Table 1

Cardiac ultrasound examination types defined by purpose of study, clinical setting and healthcare provider

	Diagnostic echocardiogram	Procedural guidance
	Diagnostic echocardiogram	Cardiac surgery	Interventional procedures	Electrophysiology (EP) procedures	Point-of-care echocardiography
Purpose of imaging	Diagnose and measure disease severity, evaluate progression or response to therapy, integrate with clinical information and other imaging approaches	Comprehensive perioperative exam and/or procedure guidance (baseline data, measure results, detect complications)	Direct catheter and device positioning, evaluate procedural results, detect complications	Direct catheter and device positioning, detect complications	Immediate patient triage and management or monitoring cardiac parameters
Clinical setting	Any inpatient or outpatient location under the auspices of a structured echocardiography laboratory*	Operating room	Interventional suite or hybrid operating room	Electrophysiology lab	Inpatient bedside, emergency department or outpatient clinic
Healthcare provider	Images recorded by cardiac sonographer and interpreted by cardiologist with expertise in echocardiography	Interventional echocardiographer or cardiac anaesthetist with expertise in echocardiography	Interventional echocardiographer, interventional cardiologist or anaesthetist†	Clinical cardiac electrophysiologist or anaesthetist†	Physician providing direct care to the patient with limited training in echocardiography
Ultrasound modalities	All echocardiographic modalities as appropriate	TOE Epicardial	TOE ICE TTE	TOE ICE TTE	TTE—primarily two-dimensional imaging and colour Doppler
Documentation	Formal written report in medical record	Results integrated into anaesthesiology procedure note	Results integrated into interventional procedure report	Results integrated into EP procedure report	Results reported in clinical progress note
Quality improvement	Long term PACS storage of digital images documenting entire study	Long term PACS storage of representative digital images	Optional long term PACS storage of representative images	Optional long term PACS storage of representative images	Images typically not recorded although key images may be saved for CQI

*Ideally the echocardiography laboratory is accredited by the Intersocietal Commission for the Accreditation of Echocardiography Laboratories (ICAEL) or equivalent process.
†Imaging may be performed by an anaesthetist with expertise in echocardiography, a cardiologist or the interventional cardiologist.
CQI, continuous quality improvement; ICE, intracardiac echocardiography; PACS, picture archiving and communications system; TOE, transoesophageal echocardiography; TTE, transthoracic echocardiography.