PowerPoint Presentation

ozo JLO-MED TRAINING CENTER.

[Audio] Course Objectives:: At the end of the today’s training, participants will be able to: Be oriented to house rules & regulations of the training program Understand and identify the function and parts of the heart Understand the general idea of the echocardiography diagnostic procedure Understand what echocardiographic ultrasonography is all about.

[Audio] House Rules Punctuality: Please join the meeting at least 15 minutes early to address any technical issues that may arise and to ensure a timely start. Dress Code: Please make sure you to wear decent and appropriate attire. No revealing outfits are allowed during the entire session as this is recorded. Audio Etiquette: Keep your microphone muted unless you are speaking to minimize background noise. Video: We encourage you to keep your video on during the lecture to facilitate a more interactive and engaging experience. Participation: We welcome questions and participation but request that you use the 'Raise Hand' feature in Zoom when you wish to speak, and wait to be called upon. Attendance: For morning and afternoon sessions a group picture will be taken for your attendance. The moderator will address everyone for a this. Please participate by opening your cameras when it is announced. Recording: Please note that the session will be recorded for educational purposes and may be shared with participants afterward.5..

[Audio] Hands On Training Rules & regulations For participating in any hands on activities or practical sessions: Safety First: Always inform relatives about your whereabouts. Logbook: Upon arrival, write legibly in the ledger. This will be done every time you come in for your practical sessions and will continue to do so until the end of your training. Identification Card: Always wear your ID within the premises. Required Materials Follow Instructions: It is crucial to follow all instructions carefully to maximize the educational benefit and maintain safety. Feedback: Participants will be given the opportunity to receive feedback on their hands on work. Photos will be taken during your sessions for documentation purposes.

Shangri-la R. U. Juan II, rn, cvs. Senior Cardiovascular Technologist & Instructor since 2020 Electrocardiogram Technologist, Echocardiography Technologist World Citi Medical Center, Heart Station 2018 - 2020 Nurse at Makati Medical Center 2009.

[Audio] Introduction to echocardiography. Introduction to echocardiography.

[Audio] Echocardiography. Echocardiography. [image].

[Audio] What is Echocardiography? An echocardiogram (echo) is a test that uses high frequency sound waves (ultrasound) to make pictures of your heart. The test is also called echocardiography or diagnostic cardiac ultrasound. An echo uses sound waves to create pictures of your heart’s chambers, valves, walls and the blood vessels (aorta, arteries, veins) attached to your heart. A probe called a transducer is passed over your chest. The probe produces sound waves that bounce off your heart and “echo” back to the probe. These waves are changed into pictures viewed on a video monitor..

[Audio] Why do patients need an echo test? An echo test shows your heart’s structure and checks how well your heart functions. The test helps your doctor find out: The size and shape of your heart, and the size, thickness and movement of your heart’s walls. How your heart moves. The heart’s pumping strength. If the heart valves are working correctly. If blood is leaking backwards through your heart valves (regurgitation). If the heart valves are too narrow (stenosis). If there is a tumor or infectious growth around your heart valves..

[Audio] What are the risks? An echo can’t harm you. An echo doesn’t hurt and has no side effects. How often is an echocardiogram done? Depending on the severity of the disease, an echocardiogram might need to be repeated more frequently. For example, Aortic Valve Stenosis (A-S---) should usually be followed every 6-12 months if the stenosis is severe; otherwise, 3-5 years is the rule for mild disease..

[Audio] How to prepare a patient for the procedure? Obtain patient’s health history (including blood pressure) and diagnostic request. Patient can eat light meals and drink at least an hour before the test. Instruct the patient to change into gown and remove accessories. Once done changing, patients is instructed to lie on bed in supine position. Explain that the procedure will last an hour at most. Input all patient’s details into the ultrasound machine and place electrodes on the patient’s chest. The electrodes have wires that hook to an electrocardiogram (ECG or E-K-G--) that keeps track of the patient’s heartbeat during the procedure..

[Audio] Ecg lead placement (R-A---) R-E-D electrode placed under right clavicle near right shoulder Within the rib cage frame (L-A---) yellow electrode placed under left clavicle near left shoulder within the rib cage frame (L-L---) G-R-E-E-N electrode placed On the left side below pectoral Muscles lower edge of left rib cage.

[Audio] 5. Instruct patient to lie on their left side, side lying (left lateral decubitus), with their left arm positioned above their head as if in a sleeping position. 6. Turn off lights. The room is dark so you can better see the video monitor..

