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Chapter 1: Coronary Artery Disease

1.2: Large basal inferior left ventricular wall aneurysm.

1.3: Akinesis of the basal and mid-inferior left ventricular wall.

1.4: Akinesis of the basal and mid-inferior left ventricular wall.

1.5: Thinning, akinesis, and increased echogenicity of the interventricular septum due to an old anterior myocardial infarction.

1.6: Absence of myocardial thickening at the mid-portion of the interventricular septum.

1.7: Thinning of the apical walls.

1.8: Abnormal "scooped" basal inferior wall shown in the two-chamber apical view.

1.9: Abnormal basal inferior left ventricular wall motion.

1.10: Abnormal basal and mid-inferior left ventricular wall motion in a patient with known inferior myocardial infarction.

1.11: Basal inferior myocardial infarction that extends to the basal lateral wall.

1.12: Short axis-normal wall motion.

1.13: Dilated cardiomyopathy with left bundle branch block on the ECG and no thickening of the interventricular septum.

1.14: Right coronary artery-parasternal short axis view.

1.15: Abnormal inferior left ventricular akinesis at rest that failed to improve with stress, indicating nonviable myocardium.

1.16a: Distal left anterior descending (LAD) coronary artery obstruction with apical inferior and apical septal scar.

1.16b: Distal left anterior descending (LAD) coronary artery obstruction with apical inferior and apical septal scar.

1.17a: Dilated hypokinetic right ventricle in a patient with acute inferior myocardial infarction.

1.17b: Dilated hypokinetic right ventricle in a patient with acute inferior myocardial infarction.

1.18: Inferoseptal left ventricular wall hypokinesis extending to the adjacent right ventricular wall.

1.19: Diffuse right ventricular dysfunction with preserved wall thickness.

1.20: Akinetic infundibular right ventricular free wall.

1.21: Unusually prominent coronary artery.

1.22a: Normal left main.

1.22b: Normal left main.

1.23: Akinesis of the mid and the apical anterior left ventricular wall.

1.24a: Akinesis of the mid and the apical anterior left ventricular wall-extending to the apical inferior wall.

1.24b: Akinesis of the mid and the apical anterior left ventricular wall-extending to the apical inferior wall.

1.25: Contrast enhanced akinesis of the mid and of the apical anterior left ventricular wall-extending to the apical inferior wall.

1.26: Anterior myocardial infarction.

1.27: Apical left ventricular aneurysm.

1.28: Apical left ventricular aneurysm with a hazy apical artifact.

1.29a: Walled off rupture of the basal inferior left ventricular wall with a circumferential pericardial effusion.

1.29b: Walled off rupture of the basal inferior left ventricular wall with a circumferential pericardial effusion.

1.29c: Walled off rupture of the basal inferior left ventricular wall with a circumferential pericardial effusion.

1.30: Apical left ventricular thrombus.

1.31a: Apical left ventricular aneurysm with superimposed thrombus.

1.31b: Apical left ventricular aneurysm with superimposed thrombus.

1.31c: Apical left ventricular aneurysm with superimposed thrombus.

1.31d: Apical left ventricular aneurysm with superimposed thrombus.

1.31e: Apical left ventricular aneurysm with superimposed thrombus.

1.31f: Apical left ventricular aneurysm with superimposed thrombus.

1.31g: Apical left ventricular aneurysm with superimposed thrombus.

1.31h: Apical left ventricular aneurysm with superimposed thrombus.

1.31i: Apical left ventricular aneurysm with superimposed thrombus.

1.31j: Apical left ventricular aneurysm with superimposed thrombus.

1.31k: Apical left ventricular aneurysm with superimposed thrombus.

1.32a: Apical left ventricular thrombus.

1.32b: Apical left ventricular thrombus.

1.32c: Apical left ventricular thrombus.

1.33: Apical left ventricular thrombus intentionally outlined by color Doppler.

1.34a: Left ventricular thrombus found from the parasternal window.

1.34b: Left ventricular thrombus found from the parasternal window.

1.35a: Right ventricular apical thrombus.

1.35b: Right ventricular apical thrombus.

1.36: Inferior left ventricular wall akinesis.

1.37: Flail mitral chordae. Dilated left ventricle and left atrium.

1.38: Papillary muscle rupture.

1.39a: Ventricular septal rupture complicating acute myocardial infarction.

1.39b: Ventricular septal rupture complicating acute myocardial infarction.

1.39c: Ventricular septal rupture complicating acute myocardial infarction.

1.39d: Ventricular septal rupture complicating acute myocardial infarction.

1.39e: Ventricular septal rupture complicating acute myocardial infarction.

1.39f: Ventricular septal rupture complicating acute myocardial infarction.

1.40a: Failed attempt to patch ventricular septal rupture in a patient with cardiogenic shock.

1.40b: Failed attempt to patch ventricular septal rupture in a patient with cardiogenic shock.

1.41: Apical left ventricular aneurysm with basal septal hypertrophy.

1.42: Mid left ventricular cavity narrowing in systole.

1.43: Hypertrophic cardiomyopathy.

Chapter 2: Pulmonary Disease

2.1a: Basal and mid right ventricular free wall akinesis.

2.1b: Basal and mid right ventricular free wall akinesis.

2.1c: Basal and mid right ventricular free wall akinesis.

2.1d: Basal and mid right ventricular free wall akinesis.

2.1e: Basal and mid right ventricular free wall akinesis.

2.2: Embolus in the main pulmonary artery.

2.3a: Thrombus in the inferior vena cava.

2.3b: Thrombus in the inferior vena cava.

2.4: Loss of tricuspid leaflet opposition renders Doppler unusable for pressure estimation.

2.5: Right ventricular hypertrophy and dilatation in a patient with severe pulmonary hypertension.

2.6: Right to left displacement of the interatrial septumin pulmonary hypertension with tricuspid regurgitation.

2.7: Dilated right ventricle.

2.8: Dilated right ventricular outflow.

2.9: Right ventricular outflow dilatation and hypertrophy.

2.10a: Hypertrophy of the right ventricular free wall.

2.10b: Hypertrophy of the right ventricular free wall.

2.11: Right ventricular hypertrophy.

2.12a: Thrombus and spontaneous contrast in the inferior vena cava.

2.12b: Thrombus and spontaneous contrast in the inferior vena cava.

2.13a: Changes in the caliber of the inferior vena cava-indicating normal right atrial pressures.

2.13b: Changes in the caliber of the inferior vena cava-indicating normal right atrial pressures.

2.13c: Changes in the caliber of the inferior vena cava-indicating normal right atrial pressures.

2.13d: Changes in the caliber of the inferior vena cava-indicating normal right atrial pressures.

2.14: Elevated right atrial pressure-manifested as minimal collapse of the dilated inferior vena cava on inspiration.

