1. Winston Tsui MD FRCPC October 26, 2016
Echo 101
Winston Tsui MD FRCPC
October 26, 2016

2. Learning Objectives
1. Appropriate indications for echoes 2. Appreciate how echoes assess LV function 3. Appreciate how echoes assess valvular function

3. Disclosures
I like tennis.
Otherwise none.

4. History of echoes
Origins date back to Curie and Curie, first discovered piezoelectricity published in 1880.
Squeeze certain crystals (eg. quartz) and you can make electricity flow through them.
The reverse is true : if you pass electricity through the same crystals, they "squeeze themselves" by vibrating back and forth forming utrasonic waves.

5. History of ECHO
Sokolov in 1937, Firestone 1942 received patents, accelerated developments during World War II, used for naval sonar.
John Julian Wild born on August 11, 1914 first investigators to examine the heart ultrasonically, primarily with autopsy specimens.

6. Echocardiography as we know it today is usually credited to Edler and Hertz.
M-Mode

10. Indications for transthoracic examination
Symptoms potentially due to suspected cardiac etiology.
Assessment of known or suspected adult congenital heart disease.
Evaluation of suspected complication of myocardial ischemia/infarction.
Initial evaluation of murmur in patients for whom there is a reasonable suspicion of valvular or structural heart disease.
Initial evaluation of prosthetic valve for establishment of baseline after placement.
Initial evaluation of suspected infective endocarditis
Evaluation of cardiac mass (suspected tumor or thrombus).
Evaluation of pericardial conditions: e.g. pericardial effusion
Known or suspected Marfan disease aortic root and/or mitral valve.
Initial evaluation of known or suspected cardiomyopathy.

11. Strengths Structure Function: 2D, doppler, tissue doppler. Real time
Portable
Inexpensive
Safe, basically no contraindication

12. Weakness Technical difficulties: Availability
Patient: body habitus (too large or small), positioning, cooperation, comorbidities (COPD)
Technician – not at our site!
Reader – not at our site!
Availability

13. Echo not able to
Assess LAA
Coronaries
Less well: RV, pulmonic valve

15. Alternatives to transthoracic echo
TEE
Cardiac MRI
MUGA
Catheter based Angiography
CT angiography

16. Echo Report Deciphered

19. EXAMPLES

20. Valve Assessment

21. LV function

22. Endocarditis

23. Congenital Heart Disease

24. Pericardial pathology

25. PULMONARY HTN