave (PW) and Continuous-Wave (CW) Doppler regarding velocity measurement?
What is a key difference between Pulsed-Wave (PW) and Continuous-Wave (CW) Doppler regarding velocity measurement?
Why is continuous wave Doppler used to interrogate high velocity blood flow?
Why is continuous wave Doppler used to interrogate high velocity blood flow?
According to the lecture, what should one do to prepare for tomorrow's session on echocardiography?
According to the lecture, what should one do to prepare for tomorrow's session on echocardiography?
What can be interpreted from the velocity of movement detected by the ultrasound?
What can be interpreted from the velocity of movement detected by the ultrasound?
What is the main reason the left apical views are important during Doppler?
What is the main reason the left apical views are important during Doppler?
In the context of Doppler echocardiography, the term 'aliasing' refers to:
In the context of Doppler echocardiography, the term 'aliasing' refers to:
Which factor is critical in acquiring optimal parasternal window images?
Which factor is critical in acquiring optimal parasternal window images?
Normally in systole, blood flows away from the probe through which structure?
Normally in systole, blood flows away from the probe through which structure?
Why is it important to have standardized views?
Why is it important to have standardized views?
During a right parasternal short axis view, what would be seen at the level of the left ventricle?
During a right parasternal short axis view, what would be seen at the level of the left ventricle?
What is the other name for the 'Right Peristernal Long Axis Inflow Outflow View'?
What is the other name for the 'Right Peristernal Long Axis Inflow Outflow View'?
A veterinary cardiologist mentions using the 'Beluga View' during an echocardiogram. Which standard view are they referring to?
A veterinary cardiologist mentions using the 'Beluga View' during an echocardiogram. Which standard view are they referring to?
Which wave is being formed when blood flows from the right atrium back into the left ventricle during diastole?
Which wave is being formed when blood flows from the right atrium back into the left ventricle during diastole?
How do you decide you need continuous wave instead of pulse wave?
How do you decide you need continuous wave instead of pulse wave?
What is the primary goal of today's lecture on echocardiography?
What is the primary goal of today's lecture on echocardiography?
What is a key reason echocardiography is valuable for assessing the heart?
What is a key reason echocardiography is valuable for assessing the heart?
What is a potential limitation of echocardiography?
What is a potential limitation of echocardiography?
In the context of echocardiography, what information does the 2D or 'Brightness mode' (B-mode) primarily provide?
In the context of echocardiography, what information does the 2D or 'Brightness mode' (B-mode) primarily provide?
What information is primarily obtained from M-mode echocardiography?
What information is primarily obtained from M-mode echocardiography?
What information does Doppler echocardiography provide regarding heart function?
What information does Doppler echocardiography provide regarding heart function?
When performing echocardiography, where do you start to acquire diagnostic images of the heart?
When performing echocardiography, where do you start to acquire diagnostic images of the heart?
Why is it important to standardize the views during echocardiography?
Why is it important to standardize the views during echocardiography?
When performing echocardiography, what is represented by the 'five-chamber view'?
When performing echocardiography, what is represented by the 'five-chamber view'?
What anatomical structures are excluded from the four-chamber view compared to the five-chamber view?
What anatomical structures are excluded from the four-chamber view compared to the five-chamber view?
In echocardiography via Right Parasternal Short Axis, which view looks like a 'fish mouth'?
In echocardiography via Right Parasternal Short Axis, which view looks like a 'fish mouth'?
Which of the following describes the 'Beluga' view?
Which of the following describes the 'Beluga' view?
How does the orientation of the heart appear in images acquired from the left apical window?
How does the orientation of the heart appear in images acquired from the left apical window?
How is blood flow direction indicated on a Doppler spectral display?
How is blood flow direction indicated on a Doppler spectral display?
What is the main use of the left apical window during Doppler echocardiography?
What is the main use of the left apical window during Doppler echocardiography?
How is the timing of cardiac events assessed using M-mode echocardiography?
How is the timing of cardiac events assessed using M-mode echocardiography?
During M-mode assessment of the mitral valve, what does the early opening of the mitral valve during diastole represent?
During M-mode assessment of the mitral valve, what does the early opening of the mitral valve during diastole represent?
Why should the ultrasound direction be parallel to the object when using Doppler?
Why should the ultrasound direction be parallel to the object when using Doppler?
How do the blood cells affect the ultrasound?
How do the blood cells affect the ultrasound?
According to the Doppler effect, how does the frequency of a sound wave change as an object moves toward the observer?
According to the Doppler effect, how does the frequency of a sound wave change as an object moves toward the observer?