2.15a: Dilated superior vena cava.

2.15b: Dilated superior vena cava.

2.15c: Dilated superior vena cava.

2.16: Large pulmonary regurgitation color flow jet.

2.17: Magnified view showing loss of pulmonic leaflet coaptation.

2.18: Right ventricular hypertrophy.

Chapter 3: Valvular Disease

3.1: Aortic stenosis with delayed systolic peaking of both Doppler flow and of the stenosis murmur.

3.2: Aortic sclerosis

3.3: Calcified aortic valve.

3.4: Patchy aortic valve calcifications.

3.5: Calcified aortic valve.

3.6: Dimensionless index.

3.7a: Aortic leaflet thickening.

3.7b: Aortic leaflet thickening.

3.8a: Bicuspid aortic valve.

3.8b: Bicuspid aortic valve.

3.9: Eccentric aortic regurgitation with a doming bicuspid aortic valve.

3.10: Artifact due to the raphe of a bicuspid aortic valve.

3.11: Trivial eccentric aortic regurgitation.

3.12: Diastolic mitral regurgitation (red color flow) is typically found in acute severe aortic regurgitation(where the left ventricular diastolic pressure rises above the left atrial pressure at end diastole).

3.13: Severe aortic regurgitation with loss of leaflet coaptation.

3.14a: Diastolic flow reversal in the descending aorta.

3.14b: Diastolic flow reversal in the descending aorta.

3.15: Diastolic mitral regurgitation on color M-mode-red color flow before the QRS.

3.16a: Continuous systolic and diastolic aortic regurgitation in a patient with a ventricular assist device, and no forward flow through the aortic valve in systole.

3.16b: Continuous systolic and diastolic aortic regurgitation in a patient with a ventricular assist device, and no forward flow through the aortic valve in systole.

3.17: Acute severe aortic regurgitation due to endocarditis.

3.18a: Color flow can be used to calculate mitral stenosis orifice area.

3.18b: Color flow can be used to calculate mitral stenosis orifice area.

3.18c: Color flow can be used to calculate mitral stenosis orifice area.

3.19a: Anterior mitral leaflet doming in mitral stenosis.

3.19b: Anterior mitral leaflet doming in mitral stenosis.

3.19c: Anterior mitral leaflet doming in mitral stenosis.

3.19d: Anterior mitral leaflet doming in mitral stenosis.

3.20: Massively dilated left atrium in a patient with mitral stenosis.

3.21a: Cor triatriatum was sometimes clinically confused with mitral stenosis prior to the advent of echocardiography.

3.21b: Cor triatriatum was sometimes clinically confused with mitral stenosis prior to the advent of echocardiography.

3.22a: Mid-to-late systolic mitral regurgitation in mitral valve prolapse.

3.22b: Mid-to-late systolic mitral regurgitation in mitral valve prolapse.

3.23: Color flow of mitral regurgitation must be distinguished from pulmonary vein inflow.

3.24a: Posterior mitral leaflet prolapse.

3.24b: Posterior mitral leaflet prolapse.

3.24c: Posterior mitral leaflet prolapse.

3.24d: Posterior mitral leaflet prolapse.

3.24e: Posterior mitral leaflet prolapse.

3.24f: Posterior mitral leaflet prolapse.

3.25a: High-resolution TEE images of mitral valve prolapse.

3.25b: High-resolution TEE images of mitral valve prolapse.

3.26: Calcified previously prolapsing posterior mitral leaflet.

3.27a: Anterior mitral leaflet prolapse.

3.27b: Anterior mitral leaflet prolapse.

3.27c: Anterior mitral leaflet prolapse.

3.28a: Flail posterior mitral leaflet chordae.

3.28b: Flail posterior mitral leaflet chordae.

3.28c: Flail posterior mitral leaflet chordae.

3.29a: Bileaflet mitral valve prolapse.

3.29b: Bileaflet mitral valve prolapse.

3.29c: Bileaflet mitral valve prolapse.

3.30: Mitral leaflet thickening and bileaflet prolapse.

3.31a: Borderline posterior mitral leaflet prolapse.

3.31b: Borderline posterior mitral leaflet prolapse.

3.32a: Mitral annular calcium.

3.32b: Mitral annular calcium.

3.32c: Mitral annular calcium.

3.32d: Mitral annular calcium.

3.33: Mitral valve prolapse with consequent mitral annular calcification and possible superimposed vegetation.

3.34: Calcified papillary muscle tip.

3.35: Calcified papillary muscle tips.

3.36a: Apical left ventricular hypertrophy.

3.36b: Apical left ventricular hypertrophy.

3.36c: Apical left ventricular hypertrophy.

3.37: Spade shape of color flow Doppler in apical left ventricular hypertrophy.

3.38a: PISA radius.

3.38b: PISA radius.

3.38c: PISA radius.

3.39: PISA and vena contracta (dark red).

3.40: Central mitral regurgitation jet.

3.41: Eccentric mitral regurgitation jet directed toward the right pulmonary vein.

3.42a: Mitral regurgitation jet directed toward the right pulmonary vein.

3.42b: Mitral regurgitation jet directed toward the right pulmonary vein.

3.43: Normal pulmonary vein inflow should not be confused with mitral regurgitation.

3.44: The tricuspid regurgitation v wave cutoff sign indicates elevated end-systolic right atrial pressure.

3.45a: Severe tricuspid regurgitation and/or severe pulmonary hypertension can cause systolic flow reversal in the hepatic veins.

3.45b: Severe tricuspid regurgitation and/or severe pulmonary hypertension can cause systolic flow reversal in the hepatic veins.

3.45c: Severe tricuspid regurgitation and/or severe pulmonary hypertension can cause systolic flow reversal in the hepatic veins.

3.45d: Severe tricuspid regurgitation and/or severe pulmonary hypertension can cause systolic flow reversal in the hepatic veins.

3.45e: Severe tricuspid regurgitation and/or severe pulmonary hypertension can cause systolic flow reversal in the hepatic veins.

3.45f: Severe tricuspid regurgitation and/or severe pulmonary hypertension can cause systolic flow reversal in the hepatic veins.

3.46: Phasic respiratory hepatic vein flow changes(unaffected by the first premature ventricular contraction).

3.47: Pulsatile to-and-fro hepatic vein flow.

3.48a: Severe tricuspid regurgitation.

3.48b: Severe tricuspid regurgitation.

3.48c: Severe tricuspid regurgitation.

3.48d: Severe tricuspid regurgitation.

3.48e: Severe tricuspid regurgitation.

3.48f: Severe tricuspid regurgitation.

3.48g: Severe tricuspid regurgitation.

3.48h: Severe tricuspid regurgitation.

