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Anatomic basis of cross-sectional echocardiography
  1. Robert H Anderson
  1. Siew Yen Ho
  1. Stephen J Brecker
  1. Cardiac Unit, Institute of Child Health, University College, London, UK
  2. National Heart & Lung Institute, Imperial College School of Medicine, London, UK
  3. Department of Cardiology, St George's Hospital Medical School, London, UK
  1. Professor Robert Anderson, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 3EH, UKr.anderson{at}

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There can be little doubt that the cross-sectional echocardiographer will be tomorrow's anatomist. The level of discrimination of modern day echocardiographic machines is such that all but the finest details of cardiac structure are revealed in real time. Advances in three dimensional reconstruction now amplify the information obtained, and make it more amenable to clinical interpretations. It remains true, nonetheless, that the information available to the echocardiographer will be more accurately interpreted if the investigator has a good working knowledge of cardiac anatomy. This is not difficult to obtain. The basic rules and principles are exactly as we set them out in 1983.1 As with any three dimensional structure, so as to determine the interrelationships of the cardiac components, it is necessary to obtain details as seen in the three orthogonal planes. These planes, at right angles to each other, are the equivalent of the floor plan, the frontal elevation, and the side elevation of any building. When considering the heart, however, the information obtained must be interpreted taking account of the fact that the orthogonal planes of the heart itself are very malaligned relative to the orthogonal planes of the body. The steps involved in gaining the basic knowledge, therefore, are to begin by reviewing the orthogonal planes of the body. It is then essential to understand the usual position of the heart within the body, along with the orientation of its own orthogonal planes. Thereafter, it is necessary to understand the usual positions of the cardiac chambers and valves within the cardiac silhouette. The basic anatomic information must then, self-evidently, be understood in sectional format. There are, of course, no standard sections which will always deliver the necessary information, since no two individuals have exactly identical relations of the cardiac components. So, it is not always possible …

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