What are the chambers of the human heart? How do the heart’s valves function to keep blood flowing in the right direction? Discover the key structural components that enable this vital organ to pump blood throughout the body.

The Anatomy of the Heart: A Closer Look

The human heart is a remarkable muscular organ, roughly the size of a closed fist, with two-thirds of its mass situated to the left of the body’s midline. Encased within a pericardial sac, the heart is lined with a serous membrane, the visceral layer of which forms the epicardium.

Layers of the Heart Wall

The heart wall is composed of three distinct layers of tissue. The outermost layer is the epicardium, the middle layer is the myocardium, and the innermost layer is the endocardium.

Chambers of the Heart

The internal cavity of the heart is divided into four distinct chambers: the right atrium, right ventricle, left atrium, and left ventricle. The thin-walled atria receive blood from the veins, while the thick-walled ventricles forcefully pump blood out of the heart. The differences in chamber wall thickness reflect the varying amounts of myocardium present, which corresponds to the force each chamber must generate.

The Heart’s Valves: Ensuring Proper Blood Flow

The heart is equipped with two types of valves that maintain the proper direction of blood flow. The atrioventricular valves, also known as cuspid valves, are located between the atria and ventricles. The semilunar valves are situated at the bases of the large vessels leaving the ventricles.

The Tricuspid and Mitral Valves

The right atrioventricular valve is the tricuspid valve, while the left atrioventricular valve is the bicuspid, or mitral, valve. These valves close during ventricular contraction to prevent blood from flowing back into the atria.

The Semilunar Valves

The valve between the right ventricle and pulmonary trunk is the pulmonary semilunar valve, and the valve between the left ventricle and aorta is the aortic semilunar valve. These valves close during ventricular relaxation to prevent blood from flowing back into the ventricles.

The Pathway of Blood through the Heart

While it is convenient to describe the flow of blood through the right side of the heart and then the left side, it is important to understand that the atria and ventricles contract simultaneously. The heart functions as two coordinated pumps, one on the right and one on the left, working in tandem.

Blood flows from the right atrium to the right ventricle, then is pumped to the lungs to receive oxygen. From the lungs, the oxygenated blood flows to the left atrium, then to the left ventricle, and finally is pumped into the systemic circulation.

Blood Supply to the Myocardium

The myocardium, the heart’s muscular wall, requires a continuous supply of oxygen and nutrients to function efficiently. To meet this demand, the heart has an extensive network of blood vessels, with the right and left coronary arteries, branches of the ascending aorta, supplying blood to the myocardium.

After passing through the myocardial capillaries, the deoxygenated blood enters a system of cardiac, or coronary, veins, the majority of which drain into the coronary sinus, which then opens into the right atrium.

Understanding Echocardiography

Echocardiography is a non-invasive procedure used to assess the heart’s structure and function. During the procedure, a transducer (similar to a microphone) emits high-frequency sound waves that bounce off the heart’s structures, allowing a computer to create moving images of the heart walls and valves.

There are several types of echocardiography, including M-mode echocardiography, which produces a tracing-like image useful for measuring heart structures, and Doppler echocardiography, which measures and assesses blood flow through the heart’s chambers and valves.

The Importance of Understanding Heart Anatomy

Comprehending the intricate structure and function of the human heart is essential for maintaining cardiovascular health and treating heart-related conditions. By exploring the heart’s chambers, valves, and blood supply, we can gain a deeper appreciation for the remarkable efficiency and resilience of this vital organ.

Structure of the Heart | SEER Training

The human heart is a four-chambered muscular organ, shaped and sized roughly like a man’s closed fist with two-thirds of the mass to the left of midline.

The heart is enclosed in a pericardial sac that is lined with the parietal layers of a serous membrane. The visceral layer of the serous membrane forms the epicardium.

Layers of the Heart Wall

Three layers of tissue form the heart wall. The outer layer of the heart wall is the epicardium, the middle layer is the myocardium, and the inner layer is the endocardium.

