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Echocardiogr
aphy
Transverse Sweep
60%
of
major
malformations
cardiac
Heart size
The
heart
normally
occupies one third of the
area of the chest.
The normal C/T ratio is
around 0.55 (range 0.50.6).
Heart position
Most of the heart lies in the left chest.
The left atrium (LA) is the most
posterior chamber in the normal
heart and it the nearest chamber to
the spine.
The descending aorta lies anterior to
the spine and behind the left atrium
The right ventricle (RV) lies behind the
sternum
Heart position
The heart normally lies
with the inter-ventricular
septum at about 45
(range 25-70) to the
midline of the thorax
with the apex pointing
out of the left anterior
chest wall
Heart position
6.wmv
Heart structure
There
are
two
atria
approximately equal size
of
Heart structure
Heart function
The two ventricles contract equally and briskly
The two atrioventricular (AV) valves open
equally and freely
On colour flow mapping, there is equal filling
of both ventricles and there is no significant
AV valve regurgitation
A small amount of tricuspid regurgitation on
colour flow mapping is not uncommon with
modern sensitive ultrasound machines and is
usually of no significance in the midtrimester
fetus
The atria and ventricles contract synchronously
and regularly at a rate of about 140 beats per
minute with a range of 120-180
Summary
The 4-chamber view:
Is the most important of the cardiac views
It must be checked systematically in terms
of size, position, structure and function
It is the starting point for initiating the
transverse sweep or for turning the
transducer into the longitudinal views
Correct analysis and interpretation of this
view depends on a thorough familiarity with
the normal
Normality of the 4chV excludes over 60% of
the major congenital heart malformations
Questions
In the normal heart the moderator band lies
in the left ventricle
The 4-chamber view is abnormal in all major
cardiac malformations
In the normal heart the tricuspid valve inserts
more apically than the mitral valve
The normal heart lies equally in the left and
right chest
The two ventricles are normally of equal size
reference
to
size,
duct
and
connects
to
the
Summary
The great artery views:
Familiarity with the typical appearance will
allow the normal features of great artery
size, position, structure and function to be
checked during a routine ultrasound scan
The transverse views usually provide all the
necessary information about normality in
the fetal heart
Summary
The sagittal views can also be used for
analysis and can add information in
defining and documenting a cardiac defect
The rules for the analysis of each view are the
same no matter what the fetal position and
orientation of the sections
Questions
Please answer with a yes or no if the
the following statements are correct: