The Benefits and

Developments of
Echocardiography
PRESENTED BY : AARON LASSMANN
MENTOR : MASOOD AHMAD, MD
SITE : UTMB
ISM TEACHER : MRS. KRISTI CLICK
INDEPENDENT STUDY MENTORSHIP: HST
FALL 2015

*Some information in this presentation comes from outside sources*

What is ISM?
Class for interested students in 11th and 12th grade
In-depth study of a particular field
Shadow a mentor in a chosen field
Work one-on-one with the mentor
Collegiate/Professional Level of Work

Construct or Complete a Collegiate/Professional Level Product

Build an online portfolio
Weekly Journals and Activity Logs

About My Mentor
Student: Aaron Lassmann
Mentor: Masood Ahmad, MD
Occupation: Director, Echocardiography Laboratory
Employment: UTMB
Education:

Medical degree from Kashmir Medical College in Kashmir, India

Completed residency in Internal Medicine
Competed fellowship in Cardiology
Board Certified in Internal Medicine and in Cardiovascular Disease

Mentorship Site: UTMB

The University of Texas Medical Branch
Located in Galveston, Texas
Established in 1891 as the first medical school in Texas
Operates numerous hospitals and clinics
in the area
Nationally recognized echocardiography
laboratory

Online Portfolio
http://aaronlassmanncardiology.weebly.com

What is Echocardiography?
What is Echocardiography?
Echo = reflected sound, Cardio = heart, Graphy = process of recording
Echocardiography is a noninvasive test that uses sound
waves to create images of the heart, showing the
structure, blood flow and beating of it.

Why did I choose this topic?

Ive always had an interest in medicine
I find the heart extremely interesting

Project?
Focuses on the history of the echocardiography and its
benefits
Also looks at the continuing developments and uses of echocardiography

History of Echocardiography
Idea originates from the use of echolocation in bats
Led to development of radar and similar technologies

1941 - First attempt at medical use on the brain

Austrian neurologist, Karl Theo Dussik
Unsuccessful due to issues with reflection by the cranium

Late 1940s - German physicist, Wolfe Dieter Keidel, envisioned

the use of transmitted continuous ultrasound for recording the
rhythmic volume variations of the heart
Failed to make a quantitative method

Inge Edler Father of Echocardiography

Inge Edler

Singh, Siddharth, and Abha Goyal. The Origin of Echocardiography: A Tribute to

Inge Edler. Texas Heart Institute Journal 34.4 (2007): 431438. Print.

History of Echocardiography
Edler - Director of the Cardiovascular Laboratory at
the University Hospital of Lund
Distinction between mitral stenosis and
regurgitation could only be found after surgery or
through catheterization
Need for a simpler, noninvasive method
Hertz with the 1953 ultrasound
reflectoscope
Singh, Siddharth, and Abha Goyal. The Origin of
Echocardiography: A Tribute to Inge Edler.
Texas Heart Institute Journal 34.4 (2007):
431438. Print.

1953 - Inge Edler and physicist Hellmuth Hertz

developed M-mode echocardiography
Procedure was initially rejected, but later achieved
wide usage

Technical Aspects
Ultrasonic waves - sound waves above the threshold of human hearing
>20,000 Hz

Echocardiography - the waves generally range from 4 to 7 MHz

Sound waves created through electrical stimulation of piezo-electric crystals

Some waves are reflected back to the probe at density barriers in tissue
Process is reversed and the
resulting electrical impulses can
be analyzed
Ashley, Euan A., and Josef Niebauer. "Understanding the
Echocardiogram." Cardiology Explained. London:
Remedica, 2004. N. pag. Print.

Uses and Benefits

Noninvasive
Detects problems that previously required catheterization or surgery to see

Low cost

Shows the size, structure, and movement

parts of the heart
What can it detect?