Chambers of the Heart

The internal cavity of the heart is divided into four chambers:

• Right atrium
• Right ventricle
• Left atrium
• Left ventricle

The two atria are thin-walled chambers that receive blood from the veins. The two ventricles are thick-walled chambers that forcefully pump blood out of the heart. Differences in thickness of the heart chamber walls are due to variations in the amount of myocardium present, which reflects the amount of force each chamber is required to generate.

The right atrium receives deoxygenated blood from systemic veins; the left atrium receives oxygenated blood from the pulmonary veins.

Valves of the Heart

Pumps need a set of valves to keep the fluid flowing in one direction and the heart is no exception. The heart has two types of valves that keep the blood flowing in the correct direction. The valves between the atria and ventricles are called atrioventricular valves (also called cuspid valves), while those at the bases of the large vessels leaving the ventricles are called semilunar valves.

The right atrioventricular valve is the tricuspid valve. The left atrioventricular valve is the bicuspid, or mitral, valve. The valve between the right ventricle and pulmonary trunk is the pulmonary semilunar valve. The valve between the left ventricle and the aorta is the aortic semilunar valve.

When the ventricles contract, atrioventricular valves close to prevent blood from flowing back into the atria. When the ventricles relax, semilunar valves close to prevent blood from flowing back into the ventricles.

Pathway of Blood through the Heart

While it is convenient to describe the flow of blood through the right side of the heart and then through the left side, it is important to realize that both atria and ventricles contract at the same time. The heart works as two pumps, one on the right and one on the left, working simultaneously. Blood flows from the right atrium to the right ventricle, and then is pumped to the lungs to receive oxygen. From the lungs, the blood flows to the left atrium, then to the left ventricle. From there it is pumped to the systemic circulation.

Blood Supply to the Myocardium

The myocardium of the heart wall is a working muscle that needs a continuous supply of oxygen and nutrients to function efficiently. For this reason, cardiac muscle has an extensive network of blood vessels to bring oxygen to the contracting cells and to remove waste products.

The right and left coronary arteries, branches of the ascending aorta, supply blood to the walls of the myocardium. After blood passes through the capillaries in the myocardium, it enters a system of cardiac (coronary) veins. Most of the cardiac veins drain into the coronary sinus, which opens into the right atrium.

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Echocardiogram | Johns Hopkins Medicine

An echocardiogram is a noninvasive (the skin is not pierced) procedure used to assess the heart’s function and structures. During the procedure, a transducer (like a microphone) sends out sound waves at a frequency too high to be heard. When the transducer is placed on the chest at certain locations and angles, the sound waves move through the skin and other body tissues to the heart tissues, where the waves bounce or “echo” off of the heart structures. These sound waves are sent to a computer that can create moving images of the heart walls and valves.

An echocardiogram may use several special types of echocardiography, as listed below:

• M-mode echocardiography. This, the simplest type of echocardiography, produces an image that is similar to a tracing rather than an actual picture of heart structures. M-mode echo is useful for measuring or viewing heart structures, such as the heart’s pumping chambers, the size of the heart itself, and the thickness of the heart walls.

• Doppler echocardiography. This Doppler technique is used to measure and assess the flow of blood through the heart’s chambers and valves. The amount of blood pumped out with each beat is an indication of the heart’s functioning. Also, Doppler can detect abnormal blood flow within the heart, which can indicate a problem with one or more of the heart’s four valves, or with the heart’s walls.

• Color Doppler. Color Doppler is an enhanced form of Doppler echocardiography. With color Doppler, different colors are used to designate the direction of blood flow. This simplifies the interpretation of the Doppler technique.

• 2-D (two-dimensional) echocardiography. This technique is used to “see” the actual motion of the heart structures. A 2-D echo view appears cone-shaped on the monitor, and the real-time motion of the heart’s structures can be observed. This enables the doctor to see the various heart structures at work and evaluate them.

• 3-D (three-dimensional) echocardiography. 3-D echo technique captures three-dimensional views of the heart structures with greater detail than 2-D echo. The live or “real time” images allow for a more accurate assessment of heart function by using measurements taken while the heart is beating. 3-D echo shows enhanced views of the heart’s anatomy and can be used to determine the appropriate plan of treatment for a person with heart disease.

