1. Introduction to Echocardiography MOHAMMED R ARAFAH MBBS FACP FRCPC FACC PROFESSOR OF CARDIOLOGY

2. What is an Echo? Simply it is an ultrasound of the heart using an echo machine equipped with a range of probes, each has a spectrum of frequencies Simply it is an ultrasound of the heart using an echo machine equipped with a range of probes, each has a spectrum of frequencies Other names for the same modality are, transthoracic echo or TTE, cardiac Doppler cardiac ultrasound or ultrasonography, Other names for the same modality are, transthoracic echo or TTE, cardiac Doppler cardiac ultrasound or ultrasonography,

3. What are types of Echocardiography? 1. M-Mode 2. 2-D (2 Dimensional) 3. Color Doppler 4. TDI 5. Contrast 6. 3-D 7. Strain and strain rate 8. 4-D

4. What an Echo can do? Chamber size, thickness and function Chamber size, thickness and function Assess all cardiac valves Assess all cardiac valves Assess hemodynamics Assess hemodynamics Congenital heart diseases Congenital heart diseases Some extracardiac shunts Some extracardiac shunts

5. Who can perform it? Obviously Echocardiologists as categorized by ASE (American Society of Echocardiography) Obviously Echocardiologists as categorized by ASE (American Society of Echocardiography) Cardiac Sonographers with proper and formal training in the field Cardiac Sonographers with proper and formal training in the field

6. More Details! Echocardiography uses high-frequency sound waves (also called ultrasound) that can provide a moving picture of your heart. The sound waves are sent through the body with a device called a transducer. The sound waves bounce off of the heart and return to the transducer as echoes. The echoes are converted into images on a television monitor to produce pictures of your heart. Echocardiography uses high-frequency sound waves (also called ultrasound) that can provide a moving picture of your heart. The sound waves are sent through the body with a device called a transducer. The sound waves bounce off of the heart and return to the transducer as echoes. The echoes are converted into images on a television monitor to produce pictures of your heart. One-dimensional or M-mode echocardiography is one beam of ultrasound directed toward the heart. Doctors most often use M- mode echocardiography to see just the left side (or main pumping chamber) of your heart. One-dimensional or M-mode echocardiography is one beam of ultrasound directed toward the heart. Doctors most often use M- mode echocardiography to see just the left side (or main pumping chamber) of your heart. Two-dimensional echocardiography produces a broader moving picture of your heart. Two-dimensional echocardiography is one of the most important diagnostic tools for doctors. Two-dimensional echocardiography produces a broader moving picture of your heart. Two-dimensional echocardiography is one of the most important diagnostic tools for doctors. Doppler echocardiography measures blood flowing through the arteries and shows the pattern of flow through the heart. Doppler echocardiography measures blood flowing through the arteries and shows the pattern of flow through the heart.

7. How? By taking the images from different windows such as parasternal long axis By taking the images from different windows such as parasternal long axis Or parasternal short axis Or parasternal short axis

8. Apical 4 chambers Apical 4 chambers Apical 2 Apical 2

9. Apical 3 Apical 3 Apical 5 with color Apical 5 with color

10. S.S.N. (Suprasternal Notch views) S.S.N. (Suprasternal Notch views) Sub-Xyphoid or Subcostal views Sub-Xyphoid or Subcostal views

11. M-Mode, first echo modality. M-Mode, first echo modality. Color Doppler (Small ASD or PFO seen) Color Doppler (Small ASD or PFO seen)

12. Tissue Doppler Tissue Doppler Spectral Tissue Doppler Spectral Tissue Doppler

13. Contrast Echo, apical views Contrast Echo, apical views Contrast, short axis views Contrast, short axis views

14. 3-D, dilated cardiomyopathy 3-D, dilated cardiomyopathy 3-D, Rheumatic Mitral valve 3-D, Rheumatic Mitral valve

15. Strain Imaging Q- Analysis of Global Hypokinesis Strain Imaging Q- Analysis of Global Hypokinesis Strain Imaging Q- Analysis Lateral Basal Hypokinesis Strain Imaging Q- Analysis Lateral Basal Hypokinesis

16. Real time 4D color full volume imaging Real time 4D color full volume imaging Real time 4D, parasternal long axis, full volume imaging Real time 4D, parasternal long axis, full volume imaging

17. How fascinating is an echo? Well it is hard to say that! Well it is hard to say that! Simply because it might be fascinating for you but catastrophic for others!! Simply because it might be fascinating for you but catastrophic for others!! And there is a proof to that!!!!!!!! And there is a proof to that!!!!!!!!

18. Or Or How about this? How about this?

19. This one is better! This one is better! But, I prefer this But, I prefer this

20. Why not this? Why not this? I like this I like this

21. And million thanks for your attention!