3.49a: Severe tricuspid regurgitation demonstrated by reversal of saline contrast into the hepatic veins after injection into an arm vein.

3.49b: Severe tricuspid regurgitation demonstrated by reversal of saline contrast into the hepatic veins after injection into an arm vein.

3.50: Dilated inferior vena cava due to elevated right atrial pressure.

3.51a: Normal inferior vena cava oscillation in a patient with normal right atrial pressure.

3.51b: Normal inferior vena cava oscillation in a patient with normal right atrial pressure.

3.52: Normal brief hepatic vein flow reversal following the atrial contraction.

3.53: Visual exercise.

3.54: Normal inspiratory increase in hepatic vein flow toward the heart (blue color flow).

3.55: Chronic severe tricuspid regurgitation.

3.56: Severe tricuspid regurgitation.

3.57a: Severe tricuspid regurgitation with loss of leaflet coaptation.

3.57b: Severe tricuspid regurgitation with loss of leaflet coaptation.

3.57c: Severe tricuspid regurgitation with loss of leaflet coaptation.

3.58: Tricuspid regurgitation from the mid-esophagus.

3.59: Tricuspid regurgitation directed toward the eustachian valve.

3.60a: Color flow of mild pulmonic valve regurgitation originating very close to the area where the proximal left main coronary artery can be visualized.

3.60b: Color flow of mild pulmonic valve regurgitation originating very close to the area where the proximal left main coronary artery can be visualized.

3.60c: Color flow of mild pulmonic valve regurgitation originating very close to the area where the proximal left main coronary artery can be visualized.

3.61a: Color flow in the left main coronary artery.

3.61b: Color flow in the left main coronary artery.

3.61c: Color flow in the left main coronary artery.

3.62: Aortic prosthesis dehiscence.

3.63: Abnormal bileaflet mechanical mitral prosthesis.

3.64a: Aortic bioprosthesis struts on TEE.

3.64b: Aortic bioprosthesis struts on TEE.

3.65a: Mitral bioprosthesis.

3.65b: Mitral bioprosthesis.

3.66: Paravalvular mitral regurgitation.

3.67a: Partial dehiscence of a prosthetic mitral ring.

3.67b: Partial dehiscence of a prosthetic mitral ring.

3.67c: Partial dehiscence of a prosthetic mitral ring.

3.67d: Partial dehiscence of a prosthetic mitral ring.

3.67e: Partial dehiscence of a prosthetic mitral ring.

3.67f: Partial dehiscence of a prosthetic mitral ring.

3.68a: Tricuspid bioprosthesis.

3.68b: Tricuspid bioprosthesis.

3.69: Reverberation artifact due to a mechanical aortic prosthesis.

3.70a: Mitral and aortic bioprosthesis.

3.70b: Mitral and aortic bioprosthesis.

3.71a: Fluoroscopic appearance of a mechanical mitral bileaflet prosthesis.

3.71b: Fluoroscopic appearance of a mechanical mitral bileaflet prosthesis.

3.72a: Fluoroscopic appearance of a ball-in-cage Starr-Edwards aortic prosthesis.

3.72b: Fluoroscopic appearance of a ball-in-cage Starr-Edwards aortic prosthesis.

Chapter 6: Endocarditis

6.1: Partial dehiscence of a prosthetic mitral ring.

6.2: Endocarditis with perforation of the posterior mitral leaflet.

6.3: Calcified vegetations on both the atrial and on the ventricular side of the mitral valve.

6.4a: Paravalvular mitral prosthesis regurgitation.

6.4b: Paravalvular mitral prosthesis regurgitation.

6.5a: Vegetation on the right atrial side of the tricuspid valve.

6.5b: Vegetation on the right atrial side of the tricuspid valve.

6.5c: Vegetation on the right atrial side of the tricuspid valve.

6.5d: Vegetation on the right atrial side of the tricuspid valve.

6.6: Vegetation on a pacemaker wire-tethered at the point of entry of the wire into the right atrium from the superior vena cava.

6.7: Vegetation on a pulmonic valve.

6.8: Aortic valve vegetation.

6.9: Aortic root abscess.

6.10: Abscess in the intervalvular fibrosa.

6.11: Large Lambl's excrescence on the right coronary aortic cusp.

6.12a: Pseudo aneurysm of the aorta in a patient with endocarditis.

6.12b: Pseudo aneurysm of the aorta in a patient with endocarditis.

6.13a: Pacemaker wire vegetations.

6.13b: Pacemaker wire vegetations.

6.14: Partial dehiscence of an aortic valve prosthesis may occur due to endocarditis.

6.15: Normal eustachian valve.

6.16a: Right atrial Chiari network should not be confused with vegetations.

6.16b: Right atrial Chiari network should not be confused with vegetations.

6.16c: Right atrial Chiari network should not be confused with vegetations.

6.16d: Right atrial Chiari network should not be confused with vegetations.

6.16e: Right atrial Chiari network should not be confused with vegetations.

6.16f: Right atrial Chiari network should not be confused with vegetations.

6.16g: Right atrial Chiari network should not be confused with vegetations.

6.16h: Right atrial Chiari network should not be confused with vegetations.

6.16i: Right atrial Chiari network should not be confused with vegetations.

6.17: Systolic anterior motion of the mitral valve chordae should not be confused with vegetations.

Chapter 8: Cardiomyopathies

8.1: High-velocity mitral regurgitation in hypertrophic obstructive cardiomyopathy.

8.2: TEE color flow Doppler of left ventricular outflow obstruction being "depressurized" by mitral regurgitation.

8.3a: Asymmetric septal hypertrophy.

8.3b: Asymmetric septal hypertrophy.

8.3c: Asymmetric septal hypertrophy.

8.3d: Asymmetric septal hypertrophy.

8.4a: Asymmetric septal hypertrophy-short-axis view.

8.4b: Asymmetric septal hypertrophy-short-axis view.

8.5a: Asymmetric septal hypertrophy.

8.5b: Asymmetric septal hypertrophy.

8.5c: Asymmetric septal hypertrophy.

8.6a: Severe asymmetric septal hypertrophy.

8.6b: Severe asymmetric septal hypertrophy.

8.7: Systolic anterior mitral leaflet motion with loss of leaflet coaptation.

8.8: Apical left ventricular hypertrophy.

8.9a: Apical left ventricular hypertrophy.

8.9b: Apical left ventricular hypertrophy.

8.10a: Spade-shaped contrast left ventriculogram in apical hypertrophy.

8.10b: Spade-shaped contrast left ventriculogram in apical hypertrophy.

8.11: Concentric left ventricular hypertrophy.

8.12: Left ventricular hypertrophy in a hypertensive patient.

8.13: Pathologic left ventricular hypertrophy with decreased mitral leaflet coaptation and consequent mitral regurgitation.