Structural problems
Valve problems
Enlarged heart
Weak muscle
Tumors or clots

Chen, Michael A. "Echocardiogram: MedlinePlus Medical Encyclopedia." U.S

National Library of Medicine. U.S. National Library of Medicine, 1 May
2013. Web. 16 Oct. 2015.

of

Types of Echocardiography
Transthoracic
Most commonly performed type
Provides physician with a basic heart image
Probe is placed on specific acoustic windows on the patients
chest

Doppler
Compares frequency change between transmitted and
reflected sound waves
Estimates blood-flow velocity
Often used to screen for valve leakage
Continuous-wave (CW) - Measures along the whole beam
Pulsed-wave (PW) - Measures at a specific depth
Color-flow mapping (CFM) - Flow superimposed on a 2-D image
American Society of Echocardiography. "Types of Heart Ultrasound." See My Heart.
American Society of Echocardiography, 27 May 2011. Web. 15 Oct. 2015.

Types of Echocardiography
Stress echocardiography
Patient exercises or takes medicine to make the heart work
harder and beat faster
Used to view effects of elevated heart rate on function

Contrast

An IV solution is injected in the patients bloodstream

Saline or synthetic contrast creates reflective microbubbles
Provides a clearer image
Only viewable on the right side of the heart before the
contrast is trapped and absorbed by the pulmonary capillaries
American Society of Echocardiography. "Types of Heart Ultrasound." See My Heart.
American Society of Echocardiography, 27 May 2011. Web. 15 Oct. 2015.

Types of Echocardiography
Transesophageal echocardiography(TEE)
Invasive form of echocardiography
Probe placed down the esophagus
Clearer images can be obtained without interference from ribs
and lungs
Provides views from the posterior of the heart

3-D echocardiography
Produces a three-dimensional image of the heart
Conducted with transthoracic or transesophageal echo
Provides an additional view of malformed heart structures
American Society of Echocardiography. "Types of Heart Ultrasound." See My Heart.
American Society of Echocardiography, 27 May 2011. Web. 15 Oct. 2015.

Viewing Windows
Parasternal
Transducer placed lateral to the sternum between the 3rd and 5th intercostal spaces
Commonly used in adults
Perpendicular to many heart structures, providing clear images

Apical
Transducer placed in the fifth intercostal space upon the cardiac apex
Commonly used in adults
Provides additional multi-chamber images

Subcostal
Transducer placed below the ribs in the epigastrium area
Only possible window in pediatric patients and adults with
acoustic window due to respiratory diseases

Suprasternal Notch
Transducer placed in the suprasternal notch below the neck
Provides complementary views of the aorta supraaortic vessels
Adams, David, and Emily Forsberg. "Conducting a Cardiac Ultrasound Examination." Echocardiography. By
Petros Nihoyannopoulos and Joseph A. Kisslo. Dordrecht: Springer, 2009. 31-46. Print.

a limited

Developments
Shift to digital recording
Allows for easier sharing and viewing

New technology has brought previously unviewable areas into focus

New operator techniques for obtaining clearer images

Development of 3-D scanning technology
Strain echocardiography can differentiate
between active and passive movement

Dragulescu, Andreea, and Luc L. Mertens. "Developments in Echocardiographic

Techniques for the Evaluation of Ventricular Function in Children."
Science Direct. Science Direct, 2010. Web. 16 Oct. 2015.

Product
Research Paper

Product Guidelines
Required component of the mentorship
experience
Should reflect a high level of work

Must be featured in the final presentation

and presented to the evaluators
Secondary Research Read and analyze
scientific research on your subject and
write a formal research paper

Research Paper
Research paper over echocardiography
In-depth history of its development
Sections devoted to exploring the various
forms
Looks at the various future pathways for
development

Covers many of the areas mentioned in

this presentation on a more
comprehensive level

Conclusion
Echocardiography is an extremely
beneficial procedure
Variety of benefits and advantages
Noninvasive
Low-cost

Allows for easier diagnosis

Previously surgery may have been
required to diagnose

Still developing new methods and

technologies
New diagnostic abilities

Thank You
MENTOR:

DR. MASOOD AHMAD, MD

EVALUATORS:

MS. VALERIE RAMOS, RN

MR. MATTHEW THOMAS

TEACHER:

MS. KRISTI CLICK, RN,

PARENT:

MICHELLE MOORE

BSN, MS

Questions? Comments? Concerns?