[Audio] What happens after the procedure? Help the patient clean the gel off their chest. Assist patient into sitting position and have them stay in same position for at least a minute to avoid them abruptly standing and getting dizzy. Wipe the gel of from the probe with a dry tissue after use and disinfect between patients. Always do aftercare. Probe care is life..

[Audio] Cardiac Anatomy: Whispers of the Heart. Cardiac Anatomy: Whispers of the Heart.

[Audio] The Heart A vital organ Pumping blood for circulation Muscular organ the size of a fist The heart is a vital organ in the circulatory system, responsible for pumping blood throughout the body. It is a muscular organ located in the thoracic cavity, between the lungs, and is roughly the size of a fist. The heart's structure is complex, consisting of various parts that work together to ensure efficient blood circulation..

[Audio] The Function Pumping blood Circulation: Systemic Pulmonary Blood Pressure regulation 1. Pumping Blood: The primary function of the heart is to pump blood throughout the body, delivering oxygen and nutrients to tissues and removing carbon dioxide and waste products. 2. Circulation: Systemic Circulation: The left side of the heart pumps oxygenated blood to the body. Pulmonary Circulation: The right side of the heart pumps deoxygenated blood to the lungs for oxygenation. 3. Regulation of Blood Pressure: The heart helps maintain blood pressure by adjusting the force and rate of its contractions, ensuring adequate blood flow to meet the body's needs..

[Audio] The Function Hormonal regulation Electrical Conduction Adaptation to demand 4. Hormonal Regulation: The heart releases hormones such as atrial natriuretic peptide (A-N-P--), which helps regulate blood volume and pressure. 5. Electrical Conduction: The heart has its own electrical conduction system that controls the heartbeat, ensuring that the heart beats in a coordinated and efficient manner. 6. Adaptation to Demand: The heart can increase its output during physical activity or stress by increasing the heart rate and stroke volume, adapting to the body's changing needs. These functions are crucial for maintaining homeostasis and ensuring that all body systems receive the necessary blood supply to function effectively..

[Audio] Structure 4 Chambers of the Heart Right Atrium (1) Right Ventricle (2) Left Atrium (3) Left Ventricle (4) Chambers: The heart has four chambers: 1.Right Atrium: Receives deoxygenated blood from the body via the superior and inferior vena cavae. 2.Right Ventricle: Pumps deoxygenated blood to the lungs through the pulmonary arteries. 3.Left Atrium: Receives oxygenated blood from the lungs via the pulmonary veins. 4.Left Ventricle: Pumps oxygenated blood to the rest of the body through the a.

[Audio] Valves of the heart Tricuspid Valve Pulmonary Valve Mitral Valve Aortic valve Tricuspid Valve: Located between the right atrium and right ventricle. Pulmonary Valve: Located between the right ventricle and pulmonary artery. Mitral Valve: Located between the left atrium and left ventricle. Aortic Valve: Located between the left ventricle and aorta..

[Audio] Mitral Valve Pulmonary Valve c Aortic Valve Tricuspid Valve Semilunar Valves: PV & AV (due to crescent shape) Atrioventricular Valves: 1005 & AV (both have atria & Ventricles).

[Audio] layers of the Heart Epicardium (Pericardium) Myocardium Endocardium Epicardium: The outer layer, which is also part of the pericardium. Has 2 layers: Myocardium: The middle layer, composed of cardiac muscle, responsible for the heart's pumping action. Endocardium: The inner layer that lines the chambers and valves..

[Audio] Epicardium (Pericardium) Outermost layer Protective barrier Contains blood vessels, nerves & lymphatics Pericardial fluid: Avoid friction >The epicardium is the outermost layer of the heart wall. It is a thin layer of tissue that serves as a protective covering for the heart. The epicardium is composed of connective tissue and is also part of the pericardium, which is the double walled sac that surrounds the heart. This layer contains blood vessels, nerves, and lymphatics that supply the heart. >Additionally, the epicardium plays a role in the production of pericardial fluid (small amount of fluid), which helps reduce friction between the heart and the surrounding structures as the heart beats..

[Audio] Myocardium Middle Layer Responsible for the contraction & pumping action Crucial role: pump& circulate blood A vital part for heart function The myocardium is the thick, muscular middle layer of the heart wall. It is primarily composed of cardiac muscle tissue, which is responsible for the heart's contraction and pumping action. The myocardium plays a crucial role in maintaining the heart's ability to pump blood efficiently throughout the body. Its strength and elasticity allow it to contract and relax rhythmically, facilitating the circulation of blood to the lungs for oxygenation and to the rest of the body to supply oxygen and nutrients. The health of the myocardium is vital for overall cardiovascular function, and conditions affecting it, such as cardiomyopathy or ischemic heart disease, can significantly impact heart performance..