8.14: Pathologic left ventricular hypertrophy with small left ventricular internal dimensions.

8.15a: Severe left ventricular hypertrophy in a patient with amyloid heart disease.

8.15b: Severe left ventricular hypertrophy in apatient with amyloid heart disease.

8.15c: Severe left ventricular hypertrophy in a patientwith amyloid heart disease.

8.16a: Amyloid heart disease

8.16b: Amyloid heart disease

8.16c: Amyloid heart disease

8.16d: Amyloid heart disease

8.17: Amyloid heart disease

8.18: Nondiagnostic systolic anterior motion of the mitral chordae.

8.19: Biatrial enlargement with severe AV valve regurgitation.

8.20: Early diastolic color flow propagation velocity.

8.21: Ventricular assist device "pushing" blood into the ascending aorta.

8.22a: Severely dilated, diffusely hypokinetic left ventricle.

8.22b: Severely dilated, diffusely hypokinetic left ventricle.

8.22c: Severely dilated, diffusely hypokinetic left ventricle.

8.22d: Severely dilated, diffusely hypokinetic left ventricle.

8.22e: Severely dilated, diffusely hypokinetic left ventricle.

8.22f: Severely dilated, diffusely hypokinetic left ventricle.

8.22g: Severely dilated, diffusely hypokinetic left ventricle.

8.22h: Severely dilated, diffusely hypokinetic left ventricle.

8.23: Dilated cardiomyopathy.

8.24: Apical left ventricular wall akinesis on TEE giving the appearance of a "door knob turning."

8.25: "Door knob turning" short axis view.

8.26: Severe dilatation, diffuse hypokinesis and akinesis, thin left ventricular walls.

8.27a: Apical tethering of the mitral valve in dilated cardiomyopathy.

8.27b: Apical tethering of the mitral valve in dilated cardiomyopathy.

8.28: Decreased aortic leaflet opening due to the decreased stroke volume.

8.29: Decreased biventricular function.

8.30: Thinning and increased reflectivity of the interventricular septum, indicating scarred, nonviable myocardium.

8.31: Severely decreased biventricular systolic function.

8.32: Mitral regurgitation in dilated cardiomyopathy.

8.33: Left ventricular assist device "pushing" blood from the device to the ascending aorta.

8.34: Right ventricular assist device "pushing" blood from the device to the pulmonary artery.

8.35: Impella left ventricular assist device.

8.36a: Impella left ventricular assist device.

8.36b: Impella left ventricular assist device.

8.37a: Apical left ventricular assist device.

8.37b: Apical left ventricular assist device.

8.38: Apical left ventricular assist device.

8.39a: Apical left ventricular thrombus with normal underlying left ventricular wall motion.

8.39b: Apical left ventricular thrombus with normal underlying left ventricular wall motion.

8.40: Apical left ventricular trabeculations may resemble a thrombus.

8.41: Noncompaction.

8.42a: Noncompaction with severely decreased systolic left ventricular function.

8.42b: Noncompaction with severely decreased systolic left ventricular function.

8.42c: Noncompaction with severely decreased systolic left ventricular function.

8.43: Apical left ventricular thrombus in noncompaction.

8.44a: Cardiomyopathy with prominent trabeculations of the lateral left ventricular wall.

8.44b: Cardiomyopathy with prominent trabeculations of the lateral left ventricular wall.

8.45: Idiopathic cardiomyopathy with prominent biventricular trabeculations.

8.46: Prominent left ventricular trabeculations with preserved systolic function.

8.47a: Carcinoid tricuspid valve disease.

8.47b: Carcinoid tricuspid valve disease.

8.47c: Carcinoid pulmonic valve disease.

8.48: Saline contrast in the hepatic veins following injection into an arm vein in a patient with tricuspid regurgitation.

Chapter 9: Pericardial Disease

9.1a: Large thrombus in the pericardial space following heart surgery.

9.1b: Large thrombus in the pericardial space following heart surgery.

9.2: Large pericardial effusion with partial right atrial collapse.

9.3: Pleural and pericardial effusion with partial right atrial collapse.

9.4a: Partial right atrial collapse.

9.4b: Partial right atrial collapse.

9.5: Partial biatrial collapse.

9.6: No right atrial collapse in this view.

9.7a: Fibrin in the pericardial space.

9.7b: Fibrin in the pericardial space.

9.8: Fibrin in the pericardial space.

9.9: Saline contrast in the pericardial space during echo-guided pericardiocentesis.

9.10a: Partial collapse of the right ventricular free wall.

9.10b: Partial collapse of the right ventricular free wall.

9.10c: Partial collapse of the right ventricular free wall.

9.11: Exaggerated systolic right ventricular wall motion without diastolic inversion of the free wall.

9.12: Pericardial effusion in a dialysis patient.

9.13: Pericardial effusion in the transverse sinus between the left atrial appendage and the left upper pulmonary vein.

9.14a: Pericardial effusion in Dressler's syndrome following anterior myocardial infarction.

9.14b: Pericardial effusion in Dressler's syndrome following anterior myocardial infarction.

9.15a: Large pericardial effusion with swinging heart motion that can be responsible for an electrical alternans QRS pattern on the ECG.

9.15b: Large pericardial effusion with swinging heart motion that can be responsible for an electrical alternans QRS pattern on the ECG.

9.15c: Large pericardial effusion with swinging heart motion that can be responsible for an electrical alternans QRS pattern on the ECG.

9.15d: Large pericardial effusion with swinging heart motion that can be responsible for an electrical alternans QRS pattern on the ECG.

9.15e: Large pericardial effusion with swinging heart motion that can be responsible for an electrical alternans QRS pattern on the ECG.

9.16: Pericardial effusion (not pleural) interposed between the descending aorta and the posterior left atrial wall.

9.17: Large pleural effusion extending behind the descending aorta.

9.18: Ascites on the abdominal side of the diaphragm.

9.19: Large pericardial effusion that extends to the transverse sinus (behind the proximal ascending aorta).

9.20: Pericardial fluid in the transverse sinus.

9.21: Exaggerated excursion of the right ventricular free wall due to pericardial fluid.

9.22: Questionable collapse of the basal right ventricular free wall.

9.23a: Fibrin in the pleural space.

9.23b: Fibrin in the pleural space.

9.23c: Fibrin in the pleural space.

9.23d: Fibrin in the pleural space.

9.24: Pleural effusion extending behind the descending aorta.

9.25: Ascites can be mistaken for a pericardial cyst(diverticulum).

9.26a: Septal "bounce" in pericardial constriction.

9.26b: Septal "bounce" in pericardial constriction.

9.26c: Septal "bounce" in pericardial constriction.

