Makindo Medical Notes

🫀 Cardiac echocardiography ("echo") is a non-invasive ultrasound test that provides real-time images of the heart. It is the first-line imaging tool for assessing cardiac structure and function, offering critical insights into valves, chambers, and haemodynamics.

📖 Introduction

• 🎵 Ultrasound waves generate moving heart images in real time.
• 🩺 Non-invasive (transthoracic) and risk-free for most patients.
• 🎬 Provides dynamic images → useful for assessing function and flow.

👁️ Different Echo Views

🧩 Types of Cardiac Echocardiography

• 🟦 TTE (Transthoracic Echo) → standard, quick, painless, bedside.
• 🟨 TEE (Transoesophageal Echo) → clearer images, especially for prosthetic valves, endocarditis, left atrial thrombus.
• 🏃 Stress Echo → evaluates inducible ischaemia during exercise/pharmacological stress.
• 🌊 Doppler Echo → quantifies flow across valves & chambers (stenosis, regurgitation).
• 🌀 3D Echo → high-resolution anatomical detail (surgical planning, congenital heart disease).

🔑 Key Uses

• 📊 Measure ejection fraction & wall motion → heart failure diagnosis/prognosis.
• 🫀 Evaluate valves: stenosis, regurgitation, prolapse.
• 💧 Detect pericardial effusion or tamponade.
• 🧬 Assess congenital heart disease.
• 🩸 Identify sources of emboli (e.g., left atrial thrombus, PFO).
• 🔍 Monitor cardiac surgery outcomes (valve replacement, repair, shunts).

🌟 Advantages

• 🙌 Non-invasive and safe.
• 🎥 Real-time functional imaging.
• 🌍 Widely available and cheaper than MRI/CT.
• ☢️ No radiation exposure.

⚠️ Limitations

• 📉 Variable quality in obesity, COPD, or chest wall deformity.
• 🔲 Poor acoustic windows can limit image clarity.
• 🧪 TEE is semi-invasive → rare complications (e.g., oesophageal injury).

🧾 Indications for Echocardiogram

• 🔎 Diagnosis: Valvular disease, cardiomyopathies, congenital heart disease, pericardial effusion, cardiac tumours.
• 📈 Function: LV/RV size, EF, wall motion, cardiac output.
• ❗ Symptoms: Dyspnoea, chest pain, palpitations, syncope, new murmurs.
• 🛠️ Treatment Monitoring: Post-valve surgery, heart failure therapy response.
• 🛡️ Screening: Familial cardiomyopathies, suspected endocarditis, risk stratification.

💡 Clinical Pearls

- 💥 Aortic stenosis: Echo = gold standard for valve area, gradient, LV function. - 🌊 Mitral regurgitation: Doppler echo quantifies severity & regurgitant volume. - 🫀 Hypertrophic cardiomyopathy: Echo shows asymmetric septal hypertrophy & SAM (systolic anterior motion) of the mitral valve. - 🩸 Endocarditis: TEE is far more sensitive than TTE for detecting vegetations.