[Audio] Endocardium Innermost Layer Thin layer of endothelial cells Lines the chambers & covers the valves Helps facilitate blood flow within the heart Plays a role in the heart’s electrical conduction system & regulate valve function The endocardium is the innermost layer of the heart wall. It lines the heart chambers and covers the heart valves. Composed of a thin layer of endothelial cells, the endocardium provides a smooth surface that helps facilitate the flow of blood within the heart and prevents turbulence. It also plays a role in the heart's electrical conduction system and helps to regulate the function of the heart valves. The endocardium is important for maintaining the overall health and efficiency of the heart's pumping action..

[Audio] Cardiac circulation. Cardiac circulation.

[Audio] Cardiac Circulation Blood circulation in heart is called breaths of life as it is the essential system in the human body. It is the blood supply of the whole body and is responsible for delivering the blood to every organ. For the utmost efficiency, the heart has to beat more than 100000 times per day and pump nearly 600 gallons of blood. It is structured like a big tree; the biggest root is the heart which includes the heart tissues. The root will transport nutrition to the trunk, the major arteries, and then, the "artery trunk" will split the nutrition onto the blood vessels. The supply of blood is one of the most important processes in the human body as it is the main source that nurtures the brain..

[Audio] The biggest mission of pulmonary circulation is to distribute the oxygenated blood to every part of the body. The help of the circulation generates our daily activities that evolve muscles or brains. It produces oxygen and nutrients for the operation of external and internal sections. If we do not eat healthy, we may get coronary artery disease and heart attack. Besides, it also helps filter and eliminates the toxic waste accumulated in the body. The waste may come from respiration or the food and drink we digest..

[Audio] 2 Kinds of Circulation: Pulmonary Circulation Pulmonary circulation is the blood flow between the heart and the lungs. The heart pumps "used" blood (low in oxygen) to the lungs. In the lungs, the blood gets fresh oxygen and releases carbon dioxide. Then the oxygen rich blood returns to the heart. Systemic Circulation Systemic circulation is the blood flow between the heart and the rest of the body. The heart pumps oxygen rich blood to all body parts (like the brain, muscles, and organs). The body uses the oxygen, and the "used" blood returns to the heart to start over. Pulmonary Circulation: Think of it as the "lung loop" – where blood goes to the lungs to get cleaned and oxygenated. (Deoxygenated) IVC/SVC > RA> TV> RV> PV> PA> Lungs (for oxygenation) Systemic Circulation (Oxygenated blood) Think of it as the "body loop" – where oxygen is delivered to your whole body. Pulmonary = Heart ↔ Lungs (gas exchange) Systemic = Heart ↔ Body (oxygen delivery).

[Audio] Coronary Circulation Left Coronary artery Right Coronary artery Circumflexed Coronary artery Coronary Circulation: The heart is supplied with blood by the 2 main coronary arteries, which branch off from the aorta. The main coronary arteries are: Left Coronary Artery: Divides into the left anterior descending artery and the circumflex artery. Right Coronary Artery: Supplies the right side of the heart. Both coronary arteries are crucial for delivering oxygen rich blood to the heart muscle, ensuring its proper function and health. Blockages or issues with these arteries can lead to serious conditions, such as angina or heart attacks..

[Audio] Coronary Circulation Left Coronary artery Left Coronary Artery (L-C-A--) The L-C-A branches off from the aorta and divides into two main branches: the left anterior descending artery (L-A-D--) and the circumflex artery (L-C-X--). The L-A-D supplies blood to the front part of the left side of the heart, including the left ventricle and the interventricular septum. The L-C-X supplies blood to the lateral and posterior aspects of the left atrium and left ventricle..

[Audio] Coronary Circulation Right Coronary artery Right Coronary Artery (R-C-A--) The R-C-A also branches off from the aorta and primarily supplies blood to the right side of the heart, including the right atrium and right ventricle. It gives rise to the posterior descending artery (P-D-A--), which supplies the inferior part of the heart..

[Audio] Coronary Circulation Circumflexed Coronary artery.

[Audio] Cardiac physiology A-B-C Game. Cardiac physiology.