In the context of Doppler echocardiography, what does the term 'Doppler shift' refer to?
In the context of Doppler echocardiography, what does the term 'Doppler shift' refer to?
On a typical Doppler spectral display, what does the X-axis represent?
On a typical Doppler spectral display, what does the X-axis represent?
What is the purpose of the BART acronym?
What is the purpose of the BART acronym?
In color Doppler imaging, what does it mean if blood flow is displayed in red?
In color Doppler imaging, what does it mean if blood flow is displayed in red?
What characterizes the aortic outflow profile in normal systolic flow when assessed by Pulse-Wave Doppler echocardiography?
What characterizes the aortic outflow profile in normal systolic flow when assessed by Pulse-Wave Doppler echocardiography?
When should clinicians be prepared for tomorrow's session?
When should clinicians be prepared for tomorrow's session?
Based on the lecture, why is echocardiography considered such an invaluable tool in modern cardiology?
Based on the lecture, why is echocardiography considered such an invaluable tool in modern cardiology?
Why might visualizing extracardiac structures be challenging with echocardiography?
Why might visualizing extracardiac structures be challenging with echocardiography?
When comparing Pulse Wave Doppler to Continuous Wave Doppler, what is the key difference between a hollow versus solid profile?
When comparing Pulse Wave Doppler to Continuous Wave Doppler, what is the key difference between a hollow versus solid profile?
When is using Continuous Wave (CW) Doppler useful?
When is using Continuous Wave (CW) Doppler useful?
What is the relationship between frequency and pitch?
What is the relationship between frequency and pitch?
Why does modern veterinary cardiology depend so heavily on echocardiography?
Why does modern veterinary cardiology depend so heavily on echocardiography?
Why is it difficult to detect a moving object when the movement directions are perpendicular to the ultrasound wave?
Why is it difficult to detect a moving object when the movement directions are perpendicular to the ultrasound wave?
During a cardiac exam, why might a cardiologist choose to lay a patient on a table with a hole in it?
During a cardiac exam, why might a cardiologist choose to lay a patient on a table with a hole in it?
A beginning cardiology student is having difficulty accurately identifying structures within the 'Right Parasternal Short Axis View at the Heart Base'. What clarifying question might BEST help the student?
A beginning cardiology student is having difficulty accurately identifying structures within the 'Right Parasternal Short Axis View at the Heart Base'. What clarifying question might BEST help the student?
Imagine a scenario where you're trying to distinguish between a thrombus and a normal papillary muscle in the right ventricle during an echocardiogram. Which of the following techniques would MOST definitively differentiate the two?
Imagine a scenario where you're trying to distinguish between a thrombus and a normal papillary muscle in the right ventricle during an echocardiogram. Which of the following techniques would MOST definitively differentiate the two?
A veterinary student is attempting to master cardiac anatomy through echocardiography and asks for a strategy to cement their understanding of the standard views. What approach would MOST directly address this learning goal?
A veterinary student is attempting to master cardiac anatomy through echocardiography and asks for a strategy to cement their understanding of the standard views. What approach would MOST directly address this learning goal?
Why is it important for veterinary students to learn basic echocardiography, even if they don't plan to specialize in cardiology?
Why is it important for veterinary students to learn basic echocardiography, even if they don't plan to specialize in cardiology?
What is the primary objective of the introductory echocardiography lecture?
What is the primary objective of the introductory echocardiography lecture?
What is the function of the multiple ultrasound units contained within an echocardiography probe?
What is the function of the multiple ultrasound units contained within an echocardiography probe?
What is a unique advantage of using echocardiography compared to standard X-rays for cardiac assessment?
What is a unique advantage of using echocardiography compared to standard X-rays for cardiac assessment?
What primarily limits the ability to acquire high-quality echocardiographic images in some patients?
What primarily limits the ability to acquire high-quality echocardiographic images in some patients?
Why is standardization of views important in echocardiography?
Why is standardization of views important in echocardiography?
What cardiac structures are visualized in the 'Right Parasternal Long Axis Inflow-Outflow View' (five-chamber view)?
What cardiac structures are visualized in the 'Right Parasternal Long Axis Inflow-Outflow View' (five-chamber view)?
In the 'Right Parasternal Short Axis View' at the mid-ventricular level, which anatomical landmark is typically observed?
In the 'Right Parasternal Short Axis View' at the mid-ventricular level, which anatomical landmark is typically observed?
In M-mode echocardiography, what aspect of cardiac function is MOST directly assessed?
In M-mode echocardiography, what aspect of cardiac function is MOST directly assessed?
How does the ultrasound machine determine if blood is moving toward or away from the probe using Doppler?