Bibliography- Research
Adams, David, and Emily Forsberg. "Conducting a Cardiac Ultrasound Examination."
Echocardiography. By Petros Nihoyannopoulos and Joseph A. Kisslo. Dordrecht:
Springer, 2009. 31-46. Print.
American Society of Echocardiography. "Types of Heart Ultrasound." See My Heart.
American Society of Echocardiography, 27 May 2011. Web. 15 Oct. 2015.
Ashley, Euan A. and Josef Niebauer. "Understanding the Echocardiogram." Ashley,
Euan A and Josef Niebauer. Cardiology Explained. London: Remedica, 2004.
Print.
Chen, Michael A. "Echocardiogram: MedlinePlus Medical Encyclopedia." U.S National
Library of Medicine. U.S. National Library of Medicine, 1 May 2013. Web. 16 Oct.
2015.

Bibliography- Research
Hung, Judy, et al. "3D Echocardiography: A Review of the Current Status and Future
Directions." Journal of the American Society of Echocardiography 20.3 (2007):
213-33. American Society of Echocardiography. American Society of
Echocardiography, Mar. 2007. Web. 2 Nov. 2015.
Peterson, Gail E., M. Elizabeth Brickner, and Sharon C. Reimold. "Transesophageal
Echocardiography: Clinical Indications and Applications." Circulation 107.19
(2003): 2398-402. Web. 4 Nov. 2015.

Singh, Siddharth, and Abha Goyal. The Origin of Echocardiography: A Tribute to Inge
Edler. Texas Heart Institute Journal 34.4 (2007): 431438. Print.

Bibliography- Images
https://commons.wikimedia.org/wiki/File:Ventricular_Septal_Defect.jpg
http://www3.gehealthcare.com.au/enau/products/categories/ultrasound/vivid/vivid_e9

http://sealy-smith-foundation.org/gallery/g2/
http://www.howtodrawguide.com/how-to-draw-stuff/how-to-draw-a-heart-54/
http://www.monsterpreps.com/high-schools/clear-springs-high-school-leaguecity/football.htm
http://www.medicinhistoriskasyd.se/smhs_bilder/albums/SMHS_egna/normal_Inge
_Edler.jpg
http://www.palomarhealth.org/media/Image/Cardiovascular%20Services/Cardiac_C
ongestiveHeartFailure.jpg

Bibliography- Images
https://upload.wikimedia.org/wikipedia/commons/b/b3/PLAX_Mmode.jpg
https://www.siemens.com/history/en/news/1218_echocardiography.htm
http://www.ndk.com/en/sensor/ultrasonic/images/basic02/main_pic.jpg
https://www.nhlbi.nih.gov/sites/www.nhlbi.nih.gov/files/images_306
http://www.vetmed.ucdavis.edu/vmth/small_animal/cardio_kittleson/cases/case11
/images/colormr.jpg

http://www.teachingmedicine.com/Media//module_t/im1008_38.png
https://i.ytimg.com/vi/CiqjT5gWU1U/hqdefault.jpg
https://www.ottawahospital.on.ca/wps/wcm/connect/e22175004c58fc029fa7bf87
e2710825/CardioWeb2.jpg?MOD=AJPERES&CACHEID=e22175004c58fc029fa7bf87
e2710825

Bibliography- Images
http://www.vhlab.umn.edu/atlas/echocardiography-tutorial/graphics/acoustic
_windows.JPG
http://www.escardio.org/static_file/Escardio/Medias/councils/council-for-cardiologypractice/e-journal/ej-vol8n24-fig4.jpg