Two-Dimensional and Three-Dimensional Echocardiograms

The two-dimensional (2-D) echocardiogram uses crystals in the transducer to create a

cross-sectional imaging plane. Sections of the heart are then viewed from a number of different
angles. The 2-D echocardiogram images a whole slice of the heart at once and is used for
direct measurement of LV volumes and wall mass. The 2-D slice also permits visualization of
the cardiac structures in relation to each other and readily identifies valvular dysfunction and
wall motion abnormalities after MI.

A more recent innovation is the three-dimensional (3-D) echocardiogram. It produces a

more realistic image of structures such as the mitral valve.

Motion-Mode Echocardiography

In motion-mode (M-mode) TTE, a thin beam of ultrasound is directed through the heart.
Each interface is represented by a dot, and when recorded over time (like an ECG tracing), each
dot becomes a line on an oscilloscope. A strip-chart recording can be made of this tracing as the
heart beats. M-mode echocardiograms are particularly useful in detecting small pericardial
effusions and cardiac tamponade.

A, Schematic representation of cardiac structures traversed by two echobeams. B, Normal. M-mode

echocardiogram at the level of the aorta, aortic valve leatflets, and left atrium. AMVL, anterior mital
leaflet; Ao, aorta; AV, aortic valve; IVS, interventricular septum; LA, left atrium; LV, left ventricle;
PMVL, posterior mitral valve leatflet; PPM, posterior papillary muscle; RV, right ventricle; T, transducer.
(B from Kinney M et al: Andreolis comprehensive cardiac care, ed 8, St Louis, 1995, Mosby.)