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Since its discovery as an imaging modality for cardiac evaluation, echocardiogram has evolved tremendously. It has become the 1st choice for structural and functional evaluation of the human heart. In this review, we will highlight the different echocardiographic techniques relevant to physicians and allied healthcare professionals. Objectives: Describe the basics of ultrasound physiology. Outline the different echocardiographic techniques. Explain the different technical terms used in echocardiography. Review the different basic echocardiographic views. Access free multiple choice questions on this topic.

The basic concept of echocardiography was first demonstrated by Lazzaro Spallanzani in the 18 century when he described the reflected echoes of inaudible sound.[1]  Hertz and Edler reported the first use of ultrasound in the cardiac evaluation and continuous monitoring of heart movements in 1954.[2] They used an industrial ultrasonic flaw detector and obtained time-varying echoes transcutaneously from the heart. The assessment of the mitral valve with the help of M-mode was the first clinical application of an echocardiogram.[3] Since then, echocardiography has expanded tremendously and exponentially over the decades and has become an integral part of cardiac evaluation.[4] Although echocardiography started with B-mode, with the discovery of new technologies, including Doppler and 3-dimensional imaging, the echocardiographic examination has progressively become longer and more comprehensive.[5][6] With the advent of echocardiographic contrast media and transesophageal probes, the sensitivity of echocardiographic examination has improved significantly, and it has become an important part of cardiac surgical procedures involving valvular reconstruction.[7][8] In some aspects, new technologies have completely replaced old methods. In other circumstances, new technologies have been incorporated to enhance existing capabilities. Even in the contemporary era of newer imaging modalities, an echocardiogram is recommended as the first choice for structural and functional assessment of the heart. This chapter aims to review the basics of ultrasound physiology, important terms used in echocardiography, different echocardiographic techniques, and basic echocardiographic views.

Other than an allergic reaction to gel, a transthoracic echocardiogram has no significant complications. A transesophageal echocardiogram is rarely associated with trauma to the teeth, oral mucosa, and esophagus. Esophageal rupture, vasovagal reflex, and aspiration pneumonia are the other rare complications associated with a transesophageal echocardiogram.

A comprehensive echocardiographic examination requires a team that includes an imaging cardiologist as well as an echocardiography technician. It is vital to take a proper history and perform a detailed physical examination pre-procedure to understand the appropriate indications of the procedure. Communication between the referring physician, echocardiography technicians, and the cardiologist is essential, especially when there is a discrepancy in the clinical examination and echocardiography findings.