cardiac anatomy and abnormal imaging - echo

Question 1

what are the echocardiography indications

Answer 1

• rule out heart disease
• identify the cause of a murmur
• search for structural heart disease in an animal with an arrhythmia
• quantify the severity or stage of heart disease
• assess prognosis and response to treatment
• assess safety during exercise (horse)

Question 2

how to obtain an echo

Answer 2

start with standard echo LONG Axis View from the right side: imagine a lateral x-ray

Question 3

what are the right parasternal long axis views

Answer 3

• 4 chamber right sided parasternal view (RV, LV, RA, LA)
• 5 chamber right sided parasternal view (included all above and the aorta)

Question 4

what are the standard echo short axis views recorded from the right side

Answer 4

• left atrium to aorta (LA:AO) view
• left ventricle (mushroom) view

Question 5

what does the right sided short axis view help determine

Answer 5

LA and LV size

Question 6

what is the right parasternal LV short axis “mushroom” view in a normal dog look like

Answer 6

• circular outer shape
• wall thickness ~ 1/4 diameter of the ventricular chamber
• ventricle contracts by 35-45% with each beat

Question 7

how to assess the LV systolic function

Answer 7

M-mode

Question 8

what is M-mode

Answer 8

• refers to “motion” of the LV mushroom view
• displays time on the x-axis and depth on the Y-axis

Question 9

what is M-mode useful for

Answer 9

• measurement chamber and wall thickness: staging of dilated or hypertrophic cardiomyopathy
• assment of systolic function

Question 10

what does a positive shift mean with color flow doppler

Answer 10

flow is moving towards the transducer (higher frequency)

Question 11

what does a negative shift mean in color flow doppler

Answer 11

flow is moving away from the transducer (lower frequency)

Question 12

what is color doppler

Answer 12

• codes the various velocities and directions of blood blow
• the doppler shift is coded within each sample volume using the BART map: blue away - red towards
• red = normal mitral flow
• blue-green jet = turbulent flow: mitral insufficiency

Question 13

what is pulse wave doppler

Answer 13

• allows blood flow to be detected at specific sites
• only low velocity flows are accurately measured

Question 14

what is continuous wave doppler

Answer 14

• can interrogate high velocity blood flows to measure peak flow velocity
• exact anatomic location of turbulence cannot be known with this modality

Question 15

whats the difference with LA echo

Answer 15

• sports medicine indication - horse
• same basic views as in SA (unable to obtain apical views, performed standing, takes physical effort)