9.27: Normal motion of the interventricular septum(no "bounce") shown for comparison.

9.28a: Pericardial thickness can be measured using echocardiography only when there is fluid on both sides of the pericardium.

9.28b: Pericardial thickness can be measured using echocardiography only when there is fluid on both sides of the pericardium.

9.28c: Pericardial thickness can be measured using echocardiography only when there is fluid on both sides of the pericardium.

9.28d: Pericardial thickness can be measured using echocardiography only when there is fluid on both sides of the pericardium.

9.28e: Pericardial thickness can be measured using echocardiography only when there is fluid on both sides of the pericardium.

9.28f: Pericardial thickness can be measured using echocardiography only when there is fluid on both sides of the pericardium.

9.29: Thick pericardium delineated by pleural and pericardial fluid.

9.30: Left ventricular hypertrophy with biatrial enlargement.

9.31a: Normal phasic decrease in the diameter of the inferior vena cava.

9.31b: Normal phasic decrease in the diameter of the inferior vena cava.

9.32: Dilated hepatic veins with prominent flow reversal(in blue).

9.33a: Fluoroscopic appearance of calcified pericardium.

9.33b: Fluoroscopic appearance of calcified pericardium.

9.33c: Fluoroscopic appearance of calcified pericardium.

9.34: Pleuropericardial fibrin.

Chapter 11: Arrhythmias and Neurological Disorders

11.1: Left atrial appendage thrombus.

11.2: Left atrial appendage thrombus located at the far part of the appendage with "shimmering" oscillations and discrete borders.

11.3a: Spontaneous contrast in the left atrial appendage.

11.3b: Spontaneous contrast in the left atrial appendage.

11.3c: Spontaneous contrast in the left atrial appendage.

11.4: Spontaneous contrast in the dilated left atrium and left atrial appendage.

11.5: Reverberation artifact in the left atrial appendage that can be mistaken for a thrombus.

11.6a: Mechanical effect of atrial flutter on the heart.

11.6b: Mechanical effect of atrial flutter on the heart.

11.7: Mechanical effect of atrial flutter on the heart.

11.8: Variable aortic leaflet opening (and variable stroke volume) in atrial flutter.

11.9: Triangular-shaped left atrial appendage.

11.10: Normal left atrial appendage contractility with prominent trabeculations and a reverberation artifact.

11.11a: Left atrial appendage that was sewn closed during heart surgery.

11.11b: Left atrial appendage that was sewn closed during heart surgery.

11.12: Left atrial appendage that was only partly closed during heart surgery.

11.13: Biatrial enlargement in atrial flutter.

11.14: Dilated cardiomyopathy with a wide QRS.

11.15a: Dilated cardiomyopathy with paradoxical motion of the interventricular septum due to bundle branch block.

11.15b: Dilated cardiomyopathy with paradoxical motion of the interventricular septum due to bundle branch block.

11.16: Pacemaker wire.

11.17: Pacemaker wire in the coronary sinus manifested as a reverberation artifact in the pleural effusion.

11.18: Chiari network in the right atrium.

11.19: Chiari network and a pacemaker wire in the right atrium.

11.20: Small left ventricular internal dimensions with systolic cavity obliteration.

11.21: Patent foramen ovale shown by color flow.

11.22a: Sometimes an unconventional view can demonstrate a patent foramen ovale with color flow.

11.22b: Sometimes an unconventional view can demonstrate a patent foramen ovale with color flow.

11.23a: Patent foramen ovale shown by saline contrast.

11.23b: Patent foramen ovale shown by saline contrast.

11.23c: Patent foramen ovale shown by saline contrast.

11.23d: Patent foramen ovale shown by saline contrast.

11.24: Atrial septal aneurysm.

11.25a: Residual interatrial communication in a patient with a stroke following attempted device closure of a patent foramen ovale.

11.25b: Residual interatrial communication in a patient with a stroke following attempted device closure of a patent foramen ovale.

11.26: Lambl's excrescence on the ventricular side of the aortic valve in a patient with dilated cardiomyopathy.

11.27a: Lambl's excrescences on the aortic valve.

11.27b: Lambl's excrescences on the aortic valve.

11.27c: Lambl's excrescences on the aortic valve.

11.28: Papillary fibroelastoma on the aortic valve.

11.29: Papillary fibroelastoma in the left ventricular outflow below the aortic valve.

11.30a: Large serpiginous thrombus in the right atrium.

11.30b: Large serpiginous thrombus in the right atrium.

11.31a: Large thrombus in the left pulmonary vein of a lung cancer patient.

11.31b: Large thrombus in the left pulmonary vein of a lung cancer patient.

11.32a: Apical ballooning-stress induced-Takotsubo cardiomyopathy.

11.32b: Apical ballooning-stress induced-Takotsubo cardiomyopathy.

11.32c: Apical ballooning-stress induced-Takotsubo cardiomyopathy.

11.33a: Patent foramen ovale demonstrated by intravenous agitated saline.

11.33b: Patent foramen ovale demonstrated by intravenous agitated saline.

11.33c: Patent foramen ovale demonstrated by intravenous agitated saline.

11.33d: Patent foramen ovale demonstrated by intravenous agitated saline.

11.33e: Patent foramen ovale demonstrated by intravenous agitated saline.

11.33f: Patent foramen ovale demonstrated by intravenousagitated saline.

11.34: Patent foramen ovale demonstrated by color flow Doppler.

11.35: Right atrial thrombus in a patient with patent foramen ovale and paradoxical embolism.

11.36a: Atrial septal aneurysm.

11.36b: Atrial septal aneurysm.

11.36c: Atrial septal aneurysm.

11.36d: Atrial septal aneurysm.

11.36e: Atrial septal aneurysm.

11.36f: Atrial septal aneurysm.

11.36g: Atrial septal aneurysm.

11.36h: Atrial septal aneurysm.

11.36i: Atrial septal aneurysm.

11.37a: Atrial septal aneurysm seen intermittently, simulating a left atrial mass.

11.37b: Atrial septal aneurysm seen intermittently, simulating a left atrial mass.

11.37c: Atrial septal aneurysm seen intermittently, simulating a left atrial mass.

11.38: Transpulmonary saline contrast shunt entering the left atrium from the left upper pulmonary vein.

Chapter 12: Congenital Heart Disease

12.1: Color flow Doppler pattern typically found with a restrictive perimembranous ventricular septal defect.

12.2: A high-velocity (4 m/s or greater) systolic flow toward the parasternal transducer (shown here in red)is due to a ventricular septal defect.

12.3: Continuous wave Doppler demonstrates that the jet is systolic, high velocity, and directed toward the transducer.

12.4: Normal patient.

12.5a: Muscular ventricular septal defect.

12.5b: Muscular ventricular septal defect.

