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©2013 UpToDate ® Print Email 2D and M mode echocardiographic images of the normal aortic root from the parasternal short axis position The M-mode beam is directed through the two dimensional image of the aortic root at the base of the heart (panel A). The resulting M-mode echocardiogram (panel B) demonstrates normal systolic and diastolic motion patterns; the anterior excursion is over 14 mm and the diastolic posterior excursion mainly occurs early in diastole. The aortic (Ao) valve leaflets open as widely as the internal dimensions of the root permit and remain open throughout systole, creating a box-like configuration. The anterior motion of the root and the behavior of the valve are typical findings when the stroke volume is normal. PA: main pulmonary artery; LA: left atrium; RVOT: right ventricular outflow tract. M-mode echocardiogram of normal aorta and left atrium The M-mode echocardiogram is obtained from the long axis parasternal two dimensional view (panel A); the dotted line represents the M-mode beam passing through the aortic root, the right (R) and noncoronary (N) cusps of the aortic valve, and the left atrium (LA). The atrium is measured at end systole (arrows) when the descent of the left ventricle base has resulted in maximal filling. Two-dimensional transthoracic echocardiogram (2D TTE) and M mode echocardiographic images along with a phonocardiogram of the normal aortic root from the parasternal short axis position

The M-mode echocardiogram is obtained from the long axis parasternal two dimensional view (panel A); the dotted line represents the M-mode beam passing through the aortic root, the right (R) and noncoronary (N) cusps of the aortic valve, and the left atrium (LA). The atrium is measured at end systole (arrows) when the descent of the left ventricle base has resulted in maximal filling. Two-dimensional transthoracic echocardiogram (2D TTE) and M mode echocardiographic images along with a phonocardiogram of the normal aortic root from the parasternal short axis position Panel A shows the short axis view from a two-dimensional echocardiogram recorded at the base of the heart at the level of the aortic valve; the line (M) bisecting the aortic valve represents the plane of the M-mode beam used to generate the M-mode echocardiogram in panel B. The aortic valve opens nearly to the aortic (Ao) walls (panel B) and while opened it has a box-like configuration. The line marks the peak of the R wave on the ECG. There is a brisk anterior systolic motion of the entire Ao root and even faster earlier diastolic relaxation (posterior motion); the posterior movement of the aortic root occurs predominantly in early diastole with very little movement in late diastole. This pattern occurs in young healthy hearts that rely predominantly on early relaxation for filling rather than atrial contraction. The M-mode echocardiogram with simultaneous phonocardiogram is seen in panel C. The vibrations on the posterior moving non-coronary aortic leaflet (down arrows) are similar in timing and frequency with the low intensity, early systolic "innocent" murmur recorded on the phonocardiogram (up arrows). These vibrations are common in normal valves with normal or elevated cardiac output.

©2013 UpToDate ® Print Email 2D and M mode echocardiographic images of the normal aortic root from the parasternal short axis position The M-mode beam is directed through the two dimensional image of the aortic root at the base of the heart (panel A). The resulting M-mode echocardiogram (panel B) demonstrates normal systolic and diastolic motion patterns; the anterior excursion is over 14 mm and the diastolic posterior excursion mainly occurs early in diastole. The aortic (Ao) valve leaflets open as widely as the internal dimensions of the root permit and remain open throughout systole, creating a box-like configuration. The anterior motion of the root and the behavior of the valve are typical findings when the stroke volume is normal. PA: main pulmonary artery; LA: left atrium; RVOT: right ventricular outflow tract.