Echocardiography

Question 1

Echocardiography

Answer 1

the use of ultrasound in order to study the function and morphology of the heart without being invasive

Question 2

equipment

Answer 2

echocardiology table
ultrasound gel
alcohol

Question 3

Patient preparation

Answer 3

shave the patient
right side- 4-6 intercostal spaces in dogs and 3-5 intercostal spaces in cats
left side- 4 intercostal space to just caudal to the ribs for small animals
alcohol and gel for thinner haired patients

Question 4

Right parasternal long axis view

Answer 4

see all four chambers
evaluate mitral and tricuspid valves
subjective view of function of left ventricle
overall morphology of the heart

Question 5

Right parasternal long axis ventricular outflow

Answer 5

5 chamber view
evaluate left ventricular outflow tract
aortic valve

Question 6

Right parasternal transverse (short axis) view

Answer 6

evaluate the thickness of the left ventricular wall
compare size of the right vs left ventricles
left ventricle (mushroom)
evaluate mitral valve morphology and motion (fish mouth)
Evaluate right ventricular outflow tract
morphology and motion of the pulmonic valve

Question 7

Right parasternal transverse (short axis) view showing heart base

Answer 7

size of the left atrium
pulmonic valve
size of the pulmonary artery
right ventricular outflow tract

Question 8

measurements

Answer 8

objective measurements can be obtained using ultrasound
M mode- cardiac structure change with systole and diastole in a graph form. Depth on the Y axis and time on the x axis
2-d measurements of cardiac structure

Question 9

M mode of the left ventricle

Answer 9

evaluate the thickness of the interventricular septum and the left ventricular free wall
evaluate the size of the left ventricle during systole and diastole
aides in determining the contractility of the heart or systolic function
fractional shortening: LV(d) - LV(s)/LV(d)x100
Normal FS for dog = 33-46%

Question 10

M mode sowing E point to septal separation of the mitral valve

Answer 10

Evaluation of left ventricular filling and function
increased EPSS means decreased ejection fraction
Normal EPSS is less than 7.7mm

Question 11

M mode of the aorta and the left atrium

Answer 11

Aorta is measured at the end of diastole
left atrium is measured at the largest chamber size
expressed as a ratio LA:Ao ratio
normal is 0.83-1.13 in dogs and 0.88-1.7 in cats

Question 12

2D measurement of aorta and left atrium

Answer 12

evaluate the size of the left atrium in relation to the aorta, LA:Ao ratio
evaluate the size of the main pulmonary artery

Question 13

Left parasternal apical 4 chamber view

Answer 13

evaluate blood flow through the mitral and tricuspid valves via color flow and spectral doppler
Evaluate the motion and anatomy of the valves

Question 14

Left parasternal apical 5 chamber view

Answer 14

Evaluate the left ventricular outflow tract, aortic valve and doppler evaluation of the blood flow within the aorta

Question 15

The use of doppler

Answer 15

sound waves used to detect the RBCs as they circulate
Color flow doppler- show directional flow
blue- away from transducer
red-towards
Spectral- velocity and direction of blood flow

Question 16

Spectral doppler

Answer 16

Try to line up the sound beam as parallel with the blood low as much as possible
blood flowing away from transducer is seen below the baseline (aorta, main pulmonary artery)
blood flowing towards the transducer seen as peaks above baseline (mitral and tricuspid valves)