12.5c: Muscular ventricular septal defect.

12.5d: Muscular ventricular septal defect.

12.5e: Muscular ventricular septal defect.

12.5f: Muscular ventricular septal defect.

12.5g: Muscular ventricular septal defect.

12.6a: Perimembranous ventricular septal defect.

12.6b: Perimembranous ventricular septal defect.

12.6c: Perimembranous ventricular septal defect.

12.7: Aneurysm created by tricuspid valve tissue in a healed ventricular septal defect.

12.8: Overriding aorta.

12.9a: Secundum atrial septal defect.

12.9b: Secundum atrial septal defect.

12.10: Large secundum atrial septal defect.

12.11: Primum atrial septal defect.

12.12: Negative contrast effect in the contrast-filled right atrium.

12.13: Intact atrial septum

12.14: Secundum atrial septal defect in a neonate.

12.15a: Secundum atrial septal defect.

12.15b: Secundum atrial septal defect.

12.15c: Secundum atrial septal defect.

12.15d: Secundum atrial septal defect.

12.16: Iatrogenic fenestration in the membrane of the fossa ovalis created by a previous electrophysiology procedure.

12.17: Increased pulmonary artery flow in a patient with a secundum atrial septal defect.

12.18: Intact atrial septum with negative contrast in the right atrium from inferior cava inflow.

12.19: Normal caval inflow may be mistaken to be anatrial septal defect.

12.20a: Atrial septal defect closure device.

12.20b: Atrial septal defect closure device.

12.21: AV canal defect.

12.22: AV canal defect with a dilated hypertrophic right ventricle due to severe pulmonary hypertension.

12.23: AV canal defect manifested as an intermittent connection of the mitral valve chordae to the interventricular septum at the left ventricular outflow.

12.24a: Mustard repair of D-TGA.

12.24b: Mustard repair of D-TGA.

12.25: Mustard procedure-severely dilated systemic ventricle.

12.26: Mustard procedure-Doppler inflow.

12.27a: Fontan operation.

12.27b: Fontan operation.

12.28: Congenitally corrected transposition (L-TGA) in an adult.

12.29: Congenitally corrected transposition (L-TGA) in an adult.

12.30: Lack of fibrous continuity between the systemic AV valve on the bottom of the screen (anatomic tricuspid)and the aortic valve (with coronary ostia) on the top of the screen.

12.31: Systemic ventricle with an infundibulum (hence the lack of fibrous continuity between the AV valve and the aortic valve).

12.32: Parasternal long-axis view showing a dilated coronary sinus.

12.33: TEE sweep from the right atrial cavity to the dilated coronary sinus.

12.34a: Saline contrast in the left SVC between the left pulmonary vein and the left atrial appendage.

12.34b: Saline contrast in the left SVC between the left pulmonary vein and the left atrial appendage.

12.34c: Saline contrast in the left SVC between the left pulmonary vein and the left atrial appendage.

12.35a: Dilated coronary sinus under the mitral annulus.

12.35b: Dilated coronary sinus under the mitral annulus.

12.35c: Dilated coronary sinus under the mitral annulus.

12.35d: Dilated coronary sinus under the mitral annulus.

12.36: Dilated coronary sinus shown on a modified apical four-chamber view that scans for the coronary sinus below the posterior mitral annulus.

12.37: A dilated coronary sinus can easily be mistaken for a loculated pericardial effusion, or a pericardial cyst.

12.38: Normal coronary sinus appearance in a patient with left ventricular hypertrophy.

12.39: Venous flow towards the heart on the left side of the chest.

12.40a: Ebstein's abnormality of the tricuspid valve.

12.40b: Ebstein's abnormality of the tricuspid valve.

Chapter 14: Cardiac Tumors

14.1: Left atrial myxoma.

14.2a: Left atrial myxoma.

14.2b: Left atrial myxoma.

14.2c: Left atrial myxoma.

14.2d: Left atrial myxoma.

14.2e: Left atrial myxoma.

14.2f: Left atrial myxoma.

14.3a: Mechanical effect of atrial fibrillation on the motion of a left atrial myxoma.

14.3b: Mechanical effect of atrial fibrillation on the motion of a left atrial myxoma.

14.4: Left atrial myxoma and a patent foramen ovale.

14.5: Left atrial myxoma extending toward the right upper pulmonary vein.

14.6a: Right atrial myxoma.

14.6b: Right atrial myxoma.

14.6c: Right atrial myxoma.

14.7: Cardiac fibroma.

14.8: Metastatic breast cancer infiltrating the left ventricle.

14.9: Extensive tumor infiltration of both atria by metastatic lung cancer.

14.10: Mobile friable thrombus in the descending aorta of a patient with heparin, induced thrombocytopenia.

14.11a: Thrombus (not a tumor) superimposed on a catheter in the superior vena cava, entering the right atrial cavity.

14.11b: Thrombus (not a tumor) superimposed on a catheter in the superior vena cava, entering the right atrial cavity.

14.11c: Thrombus (not a tumor) superimposed on a catheter in the superior vena cava, entering the right atrial cavity.

14.12: Thrombus in the superior vena cava.

14.13a: The normal atrial wall in folding between the left atrial appendage and the left pulmonary vein should notbe mistaken for a mass.

14.13b: The normal atrial wall in folding between the left atrial appendage and the left pulmonary vein should notbe mistaken for a mass.

14.14: Normal anatomy-no tumor.

14.15: Submitral chordae in dilated cardiomyopathy.

14.16: Cardiac structures that resemble tumors.

14.17a: Pulmonary vein thrombus.

14.17b: Pulmonary vein thrombus.

14.18: Large hiatus hernia impinging on the posterior left atrial wall.

14.19: Lipomatous hypertrophy of the interatrial septum.

14.20a: Lung cancer infiltrating the atrial walls and obstructing caval inflow.

14.20b: Lung cancer infiltrating the atrial walls and obstructing caval inflow.

14.20c: Lung cancer infiltrating the atrial walls and obstructing caval inflow.

14.20d: Lung cancer infiltrating the atrial walls and obstructing caval inflow.

14.20e: Lung cancer infiltrating the atrial walls and obstructing caval inflow.

14.21a: Lambl's excrescences on the left ventricular side of the aortic valve.

14.21b: Lambl's excrescences on the left ventricular side of the aortic valve.

14.21c: Lambl's excrescences on the left ventricular side of the aortic valve.

14.21d: Lambl's excrescences on the left ventricular side of the aortic valve.

14.21e: Lambl's excrescences on the left ventricular side of the aortic valve.

14.21f: Lambl's excrescences on the left ventricular side of the aortic valve.

14.21g: Lambl's excrescences on the left ventricular side of the aortic valve.

14.21h: Lambl's excrescences on the left ventricular side of the aortic valve.

