Cardiovascular Ultrasound

Ultrasound diagnosis of cardiovascular disease includes routine echocardiography, venous arteries of the neck, arteries and veins, abdominal arteries and veins, renal artery, aorta and deep veins, and hemodynamic examination. Echocardiography is to place the ultrasound probe in the chest wall and esophagus. The stereoscopic scan of the three-dimensional heart, comprehensive analysis of the location, shape, activity and blood flow characteristics of the various structures of the heart, in order to obtain the anatomy and physiology of cardiovascular disease. Pathology and hemodynamic diagnosis data. In recent years, the development of esophageal ultrasound, intravascular ultrasound, and cardiovascular three-dimensional ultrasound imaging technology has further broadened its application range and greatly improved the sensitivity and specificity of diagnosis. Basic Information Specialist classification: cardiovascular examination classification: ultrasound Applicable gender: whether men and women apply fasting: not fasting Tips: Transesophageal ultrasound examination, fasting 4-6 hours before the examination. Normal value Cardiac blood vessels are normal and there are no adverse lesions. Normal heart anatomy (a) normal heart position The heart is located in the mediastinum of the chest, about 2/3 of the frontal view is on the left side of the midline of the body, and 1/3 is on the right side of the midline. Most of the front is covered by the lungs and pleura, and there are esophagus, trachea, and thoracic aorta. On both sides are the lungs and pleura. Above the entrance and exit of the aorta, pulmonary artery and superior vena cava, the lower part is the diaphragm. (two) the internal structure of the heart Four chambers left, left, right, and right. Two compartments, room spacing. Two large aorta, pulmonary artery. Four groups of mitral, tricuspid, aortic, and pulmonary valves. Clinical significance Abnormal result 1. Determine the position of the heart and the positional relationship between the heart and the internal organs. 2. The abnormality of the heart structure was detected. Determine the size of the chamber chamber, the septum and wall thickness, the overall wall motion and segmental motion, valve function, the location and size of the ventricular septal defect, outflow tract, aorta, body (pulmonary) vein, myocardial lesions, heart Abnormal structures such as tumors, neoplasms and thrombosis, and peripheral vascular lesions. 3. Identify abnormalities in the structure of the heart. The relationship between atrial arrangement, atrial and ventricular, ventricular and arterial connections, venous return, pulmonary venous return, and abnormal coronary development and origin were determined. 4. Evaluation of cardiac hemodynamic changes. Doppler routinely measures the flow velocity and pressure difference of each valve to determine the location and origin of abnormal blood flow in the cardiovascular, quantitative or semi-quantitative shunt, outflow tract stenosis, stenosis and reflux, abnormal blood flow velocity, pressure difference and flow rate, etc. . 5, check out the pericardial disease. Localization and semi-quantitative evaluation of pericardial effusion, guidance of pericardial effusion, evaluation of drug efficacy. Determination of constrictive pericarditis, pericardial tamponade and pericardial tumors. 6. Evaluation of cardiac structure recovery and hemodynamic outcome after cardiac surgery and interventional therapy. 7. Evaluate cardiac function. Cardiac systolic function was measured routinely using two-dimensional and/or M-mode ultrasound, and Doppler ultrasound was also used to assess cardiac systolic and diastolic function. Need to check the crowd 1, chest tightness, shortness of breath, can not be supine, difficulty breathing at night. 2, the precordial area is uncomfortable or painful, and is released to the left shoulder and back. 3. Hypertensive patients. 4. Patients with coronary heart disease and myocardial infarction in the past. 5. Patients with rheumatism or rheumatic heart disease in the past. 6. Family members suffer from myocardial diseases such as hypertrophic cardiomyopathy and dilated cardiomyopathy. 7, chronic anemia, hyperthyroidism, uremia and other chronic diseases patients with heart symptoms. 8. The doctor auscultates the person with a heart murmur. 9, after crying or resting and appearing lips or whole body bruising; auscultation of the heart is murmur; often suffering from pneumonia, heart failure children. Precautions Contraindications before examination: transesophageal ultrasound examination, fasting for 4-6 hours before examination. Attention to the inspection: the examinee generally needs to lie on a highly appropriate examination bed, the position is appropriate, naturally relaxed, quiet, fully exposed to the inspection site, generally requires no clothing coverage above the waist, especially the chest area. The position of the subject varies according to the examination site and condition. Generally, when the sternal and apical examination is performed, the subject usually takes the supine position or the left lateral position of about 45 degrees. The inclination of the left lateral position depends on the purpose of the examination. Make adjustments. Inspection process Place the probe between the third and fourth ribs on the left sternal border, perpendicular to the chest wall. 1, left ventricular long axis section: M-mode ultrasound was used to take the aortic root wave group and measure the aortic sinus (diastolic phase) and the left atrial cavity (systolic phase). M-mode ultrasound was used to measure the left ventricular end-stage, left ventricular end-systolic, ventricular septal (end-diastolic), left ventricular posterior (end-diastolic) inner diameter and thickness, and the left ventricular diastolic phase was calculated. Volume (EDV), left ventricular systolic volume (ESV), left ventricular short axis shortening (FS), left ventricular ejection fraction (EF), left ventricular stroke volume (SV), cardiac output (CO) The aortic ring, the right ventricular outflow tract, and the right ventricle were measured two-dimensionally on the section. The observation room interval and the middle and basal segments of the left ventricular posterior wall were free of motion abnormalities. CDFI can observe the mitral aortic valve blood flow and left ventricular outflow tract blood flow, and the ventricular septum is intact. 