How does the ultrasound machine determine if blood is moving toward or away from the probe using Doppler?
Why is it important to align the ultrasound beam parallel to the direction of blood flow when using Doppler echocardiography?
Why is it important to align the ultrasound beam parallel to the direction of blood flow when using Doppler echocardiography?
On a typical Doppler spectral display, what information is represented on the Y-axis?
On a typical Doppler spectral display, what information is represented on the Y-axis?
What information does the BART acronym provide in the context of color Doppler imaging?
What information does the BART acronym provide in the context of color Doppler imaging?
What key distinction differentiates Pulse Wave (PW) Doppler from Continuous Wave (CW) Doppler?
What key distinction differentiates Pulse Wave (PW) Doppler from Continuous Wave (CW) Doppler?
In what clinical scenario would Continuous Wave (CW) Doppler be MOST beneficial compared to Pulse Wave (PW) Doppler?
In what clinical scenario would Continuous Wave (CW) Doppler be MOST beneficial compared to Pulse Wave (PW) Doppler?
When performing echocardiography from the left apical window, how does the orientation of the heart appear and why?
When performing echocardiography from the left apical window, how does the orientation of the heart appear and why?
A veterinarian is attempting to identify the 'Beluga View' during an echocardiogram but is unfamiliar with the term. What anatomical landmark are they MOST likely trying to visualize?
A veterinarian is attempting to identify the 'Beluga View' during an echocardiogram but is unfamiliar with the term. What anatomical landmark are they MOST likely trying to visualize?
During an echocardiogram, the veterinary cardiologist asks you to identify the 'mushroom view'. What anatomical landmark dictates the diagnostic relevance of this view?
During an echocardiogram, the veterinary cardiologist asks you to identify the 'mushroom view'. What anatomical landmark dictates the diagnostic relevance of this view?
What does the echocardiogram measure when the ultrasound beam is perpendicular to the direction of blood flow?
What does the echocardiogram measure when the ultrasound beam is perpendicular to the direction of blood flow?
While performing a cardiac exam, a cardiologist adjusts the table to include a hole so that the patient can lay on their side. What is the MOST likely reason for preferring this orientation?
While performing a cardiac exam, a cardiologist adjusts the table to include a hole so that the patient can lay on their side. What is the MOST likely reason for preferring this orientation?
Flashcards
What is echocardiogram?
What is echocardiogram?
Ultrasound imaging of the heart.
Echocardiography importance
Echocardiography importance
Modern cardiology relies heavily on echocardiography.
Weaknesses of echocardiography
Weaknesses of echocardiography
Patient-related factors, operator dependency, indirect hemodynamic assessment, can't visualize extracardiac structures.
2D 'B'rightness mode
2D 'B'rightness mode
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"M"otion mode
"M"otion mode
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Doppler echocardiography
Doppler echocardiography
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2D (B-mode) views
2D (B-mode) views
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Right Parasternal Long Axis
Right Parasternal Long Axis
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Right Parasternal Short Axis
Right Parasternal Short Axis
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Left Parasternal Window
Left Parasternal Window
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M-mode
M-mode
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Doppler Echocardiography
Doppler Echocardiography
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Doppler Shift
Doppler Shift
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Aortic outflow profile
Aortic outflow profile
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Mitral inflow profile
Mitral inflow profile
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Color Doppler (BART)
Color Doppler (BART)
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PW vs CW
PW vs CW
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Who is Dr. Bernard Chi?
Who is Dr. Bernard Chi?
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Echo Definition
Echo Definition
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Echocardiography Advantages
Echocardiography Advantages
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Table with a hole
Table with a hole
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Why standardize echo views?
Why standardize echo views?
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Long Axis View
Long Axis View
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Four-Chamber View
Four-Chamber View
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Short Axis View
Short Axis View
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Mushroom View
Mushroom View
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Fish Mouth View
Fish Mouth View
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The Whale View
The Whale View
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Beluga View
Beluga View
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Left Apical Window
Left Apical Window
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Doppler Effect
Doppler Effect
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Doppler object movement
Doppler object movement
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Study Notes
- The instructor, Dr. Bernard Chi, is a newly board-certified veterinary cardiologist and a new faculty member at Tufts University as of February 1st.
- Echocardiography makes up approximately 85% of a cardiologist's work.
- The goal is that students will be able to recognize echocardiogram images of specific conditions and interpret reports, measurements, and images from other practices
Echocardiogram Defined
- Echocardiography uses ultrasound sound waves to image the heart.
- An ultrasound probe emits ultrasonic waves that reflect off the heart and return to the probe.