Chapter 15: Ultrasound Physics

15.1a: Cavitation artifacts-mechanical bileaflet mitral prosthesis.

15.1b: Cavitation artifacts-mechanical bileaflet mitral prosthesis.

15.2a: Reverberation artifact from a breast implant interferes with imaging.

15.2b: Reverberation artifact from a breast implant interferes with imaging.

15.3: Reverberation artifact from a catheter in the right ventricular outflow.

15.4: Reverberation artifact from a ventricular assist device across the aortic valve.

15.5: Reverberation artifact from a right atrial pacemaker wire wrongly suggests that there is something in the pericardial space.

15.6: Apical artifact suggesting thrombus.

15.7: Apical artifact.

15.8: Artifacts that obscure apical and lateral left ventricular wall endocardial reflections.

15.9a: Reverberation artifact from the tricuspid annulus that may wrongly suggest a left atrial mass.

15.9b: Reverberation artifact from the tricuspid annulus that may wrongly suggest a left atrial mass.

15.9c: Reverberation artifact from the tricuspid annulus that may wrongly suggest a left atrial mass.

15.9d: Reverberation artifact from the tricuspid annulus that may wrongly suggest a left atrial mass.

15.10: Artifactual duplication of the mitral valve.

15.11: Pacemaker wire demonstrating specular reflection of ultrasound.

15.12: Unusually few distracting artifacts from a pacemaker wire.

15.13: Sideways artifacts from an aortic bioprosthesis.

15.14: Reverberation and sideways artifacts from a mechanical aortic prosthesis.

15.15: Mild attenuation artifact from the ring of a mitral bioprosthesis.

15.16: Attenuation artifact from mitral annular calcium.

15.17: Ultrasound absorption and attenuation prevents visualization of the inferior left ventricular wall.

Chapter 16: Echocardiographic Anatomy

16.1: Normal aortic leaflets.

16.2a: TEE of a normal trileaflet aortic valve.

16.2b: TEE of a normal trileaflet aortic valve.

16.2c: TEE of a normal trileaflet aortic valve.

16.3: Normal mitral leaflets.

16.4: Short-axis view of the tricuspid, aortic, and pulmonic leaflets.

16.5: Short-axis view of the mitral valve.

16.6: Both mitral leaflets are connected to the same papillary muscle in this view.

16.7: Parasternal long-axis view-presence of left ventricular hypertrophy should always be confirmed in the short-axis views that follow.

16.8: Normal short-axis view of the left ventricle.

16.9: Minimal circumferential pericardial effusion.

16.10: Normal transgastric short-axis TEE view.

16.11: Short-axis view of the mitral papillary muscles.

16.12: TEE of the tricuspid valve.

16.13: Short-axis contrast-enhanced view of the left ventricle.

16.14: Pulmonary artery bifurcation.

16.15: Right branch of the pulmonary artery behind the aorta.

16.16: High mid esophagus view of the right upper pulmonary vein, superior vena cava and aorta in cross section, and the right branch of the pulmonary artery (long section) above.

16.17: Pulsatile changes in a normal size inferior vena cava indicating that the right atrial pressure is normal.

16.18: Ascending aorta.

16.19a: Descending thoracic aorta.

16.19b: Descending thoracic aorta.

16.19c: Descending thoracic aorta.

16.20: Prominent systolic expansion of the aorta can be found in young people with normal aortic valve function.

16.21: Subcostal view of the tricuspid, pulmonic, and aortic valves.

16.22: Subcostal view of the coronary sinus.

16.23: Central line catheter entering the right atrium from the superior vena cava.

16.24: Parasternal long-axis view in a heart transplant patient showing the suture line in the left atrium.

16.25: Superior mesenteric artery on transgastric TEE of the descending aorta.

16.26: Color flow in a normal aortic arch and descending aorta.

16.27: Subcostal anatomy of right ventricular inflow and outflow.

16.28: Right ventricular apex-transgastric TEE view.

16.29: Right atrial crista terminalis.

16.30: Coronary sinus emptying into the right atrium.

16.31: Right ventricular moderator bands become more obvious with right ventricular dilatation.

16.32a: Left ventricular false tendon.

16.32b: Left ventricular false tendon.

16.33a: Unusually well-demonstrated left atrial appendage on transthoracic echo.

16.33b: Unusually well-demonstrated left atrial appendage on transthoracic echo.

16.33c: Unusually well-demonstrated left atrial appendage on transthoracic echo.

16.34: Subcostal view.

16.35: Short-axis view obtained from the subcostal window.

16.36: Transgastric TEE short-axis view.

16.37: Unusually well-visualized reflections from the spine-behind the left atrium.

16.38: Normal short-axis subcostal view of the pulmonary artery.

16.39: Vessel anatomy from the high esophagus TEE window.

16.40: Azygous vein between the descending aorta and the spine.

16.41: Right atrial "floor"

16.42a: Aortic arch anatomy.

16.42b: Aortic arch anatomy.

16.43: Aortic arch examination may show flow toward the transducer from the innominate or from the left carotid branches.

Chapter 17: Contrast Echocardiograms

17.1a: Normal wall motion.

17.1b: Normal wall motion.

17.1c: Normal wall motion.

17.1d: Normal wall motion.

17.2: Normal wall motion.

17.3a: Apical left ventricular trabeculations outlined by contrast.

17.3b: Apical left ventricular trabeculations outlined by contrast.

17.3c: Apical left ventricular trabeculations outlined by contrast.

17.4a: Anteroapical left ventricular aneurysm.

17.4b: Anteroapical left ventricular aneurysm.

17.4c: Anteroapical left ventricular aneurysm.

17.5a: Apical left ventricular aneurysm.

17.5b: Apical left ventricular aneurysm.

17.5c: Apical left ventricular aneurysm.

17.6: Large antero septal aneurysm.

17.7: It is not possible to evaluate the wall motion of the inferior wall in this parasternal long-axis view due to attenuation artifact.

17.8a: Negative contrast effect from the papillary muscles.

17.8b: Negative contrast effect from the papillary muscles.

17.8c: Negative contrast effect from the papillary muscles.

17.8d: Negative contrast effect from the papillary muscles.

17.9: Negative contrast effect from an apical thrombus.

17.10a: Dilated cardiomyopathy.

17.10b: Dilated cardiomyopathy.

17.10c: Dilated cardiomyopathy.

17.10d: Dilated cardiomyopathy.

17.10e: Dilated cardiomyopathy.

17.11: Inferior wall akinesis.

17.12: Basal inferior wall akinesis.

17.13: Mid septal thinning and akinesis.

17.14a: Apical anterior akinesis.

17.14b: Apical anterior akinesis.

17.14c: Apical anterior akinesis.

