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Cardiac anatomy
- 1. Echocardiography -why do we need it?
- 2. Overview • 90% of echo requests are for LV function assessment – Qualitative and quantitative • Remainder for valvular and structural problems
- 3. Function • The Heart is a PUMP & forms part of the Cardiovascular system •Right and left side of the heart •Work in synchrony
- 4. Basic Anatomy of the Heart
- 5. Chambers • Right Atrium (RA) • Right Ventricle (RV) – Filling Chambers • Left Atrium (LA) • Left Ventricle (LV) – Pumping chambers
- 6. Vessels • Vessels: – Aorta (Ao) – Pulmonary artery – Inferior & Superior Vena Cava (IVC & SVC) – Pulmonary Veins (PV)
- 8. Valves • The function of the cardiac valves is to prevent retrograde flow of blood through the heart
- 9. Septum • Interventricular septum (IVS) • Interatrial septum (IAS)
- 11. Coronary Arteries Left Anterior Descending Artery Circumflex Artery Right Circumflex Artery
- 12. The Cardiac Cycle • Ventricular filling – DIASTOLE – AV valves are opened – SV are closed • • Ventricular emptying – SYSTOLE – AV valves are closed – SV are opened
- 15. Two-Dimensional Echocardiography (2D) • Access to the heart can be very difficult • Windows available: – Parasternal – Apical – Subcostal – Suprasternal – Transoesophageal
- 19. Parasternal Long Axis • Right Ventricular Wall • Right Ventricle • Interventricular Septum • Left Ventricle • Posterior Wall • Mitral Valve • Papillary Muscles • Chordae Tendinae • Left Atrium • Aortic Valve • Ascending Aorta
- 20. Parasternal Short Axis (Aortic Valve Level) • Right Ventricle • Left Atrium • Tricuspid Valve • Pulmonic Valve • Pulmonary Artery • Aortic Valve • Right Atrium
- 21. Parasternal Short Axis (Mitral Valve Level) • Right Ventricular Wall • Right Ventricle • Interventricular Septum • Left Ventricle • Mitral Valve • Posterior Wall • Pericardium
- 22. Parasternal Short Axis (Papillary Level) • Right Ventricular Wall • Right Ventricle • Interventricular Septum • Left Ventricle • Papillary Muscles • Posterior Wall
- 23. Apical Four Chamber • Left Ventricular Apex • Interventricular Septum • Right Ventricle • Interatrial Septum • Left Ventricle • Lateral Wall • Mitral Valve • Tricuspid Valve • Papillary Muscles • Chordae Tendinae • Left Atrium • Right Atrium • Pulmonary Veins
- 24. Apical Five Chamber • Left Ventricular Apex • Interventricular Septum • Right Ventricle • Interatrial Septum • Left Ventricle • Lateral Wall • Mitral Valve • Tricuspid Valve • Aortic Valve • LV Outflow Tract • Left Atrium • Right Atrium • Pulmonary Veins
- 25. Apical Two Chamber • Left Ventricular Apex • Left Ventricle • Inferior Wall • Anterior Wall • Mitral Valve • Left Atrium • Pulmonary Veins
- 26. Apical Long Axis • Left Ventricular Apex • Left Ventricle • Inferior Wall • Anterior Wall • Mitral Valve • Left Atrium • AO
- 27. SUBCOSTAL
- 28. SUPRASTERNAL
- 29. Hands on!!!!!
- 30. • M-Mode is obtained by placing a cursor through structures of interest in the Heart • Only structures transected by this line are imaged and they are plotted against time to form a tracing M-Mode echocardiography
- 31. • A graph against time of the position of the reflecting structures of the heart relative to the marker is produced • The M-Mode, or Time Motion, makes accurate measurements of dimensions and velocity of motion M-Mode echocardiography
- 32. • PLAX or PSAX M-Mode AO/LA
- 33. • PLAX or PSAX M-Mode MITRAL VALVE
- 34. • PLAX or PSAX M-Mode LEFT VENTRICLE
- 35. Hands on!!!!!
- 36. • To assess blood flow VELOCITY and DIRECTION • PWD is used when the exact location of the blood flow sampled needs to be known • CWD is used when we need to determine the peak velocity of blood flow through a particular valve DOPPLER
- 37. • Blood flow from the LA to the LV • Diastole • Displayed above the baseline FLOW PATTERNS MITRAL VALVE FLOW
- 38. • Blood ejected from the LV into the Ao • Systole • Displayed below the baseline FLOW PATTERNS AORTIC VALVE FLOW
- 39. • Blood flow from the RA to the RV • Diastole • Displayed above the baseline FLOW PATTERNS TRICUSPID VALVE FLOW
- 40. • Blood ejected from the RV into the PA • Systole • Displayed below the baseline FLOW PATTERNS PULMONARY VALVE FLOW
- 41. • To assign colors to flow direction and show the entire area of any flow, normal or abnormal, within the Heart • Quick visual search of flow anomalies. • Standard practice is “BART” COLOR FLOW DOPPLER in Echocardiography
- 44. Hands on!!!!!
- 46. Ultrasound in Cardiac Assessments Ultrasound in Cardiac Assessments • Valve Disease • Cardiomyopathy • Endocarditis • Prosthetic Heart valve assessment • Pericardial effusion • Systemic Hypertension • Pulmonary Hypetension • Ischemic Heart Disease • Septal Defects • Tumours
- 47. Mitral ValveMitral Valve • Disease of the Mitral Valve – Mitral Stenosis – Mitral Regurgitation – Mitral Valve Prolapse
- 50. Aortic ValveAortic Valve • Disease – Aortic Stenosis – Aortic Regurgitation – Bicuspid Valve
- 52. Tricuspid ValveTricuspid Valve • Disease – Stenosis – Regurgitation
- 54. PulmonaryValvePulmonaryValve • Disease – Stenosis – Regurgitation