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1.1 Introduction

Echocardiography is based on the physics of the ultrasound wave. Ultrasound visualizes the heart and provides essential information about it. It permits measurement of the velocity at which blood flows and the myocardium moves, calculation of myocardial deformation, myocardial twist and rotation, visualization of blood flow, and even 3D reconstruction of cardiac structures. Despite its impressive output by way of information, ultrasound has certain limitations.

Ultrasound Wave

Ultrasound images have a rather high signal-to-noise ratio. The image quality may be quite "lousy" in some patients while artifacts may render interpretation difficult in others. In order to truly understand why this happens we need to comprehend how echocardiography works as well as its limitations. We first have to become familiar with the physical principles of ultrasound. This, and how the scanner settings influence the image, will be the focus of this chapter.