Echo 1: Introduction to echocardiography Flashcards

1
Q

Explain the piezoelectric effect in echo

A

-Pressure is generated when an electrical current is applied to the crystal
-Crystal expands and contracts to produce compressions and rarefactions (ultrasound waves)
-Crystal is struck by returning echoes which are converted into electrical currents
-These are converted into a digital display

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2
Q

How is image produced from ultrasound waves?

A

-Transducer transmits short bursts of US
-Waits for reflected US to return before transmitting next burst
-Measures time taken between emitting and return (roundtrip time)
-Uses this and propagation velocity to calculate distance between transducer and reflector
-Transducer can also determine intensity of the returning signal to build display

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3
Q

Uses of Doppler echo

A

-Measurement of velocity and direction of RBCs
-Assessment of stenotic and regurgitant valves
-Assessment of cardiac shunts
-Estimation of pressures

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4
Q

How is Doppler used to determine speed of blood flow?

A

-Frequency of returned US increases if RBCs move towards transducer
-Frequency of returned US decreases if RBCs move away from transducer
-Change in frequency = Doppler shift
-Greater Doppler shift = Faster blood flow

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5
Q

What is spectral doppler?

A

-Signal above baseline = flow towards probe
-Signal below baseline = flow away from probe
-Density of signal represents number of RBCs moving at a particular velocity

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6
Q

What is tissue doppler?

A

-Provides useful velocity information on the longitudinal function of the left ventricle in systole and diastole

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7
Q

Direction of blood in colour doppler

A

Blue away from probe
Red towards probe

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8
Q

What are the 3 types of resolution in echo?

A

Axial - distinguish between 2 points ALONG the US beam
Lateral - distinguish between points ADJACENT to each other
Temporal - ability to detect motion over time (Hz)

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9
Q

What is gain in echo and how should it be adjusted?

A

-Increases the amplitude of all returning signals
-Should be adjusted so that blood pool is black and myocardial tissues are grey
-Increase gain to improve visualisation of poor reflectors
-Decrease gain to improve visualisation of strong reflectors

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10
Q

What is time gain compensation (TGC)?

A

-Counteracts the effect of attenuation
-Attenuation - loss of amplitudes and intensity of US signal occurs exponentially with increase in depth

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11
Q

Optimised gain

A
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12
Q

High gain

A
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13
Q

Low gain

A
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14
Q

Good TGC

A
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15
Q

Bad TGC

A

-Bottom slider too left
-Can’t see posterior wall

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16
Q

Bad TGC

A

-Top slider too left
-Can’t see anteroseptum

17
Q

What is the focal zone?

A

-Highest resolution of the US beam occurs at focal zone
-Focal zone placed at area of interest

18
Q

How does sector width/depth affect frame rate?

A

-Increasing sector width/depth reduces frame rate
-Decreasing sector width/depth increases frame rate but reduces field of view

19
Q

Parasternal view

A

-Right ventricle top
-Left ventricle left

20
Q

Parasternal short axis (AV level)

A

-mercedes benz

21
Q

Parasternal short axis (LV base)

A

-fish mouth

22
Q

Parasternal short axis (LV mid)

23
Q

Parasternal short axis (LV apex)

24
Q

Apical 4 chamber

25
Apical 2 chamber
26
Apical 3 chamber/long axis
27
Subcostal 4 chamber (A&E)
28
Ejection fraction in echo
-% change in volume between systole and diastole >55% normal 50-55% borderline 35-50% impaired <35% severely impaired
29
Wall motion abnormalities
30
LV thrombus on echo
31
LV scarring on echo
-with pacing/icd lead
32
LVH on echo
Caused by: -Hypertension -Aortic stenosis -Cardiomyopathy
33
Aortic stenosis on echo
34
HCM on echo
35
Pericardial effusion (tamponade) on echo
-electrical alternans
36
LBBB on echo
-Ventricular dysynchrony
37
Left atrial enlargement (P mitrale) on echo
Possible causes: -Mitral stenosis/regurgitation
38
Right atrial enlargement (Cor pulmonale) on echo
Pulmonary hypertension
39
Interesting cases
-Quadricuspid aortic valve -Prolapsed valve -ASD -Atrial myxoma