経胸壁心エコー図、経胸壁心エコー像

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a graphical image of the heart produced by an echocardiograph

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/12 16:01:02」(JST)

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A transthoracic echocardiogram (TTE) is the most common type of echocardiogram, which is a still or moving image of the internal parts of the heart using ultrasound. In this case, the probe (or ultrasonic transducer) is placed on the chest or abdomen of the subject to get various views of the heart. It is used for a non-invasive assessment of the overall health of the heart, including a patient's heart valves and degree of heart muscle contraction (an indicator of the ejection fraction). The images are displayed on a monitor for real-time viewing and are also recorded.

Various transthoracic echocardiogram views
Apical four chamber	Subcostal	Left parasternal long axis	Apical two chamber	Left ventricle short axis	Aortic valve short axis
Each figure contains a TTE with a black background, and a corresponding colored illustration.			Patrick J. Lynch and C. Carl Jaffe, Yale University, 2006.
Click on a figure to enlarge it and see some parts of the heart identified. RV, right ventricle; LV, left ventricle; RA, right atrium; LA, left atrium; TV, tricuspid valve; MV, mitral valve; AV, aortic valve; RVOT, right ventricular outflow tract; LVOT, left ventricular outflow tract

An echocardiogram can be used to evaluate all four chambers of the heart. It can determine strength of the heart, the condition of the heart valves, the lining of the heart (the endocardium), and the aorta. It can be used to detect a heart attack, enlargement or hypertrophy of the heart, infiltration of the heart with an abnormal substance. Weakness of the heart, cardiac tumors, and a variety of other findings can be diagnosed with an echocardiogram. With advanced measurements of the movement of the tissue with time (Tissue Doppler), it can measure diastolic function, fluid status,^[1] and ventricular dyssynchrony.

TTE in adults is also of limited use for the structures at the back of the heart, such as the left atrial appendage. Transesophageal echocardiography may be more accurate than TTE because it excludes the variables previously mentioned and allows closer visualization of common sites for vegetations and other abnormalities. Transesophageal echocardiography also affords better visualization of prosthetic heart valves and clots within the four chambers of the heart.

"Bubble contrast TTE" involves the injection of agitated saline into a vein, followed by an echocardiographic study. The bubbles are initially detected in the right atrium and right ventricle. If bubbles appear in the left heart, this may indicate a shunt, such as a patent foramen ovale, atrial septal defect, ventricular septal defect or arteriovenous malformations in the lungs.^[2]

Footnotes

^ Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM, Tajik AJ. (2000). "Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: A comparative simultaneous Doppler-catheterization study" (PDF). Circulation 102 (15): 1788–94. doi:10.1161/01.cir.102.15.1788. PMID 11023933.
^ Soliman OI, Geleijnse ML, Meijboom FJ, Nemes A, Kamp O, Nihoyannopoulos P, Masani N, Feinstein SB, Ten Cate FJ (June 2007). "The use of contrast echocardiography for the detection of cardiac shunts". European Heart Journal – Cardiovascular Imaging 8 (3): s2—s12. doi:10.1016/j.euje.2007.03.006. PMID 17462958. Retrieved 2012-08-29.

External links

Virtual Transthoracic Echocardiography - online learning resource
Basic ultrasound, echocardiography and Doppler for clinicians

UpToDate Contents

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1. 経胸壁心エコー：正常の心臓の解剖および断層像 transthoracic echocardiography normal cardiac anatomy and tomographic views
2. 心エコー検査の要点：物理学および計測 echocardiography essentials physics and instrumentation
3. 三次元心エコー検査 three dimensional echocardiography
4. 組織ドップラー心エコー tissue doppler echocardiography
5. 冠動脈疾患の診断および予後における負荷心エコー stress echocardiography in the diagnosis and prognosis of coronary heart disease

English Journal

An unusual shadow above the aortic valve.

McWilliams E1, Zehr K2, Alshehri A1.
Heart (British Cardiac Society).Heart.2016 Dec 15;102(24):1942. doi: 10.1136/heartjnl-2016-309932. Epub 2016 Aug 11.
CLINICAL INTRODUCTION: A 55-year-old West African man was referred for routine echocardiography. He was completely asymptomatic, a non-smoker, working out at the gym several times weekly. He was taking hydrochlorothiazide for hypertension.Clinical examination revealed a blood pressure of 156/74 mm
PMID 27515955

Noninvasive assessment of myocardial bridging by coronary flow velocity reserve with transthoracic Doppler echocardiography: vasodilator vs. inotropic stimulation.

Aleksandric S1, Djordjevic-Dikic A2, Beleslin B2, Parapid B2, Teofilovski-Parapid G3, Stepanovic J2, Simic D2, Nedeljkovic I2, Petrovic M2, Dobric M2, Tomasevic M4, Banovic M2, Nedeljkovic M2, Ostojic M5.
International journal of cardiology.Int J Cardiol.2016 Dec 15;225:37-45. doi: 10.1016/j.ijcard.2016.09.101. Epub 2016 Sep 28.
BACKGROUND: To consider hemodynamic assessment of myocardial bridging (MB) adequate, it is believed that inotropic stimulation with dobutamine should be estimated because its dynamic nature depends on the degree of extravascular coronary compression. This study evaluated comparative assessment of he
PMID 27710800

Echocardiographic pulmonary hypertension probability is associated with clinical outcomes after transcatheter aortic valve implantation.

Nijenhuis VJ1, Huitema MP2, Vorselaars VM2, Swaans MJ2, de Kroon T3, van der Heyden JA2, Rensing BJ2, Heijmen R3, Ten Berg JM2, Post MC2.
International journal of cardiology.Int J Cardiol.2016 Dec 15;225:218-225. doi: 10.1016/j.ijcard.2016.10.010. Epub 2016 Oct 6.
AIMS: Pulmonary hypertension (PH) is associated with mortality after transcatheter aortic valve implantation (TAVI). However, diagnosis based on tricuspid regurgitant velocity (TRV) is often inaccurate and unreliable. The updated PH guidelines introduced a PH probability grading implementing additio
PMID 27732925