TWO-DIMENSIONAL ECHOCARDIOGRAPHY

Abstract

This article will attempt to place in appropriate perspective the present role of two-dimensional echocardiography in the evaluation of patients with potential cardiovascular disease. The basic aspects of this modality have been presented by James et al. and Price et al. in the introductory articles, and certain clinical aspects have been discussed by Cooperberg and by Baker in their articles in this symposium. M-mode echocardiography has well-known capabilities. No other noninvasive diagnostic modality based on modern electronic methods provides the "hands-on" characteristics that allow a physician to examine cardiac anatomy, confirm diagnostic impressions, and immediately direct and accomplish further clinical examination as well as echocardiography does. Presently, a similar clinical enthusiasm has been generated for two-dimensional echocardiography; however, there has been insufficient time to develop a mature understanding of this very promising imaging technique. Practical systems for clinical use of two-dimensional echocardiography have been developed only in the past few years. The demand for two-dimensional echocardiographic services has accelerated rapidly since that time. The ultimate clinical capabilities of this method are still uncertain; and some confusion exists regarding the indications for its use, particularly in comparison with the more traditional methods of evaluating cardiac size, shape, and performance. The use of any cardiac imaging procedure should be based on an appreciation of the type of information it provides. Cardiac images based upon common static techniques (chest radiography) or dynamic studies (fluoroscopy, cineventriculography, or radioisotope angiography) provide images of the heart and individual cardiac chambers as silhouettes. Two-dimensional echocardiography images the heart in cross section and therefore is a unique imaging modality for evaluating not only the size of the chambers, but also the thickness of myocardial walls and the performance of valves.