Why might I need an echocardiogram?

An echocardiogram may be done for further evaluation of signs or symptoms that may suggest:

• Atherosclerosis. A gradual clogging of the arteries by fatty materials and other substances in the blood stream. It can lead to problems in the wall motion or pumping function of your heart.

• Cardiomyopathy. An enlargement of the heart due to thick or weak heart muscle

• Congenital heart disease. Defects in one or more heart structures that occur during formation of the fetus, such as a ventricular septal defect (hole in the wall between the 2 lower chambers of the heart).

• Heart failure. A condition in which the heart muscle has become weakened or stiff during heart relaxation and blood can’t be pumped efficiently. This can cause fluid buildup (congestion) in the blood vessels and lungs, and edema (swelling) in the feet, ankles, and other parts of the body.

• Aneurysm. A widening and weakening of a part of the heart muscle or the aorta (the large artery that carries oxygenated blood out of the heart to the rest of the body). The aneurysm may be at risk for rupture. .

• Heart valve disease. Malfunction of one or more of the heart valves that may cause an abnormality of the blood flow within the heart. The valves can become narrowed and prevent blood from flowing through the heart or out to the lungs and body. The valves can also become leaky with blood flow leaking backwards. An echocardiogram can also check for infection of the heart valve tissue.

• Cardiac tumor. A tumor of the heart that may occur on the outside surface of the heart, within one or more chambers of the heart , or within the muscle tissue (myocardium) of the heart.

• Pericarditis. An inflammation or infection of the sac that surrounds the heart.

• Pericardial effusion or tamponade. The sac around the heart can become filled with fluid, blood, or infection. This can compress the heart muscle and prevent it from beating and pumping blood normally. This can cause symptoms of feeling dizzy, lightheaded, or a dangerous drop in blood pressure.

• Atrial or septal wall defects. Irregular channels between the right and left sides of the heart may be present at birth, or may occur form trauma, or after a heart attack. These defects occur in the upper filling chambers (atria) or the lower pumping chambers (ventricles). This may cause heart failure or poor blood flow, or increase your risk for stroke.

• Shunts. Shunts can be seen in atrial and ventricular septal defects but also when irregular blood flow is pushed through the circulation from the lungs and liver.

An echocardiogram may also be done to assess the heart’s overall function and general structure.

Your doctor may have other reasons to recommend an echocardiogram.

What are the risks of an echocardiogram?

This imaging procedure is not invasive and carries little to no risks. You may have discomfort from the positioning of the transducer because it can put pressure on the surface of the body. For some people, having to lie still on the exam table for the length of the procedure may cause some discomfort or pain.

You may have other risks depending on your specific health condition. Discuss any concerns with your doctor before the procedure.

How do I get ready for an echocardiogram?

• Your doctor will explain the procedure to you and ask if you have any questions.

• Generally, you don’t need to do any preparation such as fasting or having sedation.

• Tell your doctor of all prescription and over-the-counter medicines and herbal supplements that you are taking.

• Tell your doctor if you have a pacemaker.

• Based on your medical condition, your doctor may request other specific preparation.

What happens during the procedure?

An echocardiogram (ECG) may be done on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your doctor’s practices.

Generally, an echocardiogram follows this process:

1. You will remove any jewelry or other objects that may interfere with the procedure. You may wear your glasses, dentures, or hearing aids if you use any of these.

2. You will remove clothing from the waist up and will be given a gown to wear.

3. You will lie on a table or bed, on your left side. A pillow or wedge may be placed behind your back for support.

4. You will be connected to an ECG monitor that records the electrical activity of the heart and monitors the heart during the procedure using small, adhesive electrodes. The ECG tracings that record the electrical activity of the heart will be compared with the images displayed on the echocardiogram monitor.

5. The room will be darkened so that the images on the echo monitor can be seen by the technologist.

6. The technologist will place warmed gel on your chest and then place the transducer probe on the gel. You will feel a slight pressure as the technologist positions the transducer to get the desired images of your heart.

