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M-MODE ECHOCARDIOGRPHY

M-MODE ECHOCARDIOGRPHY. THE LOST ART. M-MODE PHYSICS. B mode echoes from an interface that changes position will be seen as echoes moving towards and away from the transducer.

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M-MODE ECHOCARDIOGRPHY

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  1. M-MODE ECHOCARDIOGRPHY THE LOST ART

  2. M-MODE PHYSICS • B mode echoes from an interface that changes position will be seen as echoes moving towards and away from the transducer. • If a trace line is place on this interface and the resulting trace is made to drift across the face of a CRT screen a motion pattern is obtained.

  3. M-MODE PHYSICS • The resulting display shows motion of a reflector over distance and time – a distance time graph • The change in distance (dy) over a period of time dt is represented by the slope of the reflector line of motion. • dy/dt = slope = velocity

  4. M-MODE PHYSICS • If this motion pattern is obtained on moving cardiac structures then the resulting images constitute M-mode echocardiography. • M-mode echocardiography is use to evaluate the morphology of structures, movement and velocity of cardiac valves and walls and timing of cardiac events.

  5. M-mode Tracing Distance Time

  6. M-mode Evaluation • Amplitude • Velocity • Time intervals • Morphology

  7. Amplitude Measurement Distance Y2 Amplitude = Y2 –Y1 Y1 Time

  8. Time Measurement Distance Time interval = T2 – T1 T1 Time T2

  9. Slope Measurement Y2 dy = Y2 –Y1 Y1 Slope = dy/dt = velocity T1 T2 dt = T2 – T1

  10. M-mode at the Mitral Valve • The mitral valve has 2 leaflets – anterior and posterior. • Specific letters corresponding to systole and diastole are assigned to the m-mode tracing of the mitral valve.

  11. EKG Tracing QRS complex T-wave P wave Systole Diastole

  12. M-mode at Mitral Valve Distance Time Diastole Systole

  13. M-mode at the Mitral Valve

  14. M-mode at Mitral Valve d e a d Distance f c Systole Time Diastole

  15. M-mode at Mitral Valve e d-e amplitude Distance Systole d Time Diastole

  16. M-mode at Mitral Valve Septum EPSS Distance e Systole Time Diastole

  17. M-mode at Mitral Valve e d-e slope Distance Diastole Systole d Time

  18. M-mode at Mitral Valve e e-f slope Distance f Systole Time Diastole

  19. M-mode at Mitral Valve

  20. M-mode at the Mitral Valve

  21. M-mode at the Mitral Valve

  22. M-mode Findings at the MV • B- bump on the AC shoulder • Premature Closure of the MV • Systolic anterior motion of the AMVL • Mitral Valve Prolapse • Mitral Regurgitation

  23. M-mode Findings at the MV • Flail PMVL • Fluttering of the AMVL • Mitral Stenosis • LA myxoma • Vegetations

  24. M-mode at Mitral Valve B-bump on the AC shoulder. Distance Time Diastole Systole

  25. M-mode at Mitral Valve Premature Closure Premature Closure- closure on or before the onset of the QRS complex. Distance Time Diastole Systole

  26. M-mode at Mitral Valve Systolic anterior motion of the AMVL Distance Time Diastole Systole

  27. M-mode at Mitral Valve Systolic anterior motion of the AMVL Distance Time Diastole Systole

  28. M-mode at Mitral Valve MV prolapse posterior leaflet Distance Time Diastole Systole

  29. M-mode at Mitral Valve MV Prolapse – both leaflet Distance Time Diastole Systole

  30. M-mode at Mitral Valve Flail posterior leaflet Distance Time Diastole Systole

  31. M-mode at Mitral Valve Aortic Regurgitation Distance Time Diastole Systole

  32. M-mode at Mitral Valve Mitral Stenosis Sinus Rhythm Distance Time Diastole Systole

  33. M-mode at Mitral Valve Mitral Stenosis Atrial Fibrillation Distance Time Diastole Systole

  34. M-mode at Mitral Valve Atrial Myxoma Distance Time Diastole Systole

  35. M-mode at Mitral Valve Vegetation Distance Time Diastole Systole

  36. Mitral Regurgitation Distance Time Diastole Systole

  37. Mitral Regurgitation Distance Time Diastole Systole

  38. Mitral Regurgitation Atrial Myxoma Distance Time Diastole Systole

  39. Mitral Regurgitation Atrial Myxoma Distance Time Diastole Systole

  40. M-mode at Mitral Valve Atrial Myxoma Distance Time Diastole Systole

  41. Color M-mode

  42. Color M-mode Propagation Velocity, Vp

  43. M- Mode Aortic Valve

  44. M-mode at the Aortic Valve • The aortic valve has 3 cusps – right coronary, left coronary and non-coronary cusps. • The cusps imaged in the PLAX view are the right coronary and the non-coronary cusps.

  45. M-mode at the Aortic Valve Non-coronary cusp Anterior aortic root Coronary cusp Posterior aortic root Left Atrium

  46. M-mode at the Aortic Valve Cusp Separation Aortic root LA dimension

  47. M-mode at the Aortic Valve Aortic root Measurements are made from leading edge to leading edge. Cusp Separation LA dimension

  48. M-mode at the Aortic Valve • Dilated LA • Dilated aortic root • Decreased excursion • Premature opening • Premature closing • Exaggerated anterior motion of Aortic Root

  49. M-mode at the Aortic Valve • Reduced anterior motion of Aortic Root • Thickening • Calcification • Vegetations • Bicuspid valve • Prosthetic valve • Aortic Regurgitation

  50. M-mode at the Aortic Valve Premature Opening Opening of the AV before the onset of the QRS complex Seen in Elevated LV-EDP

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