2, the short axis of the left sternal artery aorta: Observe the right ventricular anterior wall, right ventricular outflow tract, main pulmonary artery and its branches, aortic root and aortic valve, left atrium, atrial septum, right atrium, tricuspid left coronary artery trunk and pericardium and other cardiovascular structures, And measure the diameter of the trunk of the pulmonary artery. 3, sternal left margin papillary muscle horizontal left ventricular short axis section: Observe the right ventricular anterior wall, right ventricle, ventricular septum, left ventricle, papillary muscle, anterior wall of left ventricle, lateral wall, posterior wall and inferior wall, and cardiovascular structures such as pericardium. Two-dimensional observation of the left ventricular anterior wall, side wall, posterior wall, and inferior ventricular septum in the middle of the interval with or without motion abnormalities, M-mode ultrasound to observe the left ventricular anterior wall and posterior wall with or without segmental motor abnormalities is more intuitive. CDFI can observe right ventricular outflow tract, pulmonary valve, pulmonary artery and its branches, aortic valve blood flow, and abnormal ventricular septal shunt. 4, apical four-chamber view: Place the probe at the apex of the apex, or move the probe from the apex of the sternum to the lower ventricle until the left ventricular wall completely disappears. Point the probe direction to the right sterno-lock joint, which is perpendicular to the long-axis section of the left ventricle. The fan-shaped tip is located at the tip of the heart, the fan is pointing to the bottom of the heart, and the heart cross is generally located in the center of the image. At the same time, four heart chambers are displayed. The mitral and tricuspid valves are arranged in the left and right direction, which serves as a marker for determining the correct position of the cutting surface. The left and right orientation is the same as the actual position of the heart, and the up and down position is just reversed. Observe the cardiovascular structure of the four lumens of the heart and its heart wall, papillary muscles, atrioventricular valve, atrial septum, pulmonary veins, coronary sinus and pericardium. Two-dimensional observation of mitral valve, tricuspid valve activity, room or interventricular septum with or without echo interruption, left ventricular wall and anterior chamber septum tip, middle segment, basal segment with or without segmental motor abnormalities. The right atrial diameter (systolic phase) was measured. CDFI was used to observe the blood flow of the mitral and tricuspid valves, whether there was a septal shunt in the atrioventricular septum, and whether the position of the pulmonary vein opening was normal. PW and CW were used to observe the mitral, tricuspid, and pulmonary venous flow, and the left ventricular diastolic function was evaluated by measuring the E and A peaks through the mitral valve blood flow spectrum. 5, apical five-chamber view: The placement of the probe and its orientation are similar to the four-chamber view of the apex, but the probe is slightly deflected upward and rotated 15-20 degrees clockwise. The left ventricular outflow occurs at the central intersection of the apical four-chamber view. Road and proximal aortic root images. The aortic valve can be seen in the aortic root. CDFI was used to observe blood flow in the aortic valve, subvalvular and left ventricular outflow tract. PW and CW were used to observe the blood flow spectrum of the aortic valve, subvalvular and left ventricular outflow tract. 6, apical two-chamber heart-cut: The probe is rotated 90 degrees counterclockwise on the basis of the apical four-chamber view. The left ventricular anterior wall and the inferior wall were observed, and the wall of the apical segment, the middle segment and the basal segment had no segmental motor abnormalities. Left atrium, left ventricle and mitral valve structure. CDFI was used to observe mitral blood flow. The long axis section of the aortic arch of the sternal fossa; The patient placed the pillow on the shoulder, the head was reclined, lying on the examination bed, and the probe was placed in the upper sternum, pointing to the direction of the posterior and inferior heart. The detection plane was basically parallel to the long axis of the aortic arch, between the sagittal and coronal planes. A certain angle between the two, with a clear indication of the aortic arch and its branches as a standard. Observe the cardiovascular structure of the ascending aorta, the aortic arch and its main branches, the descending aorta, the pulmonary artery and the superior vena cava. CDFI was used to observe the ascending aorta, the aortic arch and its main branches, the descending aorta, the pulmonary artery and the superior vena cava, and the presence or absence of abnormal shunt. PW and CW detect the blood flow spectrum of the ascending aorta, aortic arch and its main branches, and the descending aorta, and check whether there is high-speed blood flow. The degree of aortic regurgitation can be estimated by the blood flow spectrum at the beginning of the descending aorta. 7, the four-chamber heart section under the xiphoid process: The patient is supine, knees bent, the abdomen is relaxed, the probe is placed under the xiphoid process, the probe direction is pointing to the left shoulder, and is perpendicular to the long axis of the sternum, the tip of the fan image and the right side are the liver, and then the right is near the apex. The ventricular wall, the fan pointing to the bottom of the heart. It is helpful to observe the structure, spatial positional relationship and function of the four heart chambers of the heart, the integrity of the room and the interventricular septum, especially the interatrial septum. CDFI observation room, room septal with or without shunt. Not suitable for the crowd No taboos. Adverse reactions and risks This check will not cause harm to the human body.