Echocardiography

Question 1

what are the key indications for trans-oesophageal echocardiogram (TOE)?

Answer 1

• infective endocarditis – if vegetations are not seen on transthoracic echo, but suspicion is high, or with prosthetic valves
• to rule out an embolic source (especially in atrial fibrillation)
• acute dissection
• mitral valve (MV) disease preoperatively

Question 2

what are the three modes the image the heart in echocardiography?

Answer 2

2d imaging, M mode, and doppler

Question 3

what does red mean on the doppler echo?

Answer 3

blood moving towards from the transducer

Question 4

What does blue mean on the doppler echo?

Answer 4

blood flow moving away from the transducer

Question 5

what does contrast help see in an echo? what contrast is used?

Answer 5

Injecting contrast helps to see atrial septal defect if it is present. Agitating saline or synthetic contrast create micro bubbles. If you see the micro bubbles moving from the right chamber to the left chamber in real time then it indicates ASD

Question 6

what are the 3 views of the heart in 2D imaging?

Answer 6

Apical view (4 chambers visible from above), parasternal short axis (only LV and RV visible), parasternal long axis (all chambers visible)

Question 7

Stress echo- how might we induce stress in the patient?

Answer 7

non pharmacologically- exercise the patient; pharmacologically- administer dobutamine.

Question 8

What do we look for on a stress echo?

Answer 8

hypokinesis

Question 9

what are some things that are better to see on TOE rather than TTE?

Answer 9

endocarditis, vegetations on pacemaker wires, atrial thrombus, mitral valve