Echocardiography has become an essential tool for good practice of cardiology. Intro duction of 2-D echocardiography has opened a new em of cardiac imaging and investigation. The rapid progress in the field of echocardiography has created an extreme need, now more than ever, for a practical book which is concise, yet complete, well illustrated with good quality tracings and which provides the latest information on the state of the art of combined M-Mode and 2-D) echocardiography. In this book The Essentials in Echocardiogra phy Drs. Laurenceau and Malergue have done an excellent job of accomplishing above goals as they discuss the basics of ultrasound, normal examination, and features of various diseases of the heart. The format of presentation, the quality of illustrations and the clarity of discussion point to the thorough and broad echographic experience of these authors. By sharing their experience with us in the form of this well-conceived book, they have done the field of echocardiography a great service. A. J. TAJIK, M. D. FACC Consultant in Cardiovascular Diseases and Pediatric Cardiology Director of Echocardiographic Laboratories Mayo Clinic TABLE OF CONTENTS FOREWORD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 PREFACE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 ABBREVIATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 PART I CHAPTER 1: PHYSICS OF ULTRASOUND ANDINSTRUMENTATION . . . 11 1. 1. History of echocardiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 1. 2. Physical properties of ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ". . . . . . . . . . . . . . . . . . . . . . . . . . . 11 1. 2. 1. ~finition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 1. 2. 2. Acoustic impedal1ce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 1. 2. 3. Resolution and penetration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 1. 2. 4. Properties of ultrasonic transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 1. 2. 5. Reflection and divergence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .