Diagnosis of an Echocardiogram
2D echocardiography, consisting of thinly sliced multiple views, is useful to diagnose
- Vegetation (intracardiac pathology)
- Valvular heart disease
- Aortic wall thickening from inflammation
- Aortic abscess
- Presence or absence of atherosclerotic calcifications
- Aortic dissection
2D echocardiography is limited by its resolution limitations.
3D echocardiography can evaluate
- Cardiac chamber volumes of the left ventricle and right ventricle
- Ejection fraction measurements of the left and right ventricles
- Atrial volumes
- Myocardial function
- Views of the mitral, tricuspid, and aortic valves and valvular heart disease
- Intracardiac masses
- Myocardial strain
3D technology can render a frame-by-frame view of the endocardial surface. New technology allows for 3D printing for pre-surgical planning.
Doppler Flow Echocardiography (Tissue Doppler Echocardiography–TDE)
Doppler flow echocardiography can measure
- Velocities of flow through the heart valves, useful in measuring the severity of stenosis.
- Left ventricular function at rest and during stress testing.
- Myocardial strain and strain rate.
Cardiac Magnetic Resonance (CMR) Imaging
Although cardiac magnetic resonance does not involve reflected sound waves but other technology, it is part of the continuum of diagnostics that begin with electrocardiography (ECG) and echocardiographic techniques. CMR is useful to assess:
- Aortic disease (aneurysms, dissection, abscesses, and coarctation).
- Atherosclerotic plaques in the aorta
- Mitral valve regurgitation and its severity
- Mitral valve stenosis
- Pericardial and myocardial disease
- Ejection fractions
- Acute coronary syndrome
- Acute and chronic MI location and extent via contrast enhancement
- 3D rendering of the aorta and its branches for preoperative strategies
Echocardiography can compare and contrast cardiac function both at rest and under stress (pharmacologic or exercise-related). Pharmacologic agents such as the adrenergic agonist, dobutamine, or dynamic exercise, such as with a treadmill, can be used in conjunction with cardiac imaging and electrocardiography (ECG) in assessing the relationship between stressing the myocardium and any resulting myocardial strain. It is useful in evaluating patients with
- Dyspnea of cardiac origin
- Pulmonary hypertension
- Mitral valve disease
- Aortic stenosis