- Many ultrasound units make up the probe, allowing it to both send and listen for reflected sound waves to form a sector-shaped image of the heart.
Why Echocardiography is Needed
- Cardiology utilizes echocardiography because the heart is dynamic and complex, with a unique physiology tied to the cardiac cycle.
- The cardiac cycle includes diastole and systole in a specific order, and any disruption causes problems.
Applications and Advantages
- Echocardiography is applicable to any species with a heart, including amphibians, fish, calves, pigs, and even brown bears.
- Echocardiography provides real-time imaging, showing the heart's activity at the moment the probe is applied.
- Prior to non-invasive imaging, diagnosis of heart disease involved inserting catheters into veins or arteries to measure pressures and injecting contrast for X-rays, which is now avoided with ultrasound.
- X-rays primarily show the cardiac silhouette's shape and size, while echocardiography reveals intracardiac structures and function.
- Modern ultrasound provides good temporal and spatial resolution and captures hemodynamic information like blood flow and velocities.
- Echocardiography is essential for modern cardiology.
Weaknesses of Echocardiography
- Image quality can be affected by patient size, shape, and chest conformation, which affects acoustic window.
- Expertise is needed to acquire good, standardized images and interpret them, requiring significant training and experience.
- Even among cardiologists, image acquisition can vary slightly between individuals.
- Pressure measurements are estimates, and cardiac catheterization may still be needed.
- Extracardiac structures, such as the aorta beyond its root, cranial and caudal vena cava, and pulmonary veins, are difficult to visualize.
Echocardiographic Exam Techniques
- A full echocardiographic exam includes 2D (B-mode)
- M-mode provides one-dimensional information.
- Doppler assesses blood flow direction and velocity for hemodynamic information.
Two-Dimensional (B-Mode) Echocardiography
- Images are obtained from both the right and left parasternal windows, with the patient often positioned on a table with a hole to allow easier access to the heart.
- Standardized views reduce inter-operator variability, aid learning, and allow findings to be described in a common language.
- When performing an ultrasound, it is helpful to imagine the image as a slice through the heart, similar to a heart dissection or necropsy.
Right Parasternal Long Axis Views
- The ultrasound sector should be aligned with the heart's long axis.
- The right side of the heart will be on the top of the image, and the left on the bottom.
Right Parasternal Short Axis Views
- Achieved by rotating the probe 90 degrees, orthogonal to the long axis views, cutting through the heart in the transverse axis from apex to base.
- Different levels from apex to base reveal distinct patterns and features.
- At the mid-ventricular level is the left ventricle view with papillary muscles.
- Above the papillary muscles, the mitral valve becomes visible.
- Above the mitral valve, at the heart base, both atria are visible.
- The highest level of the short axis is the heart base with aorta and pulmonary artery.
- This view visualizes the entire right heart and structures in the right heart.
Left Parasternal Window
Left Apical Views
- The heart appears upside down because the probe is near the apex.
- Because the probe is on the left side, the first chamber visualized is the left ventricle.
M-Mode Echocardiography
- M-mode records one-dimensional motion along a selected line (cursor) to assess timing of cardiac events.
- A line drawn across the left ventricle in the mushroom view shows ventricular contraction with time.
Doppler Echocardiography
- Doppler echocardiography uses the Doppler effect to detect blood flow direction and velocity for hemodynamic information.
- The Doppler Shift is a change in frequency of sound waves due to movement between the source and object and provides information on the direction and speed of movement.
- Frequency refers to the pitch of the sound.
- The machine detects whether the object is moving away or towards the probe.
- The machine determines how fast by the frequency shift.
- Red blood cells reflect sound waves; when these cells move away from the probe, the reflected sound wave frequency decreases, and when they move towards, the frequency increases.
- In order to apply the Doppler shift, the moving object needs to be parallel to the ultrasound.
Assessing Flows
- Pulse Wave Doppler assigns a specific spot in the sector to detect velocity information at that location
- Continuous Wave Doppler gives all velocity information along the sector.
- Collar Doppler visualizes the direction and velocity in a color map overlaid on the 2D image
- Pulse wave has hollow profile showing exact velocity
- Continuous wave has has a solid profile
- BART (Blue Away, Red Towards) is the color map used in color Doppler to indicate flow direction.
- An early filling in the atrial contraction will cause the valve to open during diastole showing a red flow.
- Pulmonary flow flows away from the probe and shows a blue color.
Course Highlights
- The instructor encouraged students to review the lecture slides.
- Review the 2D images, know the views, know what those structures mean
- Basic Doppler basics and what the image means
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