7. During the test, the technologist will move the transducer probe around and apply varying amounts of pressure to get images of different locations and structures of your heart. The amount of pressure behind the probe should not be uncomfortable. If it does make you uncomfortable, let the technologist know. You may be asked to hold your breath, take deep breaths, or even sniff through your nose during the procedure.

8. If the structures of your heart are hard to see, the technologist may use an IV contrast that helps the heart chambers show up better. This is not an iodine based contrast so you don’t have to worry if you have an allergy to shrimp or shellfish with this type of contrast.

9. After the procedure, the technologist will wipe the gel from your chest and remove the ECG electrode pads. You may then put on your clothes.

What happens after an echocardiogram?

You may resume your usual diet and activities unless your doctor tells you differently.

Generally, there is no special type of care after an echo. Y Your doctor may give you other instructions after the procedure, depending on your situation.

Next steps

Before you agree to the test or the procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how will you get the results

• Who to call after the test or procedure if you have questions or problems

• How much will you have to pay for the test or procedure

Echocardiography (ultrasound of the heart)

Echocardiography is a method of ultrasound examination of the heart. This diagnostic method is widely used to examine patients with suspected cardiac pathology. Using a sensor that emits high-frequency sound, you can get an image of the heart and evaluate its structure.

Echocardiography (ultrasound of the heart) makes it possible to study:

• structure of the heart;
• thickness of walls and partitions;
• condition of valves, arteries and aorta;
• pressure in various regions of the heart;
• speed and direction of blood flow.

How is echocardiography performed?

Before the examination, the patient is placed on the left side. This position of the body allows you to get the best image of all four chambers of the heart at the same time. The sensor of the ultrasound machine is lubricated with gel for better contact with the skin. The study lasts from 20 to 40 minutes.

Unfortunately, it is not always possible to obtain enough diagnostic information during ultrasound. The result of the study, as well as the price of echocardiography, may depend on several factors. The quality of the equipment and the experience of the doctor of ultrasound diagnostics are of great importance.

However, no matter how experienced the doctor is, no matter how accurate the equipment, and no matter what the price of echocardiography (ultrasound of the heart) is set by the diagnostic center, some anatomical features of the patient can interfere with the examination. In the presence of severe obesity, anomalies in the structure of the chest, serious lung diseases, imaging with ultrasound can be difficult. If the doctor fails to carefully examine the structure of all parts of the heart, he may recommend other diagnostic methods to the patient. For example, magnetic resonance imaging.

Indications and control of the course of the disease or recovery

• Congenital and acquired heart defects.
• Hypertension.
• Dizziness and fainting.
• Shortness of breath and swelling.
• Trembling or trembling of the heart.
• Pain in the chest radiating to the left arm.
• Suspected neoplasm in the heart.
• Heart murmur.
• Changes in the electrocardiogram graph.

Contraindications

One-dimensional, two-dimensional and Doppler echocardiography have no contraindications. This study can be carried out at any age, even for pregnant women and the fetus. There are some limitations to stress echocardiography. This diagnostic method is not used if the patient has blood clots, severe heart or respiratory failure, pathologies of the liver and kidneys, aortic aneurysm.

Transesophageal echocardiography also has a strict list of contraindications. Research is not performed in the following cases:

• varicose veins of the esophagus;
• neoplasms of the esophagus;
• hiatal hernia;
• severe osteochondrosis of the cervical spine;
• gastrointestinal bleeding;
• pronounced gag reflex.

Types of echocardiography

Currently, there are several types of heart ultrasound in medicine.

• One-dimensional, or M-echocardiography (rarely used as an independent diagnostic method, allows you to get data on the structure of the heart in the form of graphs, gives accurate information about the size of the atria and ventricles).
• Two-dimensional, or B-echocardiography (thanks to the two-dimensional image displayed on the screen, it allows you to visually assess the structure of the heart).
• Doppler echocardiography (rarely used as an independent diagnostic method, usually performed as an auxiliary study during two-dimensional echocardiography, allows you to evaluate blood flow in the chambers of the heart and vessels).
• Contrast echocardiography (performed to obtain a clearer image of the structure of the heart, its internal cavities).
• Stress echocardiography (performed during physical activity, often allows you to diagnose hidden pathologies).
• Transesophageal echocardiography (performed not through the chest, but through the esophagus, performed only with strict indications in specialized clinics).