[Audio] electrophysiology Electrophysiology (E-P---) is the study of the electrical activities of the heart, which control its rhythm and contractions. It helps in diagnosing and treating heart rhythm disorders (arrhythmias). E-C-G helps synchronize cardiac cycles in echo. Used for timing heart events. Important for detecting arrhythmias that affect cardiac function. ecg.

[Audio] The Heart’s Electrical Conduction System The heart generates and conducts electrical impulses through specialized structures: An electrocardiogram is a tracing of the electrical activity that is taking place within the heart. Under normal circumstances, an electrical impulse will travel from the sinoatrial node, spread across the atrium, to the atrioventricular node and through the ventricular septum of the heart. This electrical impulse causes the four chambers of the heart to contract and relax in a coordinated fashion..

[Audio] Electrophysiology components Key Components: Sinoatrial (S-A---) Node – The heart’s natural pacemaker, initiating each heartbeat. Atrioventricular (A-V---) Node – Delays the signal to allow the atria to contract before the ventricles. Bundle of His – Transmits impulses from the AV node to the ventricles. Purkinje Fibers – Spread the electrical signal throughout the ventricles, causing contraction.

[Audio] Depolarization refers to the contraction of myocardial muscle moves as a wave through the heart Repolarization is the return of the ions to their previous resting state, which corresponds with relaxation of the myocardial muscle. P Wave & PR Segment: Atrial depolarization Q-R-S Wave: Ventricular Depolarization ST Segment: Beginning of Ventricular Repolarization T Wave: Ventricular Repolarization components.

[Audio] ecg Heart Phases (Top Section) Systole (Purple Area) → Heart contracts and pumps blood. Diastole (Peach Area) → Heart relaxes and fills with blood. E-C-G (Black Line at the Top) Shows the electrical activity of the heart, triggering contraction. The Q-R-S complex represents ventricular contraction. The P wave represents atrial contraction. Pressure Changes (Graph with Colored Lines) Aortic Pressure (Purple Line) → Increases during systole when the heart ejects blood. Left Ventricular Pressure (Green Line) → Rises during contraction and falls during relaxation. Left Atrial Pressure (Pink Line) → Slight increase during atrial contraction. Volume Changes (Black Line in Lower Graph) End Diastolic Volume (E-D-V--): Maximum blood in the left ventricle before contraction. End Systolic Volume (E-S-V--): Minimum blood after the heart has pumped. Valve Function (Red & Green Bars at the Bottom) Mitral Valve (Between Left Atrium & Left Ventricle): Closes during systole (to prevent backflow). Opens during diastole (to allow blood filling). Aortic Valve (Between Left Ventricle & Aorta): Opens during systole (to eject blood). Closes during diastole (to prevent backflow). Doppler Signal at Mitral Tips (Top Right Corner Green Curve) Shows blood flow velocity during diastole. E wave (Early filling): Blood flows quickly into the ventricle after mitral valve opens. A wave (Atrial contraction): Boosts blood flow from the atrium before systole..

[Audio] 1️⃣ Ventricular Systole (Contraction) Mitral valve closes, aortic valve opens → Blood is pumped into the aorta. Ventricular pressure rises, causing ejection of blood. 2️⃣ Ventricular Diastole (Relaxation & Filling) Aortic valve closes, mitral valve opens → Blood flows into the ventricle. First, rapid filling (E wave) occurs. Then, atrial contraction (A wave) provides extra filling. ✅ The Wiggers Diagram connects E-C-G--, pressures, and volume changes. ✅ It shows how valves open and close in response to pressure shifts. ✅ Doppler waves (E & A) help assess diastolic function in echocardiography..

[Audio] Normal sinus rhythm A Normal Sinus Rhythm (N-S-R--) refers to the heart’s normal electrical activity, originating from the sinoatrial (S-A---) node, which is the heart’s natural pacemaker. It ensures a regular heartbeat that efficiently pumps blood throughout the body. NSR is healthy and ideal for proper circulation. Indicates a well functioning SA node and a normal conduction system. Deviations from N-S-R (for example, bradycardia, tachycardia, arrhythmias) may indicate underlying cardiac conditions..

ecg.

[Audio] Normal sinus rhythm ECG Representation of Normal Sinus Rhythm: P wave is always present and precedes each Q-R-S complex. Regular rhythm, meaning the time between each heartbeat is consistent. PR interval (0.12–0.20 sec) shows normal conduction from the atria to ventricles. Q-R-S duration (<0.12 sec) indicates normal ventricular conduction. T wave follows each Q-R-S complex, indicating ventricular repolarization..

[Audio] End of Presentation. JLO-MED TRAINING CENTER.