17.15: Thinning and dyskinesis of the apical septum.

17.16: Decrease in the contractility of the basal and mid interventricular septum.

17.17a: Akinetic interventricular septum.

17.17b: Akinetic interventricular septum.

17.18: Paradoxical septal motion.

17.19a: Normal hyperdynamic wall motion at peak stress echo.

17.19b: Normal hyperdynamic wall motion at peak stress echo.

17.20: Right ventricular hypertrophy-prominent right ventricular trabeculations.

17.21: Short axis-normal wall motion.

17.22: Short axis-abnormal lateral wall hypokinesis.

17.23: Preserved myocardial thickening with a premature atrial contraction.

Chapter 18: Wall Motion Abnormalities

18.1: Basal antero septal akinesis.

18.2a: Mid antero septal akinesis.

18.2b: Mid antero septal akinesis.

18.3: Basal and mid antero septal akinesis.

18.4a: Basal infero lateral akinesis.

18.4b: Basal infero lateral akinesis.

18.5: Basal infero lateral akinesis.

18.6: Basal and mid infero lateral akinesis.

18.7: Basal and mid infero lateral akinesis.

18.8: Basal and mid infero lateral hypokinesis.

18.9a: Basal inferior left ventricular aneurysm with mitral regurgitation due to the wall motion abnormality.

18.9b: Basal inferior left ventricular aneurysm with mitral regurgitation due to the wall motion abnormality.

18.10a: Inferior hypokinesis.

18.10b: Inferior hypokinesis.

18.10c: Inferior hypokinesis.

18.10d: Inferior hypokinesis.

18.11: Basal inferior akinesis with scar.

18.12a: Basal inferior akinesis.

18.12b: Basal inferior akinesis.

18.12c: Basal inferior akinesis.

18.13: Basal inferior and infero septal akinesis.

18.14: Basal infero septal akinesis with scar.

18.15: Basal infero lateral, mid inferolateral, and apical lateral akinesis.

18.16: Basal inferior, mid inferior, and apical inferior akinesis.

18.17: Basal inferior aneurysm.

18.18: Basal infero septal akinesis.

18.19: Basal infero septal thinning and dyskinesis.

18.20: Inferior and infero septal mid ventricular wall akinesis and thinning, indicating scarred nonviable myocardium.

18.21: Inferior and infero septal mid ventricular wall akinesis.

18.22: Infero lateral, inferior, and infero septal mid ventricular wall akinesis.

18.23: Basal inferior, mid inferior, and apical inferior akinesis.

18.24: Inferior dyskinesis.

18.25: Inferior hypokinesis.

18.26: Basal septal hypokinesis.

18.27: Thinning, akinesis, and increased reflectivity of the interventricular septum.

18.28: Basal antero septal akinesis.

18.29: Mid antero septal akinesis.

18.30: Mid antero septal hypokinesis.

18.31: Apical septal akinesis.

18.32: Apical septal akinesis.

18.33: Anterior and antero septal akinesis.

18.34: Apical akinesis.

18.35a: Apical left ventricular aneurysm.

18.35b: Apical left ventricular aneurysm.

18.36: Apical left ventricular aneurysm.

18.37: Apical left ventricular aneurysm.

18.38: Mid infero septal akinesis.

18.39: Mid infero septal akinesis.

18.40: Dilated cardiomyopathy.

18.41: Mid infero septal akinesis.

18.42: Apical septal and mid infero septal akinesis.

18.43: Large mid to apical aneurysm.

18.44: Basal and mid infero septal akinesis.

18.45: Basal and mid infero septal aneurysm.

18.46a: Lateral wall akinesis.

18.46b: Lateral wall akinesis.

18.47: Akinetic apical lateral and mid antero lateral wall.

18.48: Apical lateral wall akinesis.

18.49: Basal and mid lateral wall akinesis.

18.50: Dilated cardiomyopathy.

18.51a: Basal and mid antero lateral wall thinning and akinesis (scar).

18.51b: Basal and mid antero lateral wall thinning and akinesis (scar).

18.51c: Basal and mid antero lateral wall thinning and akinesis (scar).

18.52a: Abnormal lateral wall motion.

18.52b: Abnormal lateral wall motion.

18.53: Septal scarring, thinning, and akinesis.

18.54: Basal and mid septal akinesis.

18.55a: Inferior myocardial infarction.

18.55b: Inferior myocardial infarction.

18.55c: Inferior myocardial infarction.

18.55d: Inferior myocardial infarction.

18.55e: Inferior myocardial infarction.

18.55f: Inferior myocardial infarction.

18.55g: Inferior myocardial infarction.

18.56: Septal hypokinesis. Lateral wall akinesis.

18.57: Dilated cardiomyopathy with diffuse wall motion abnormalities.

18.58: Dilated cardiomyopathy with diffuse wall motion abnormalities.

18.59: Dilated cardiomyopathy with diffuse wall motion abnormalities.

18.60: Pacing in cardiomyopathy.

18.61: Scarring and akinesis of the interventricular septum.

18.62: Short axis.

18.63: Preserved septal thickening.

18.64: Preserved myocardial thickening.

18.65: Short-axis anterolateral hypokinesis.

18.66: Septal akinesis.

18.67: Exaggerated normal thickening of the basal inferolateral wall due to pericardial effusion.

18.68: Akinetic right ventricular free wall. Dilated right ventricle.

18.69: Apical right ventricular free wall thinning and akinesis.

18.70a: Right ventricular wall akinesis.

18.70b: Right ventricular wall akinesis.

18.71a: Effect of premature ventricular contractions on wall motion.

18.71b: Effect of premature ventricular contractions on wall motion.

18.71c: Effect of premature ventricular contractions on wall motion.

18.71d: Effect of premature ventricular contractions on wall motion.

18.71e: Effect of premature ventricular contractions on wall motion.

18.72: Apical septal akinesis.

18.73: Right ventricle being paced from the right ventricular apex.

18.74: Global hypokinesis. Dilated cardiomyopathy.

18.75: Global biventricular dysfunction.

18.76: Wall motion quiz 1.

18.77: Wall motion quiz 2.

18.78: Wall motion quiz 3.

18.79: Wall motion quiz 4.

18.80: Wall motion quiz 5.

18.81: Wall motion quiz 6.

18.82: Wall motion quiz 7.

18.83: Wall motion quiz 8.

18.84: Wall motion quiz 9.

18.85: Wall motion quiz 10.

18.86: Wall motion quiz 11.

18.87: Wall motion quiz 12.

18.88: Wall motion quiz 13.

18.89: Wall motion quiz 14.

18.90: Wall motion quiz 15.

18.91: Wall motion quiz 16.

18.92: Wall motion quiz 17.

18.93: Wall motion quiz 18.