Where to do echocardiography in St. Petersburg?

If you are looking for where to do echocardiography (ultrasound of the heart) in St. Petersburg at an affordable price, we invite you to the 7 Doctors clinic. In the clinic, you can be examined using the latest generation equipment. All doctors of ultrasound diagnostics are highly qualified and have extensive experience.

Turning to us, you choose an individual approach and attentive attitude to each patient. You can sign up for echocardiography and find out the price of the procedure by phone in St. Petersburg, indicated on the clinic’s website.

See also:

• Prostate ultrasound prices
• Neurologist consultation
• Manual therapy prices
• Physiotherapy prices

23rd August 2017

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Transesophageal echocardiography at Veresaev Hospital

• October 30, 2020

A transesophageal echocardiogram (TE or TEE) uses high-frequency sound waves (ultrasound) to take detailed pictures of your heart. An echo transducer that emits sound waves is attached to a thin tube (thickness varies from 9 to 11 mm) that passes through the mouth, down the throat, and into the esophagus. Since the esophagus is close to the upper chambers of the heart, very clear images of these structures and heart valves can be obtained.

• Physicians often use SE when they need a clearer image than a standard echocardiogram can produce;
• After the procedure, there may be a slight sore throat for a day or two.

Why is transesophageal echocardiography performed?

Doctors use SE to find problems in the structure and function of the heart. SE can provide clearer images of the upper chambers of the heart and the valves between the upper and lower chambers of the heart than standard echocardiograms.

The detailed images provided by the SE can help doctors see:

• The size of your heart and the thickness of its walls;
• Conditions of the aorta with aneurysm and dissection;
• Suspected infective endocarditis;
• If blood flows backward through the heart valves (regurgitation), or if the valves are narrowed or blocked (stenosis).
• If blood clots are in the chambers of the heart, in particular in the upper chambers, for example after a stroke.

Transesophageal echocardiography is often used to provide information during surgery to repair heart valves, aortic ruptures, or congenital heart disease. It is also used during the surgical treatment of endocarditis, a bacterial infection of the inner lining of the heart and valves.

What are the risks of PE?

Few risks of PE are associated with passage of the tube into the throat and esophagus. Medications are used before the examination to soothe and numb the throat. But there is a risk of vomiting. You may also experience sore throat for a day or two after the procedure. In very rare cases, SE causes bleeding from the esophagus.

What are the contraindications?

• Difficulties with transducer insertion;
• Pathologies of the esophagus and oral cavity;
• Internal bleeding in the gastrointestinal tract;
• Recent gastrointestinal surgery.

How to prepare for the CE?

Consult your physician. You may be asked not to drink alcoholic beverages for several days and not to eat or drink anything for at least 4-6 hours before the test. Water consumption is allowed no later than 2 hours before the session.

What happens during an ET?

Transesophageal echocardiography is performed by specially trained physicians. The procedure is usually performed in a hospital or clinic and lasts 30 to 60 minutes.

The doctor should be warned about any problems associated with the oral cavity, as well as tell him about the presence of pathologies of the digestive system, tell about allergies to medicines.

• Medicine will be sprayed down your throat to numb your throat and suppress your gag reflex;
• The doctor then gently passes a thin, flexible tube (probe) through your mouth and down your throat and asks you to swallow as it goes down.
• A transducer at the end of the probe sends sound waves to the heart and picks up the reflected echo. The image appears on the monitor. This part takes 10 to 15 minutes.
• When the doctor has finished taking the images, the probe is removed. You can then usually get up, get dressed and leave the hospital.

What happens after CE?

Your throat may become numb for a short time. Do not eat or drink anything until the feeling of numbness has passed – you may choke.

• You may experience minor swallowing problems immediately after the procedure, but these will disappear within a few hours.