This is a chapter from Grainger and Allison. I have Coolected all images from chapter 19 with caption in this presentation. In my opinion it will be very benificial to have this in your android. ,

1. DR. MUHAMMAD BIN ZULFIQAR
PGR IV FCPS SIMS/SHL
radiombz@gmail.com
19 Cardiac Anatomy and
Imaging Techniques Grainger and Allison

2. • FIGURE 19 ■ Normal postero-anterior (left) and lateral (right)
chest radiographs. Note normal cardiovascular structures: 1,
contour of superior vena cava and other vessels; 2, contour of right
atrium; 3, aortic knuckle; 4, left pulmonary artery at hilar level; 5,
contour of left ventricle; 6, anterior contour of right ventricle and
pulmonary outflow tract; 7, aortic arch; 8, upper posterior contour
of left atrium; 9, lower posterior contour of left ventricle. Note
relative bulging of left ventricular contour in relationship with
inferior vena cava.

3. • FIGURE 19 ■ Normal postero-anterior (left) and lateral (right)
chest radiographs. Note normal cardiovascular structures: 1,
contour of superior vena cava and other vessels; 2, contour of right
atrium; 3, aortic knuckle; 4, left pulmonary artery at hilar level; 5,
contour of left ventricle; 6, anterior contour of right ventricle and
pulmonary outflow tract; 7, aortic arch; 8, upper posterior contour
of left atrium; 9, lower posterior contour of left ventricle. Note
relative bulging of left ventricular contour in relationship with
inferior vena cava.

4. • FIGURE 19-2 ■ Planning acquisition of standard cardiac views. On
two transverse slices (A) and (B), the left ventricular vertical
longaxis (VLA) (C) is planned by a plane transecting the mitral valve
and the apex. The horizontal long-axis (HLA) (D) is obtained by
acquiring a plane transecting the VLA through the mitral valve and
apex. A short-axis image can be obtained perpendicular to HLA, at
mid-ventricular (E) and basal level (F). The four-chamber (G) of the
left ventricle (LV) is obtained as indicated from a plane transecting
both LV and the right ventricle. The two-chamber (H) of the LV is
acquired perpendicular to the four-chamber. The three-chamber LV
(I) is obtained from a plane transecting the LV through the LV
outflow tract.

5. • FIGURE 19-2 ■ Planning acquisition of standard cardiac views. On
two transverse slices (A) and (B), the left ventricular vertical
longaxis (VLA) (C) is planned by a plane transecting the mitral valve
and the apex. The horizontal long-axis (HLA) (D) is obtained by
acquiring a plane transecting the VLA through the mitral valve and
apex. A short-axis image can be obtained perpendicular to HLA, at
mid-ventricular (E) and basal level (F). The four-chamber (G) of the
left ventricle (LV) is obtained as indicated from a plane transecting
both LV and the right ventricle. The two-chamber (H) of the LV is
acquired perpendicular to the four-chamber. The three-chamber LV
(I) is obtained from a plane transecting the LV through the LV
outflow tract.

6. • FIGURE 19-2 ■ Planning acquisition of standard cardiac
views. On two transverse slices (A) and (B), the left
ventricular vertical longaxis (VLA) (C) is planned by a plane
transecting the mitral valve and the apex. The horizontal
long-axis (HLA) (D) is obtained by acquiring a plane
transecting the VLA through the mitral valve and apex. A
short-axis image can be obtained perpendicular to HLA, at
mid-ventricular (E) and basal level (F). The four-chamber
(G) of the left ventricle (LV) is obtained as indicated from a
plane transecting both LV and the right ventricle. The two-
chamber (H) of the LV is acquired perpendicular to the four-
chamber. The three-chamber LV (I) is obtained from a plane
transecting the LV through the LV outflow tract.

7. • FIGURE 19-3 ■ Bright-blood acquisition of the
right ventricle. Right ventricular outflow tract
(RVOT), main pulmonary artery (PA) and
pulmonary valve (PV). RA, right atrium; RV,
right ventricle; TV, tricuspid valve; Ao, aorta.

8. • FIGURE 19-4 ■ Normal cardiac anatomy on
black-blood and bright-blood acquisitions, in
sagittal (A, B) and coronal (C, D) views. Ao-Asc,
ascending aorta; Ao-Arch, aortic arch; Ao-Desc,
descending aorta; RA, right atrium; LA, left
atrium; RV, right ventricle; LV, left ventricle; PA,
pulmonary artery; RPA, right pulmonary artery

9. • FIGURE 19-4 ■ Normal cardiac anatomy on
black-blood and bright-blood acquisitions, in
sagittal (A, B) and coronal (C, D) views. Ao-Asc,
ascending aorta; Ao-Arch, aortic arch; Ao-Desc,
descending aorta; RA, right atrium; LA, left
atrium; RV, right ventricle; LV, left ventricle; PA,
pulmonary artery; RPA, right pulmonary artery

10. • FIGURE 19-4 ■ Normal cardiac anatomy on
black-blood and bright-blood acquisitions, in
sagittal (A, B) and coronal (C, D) views. Ao-
Asc, ascending aorta; Ao-Arch, aortic arch; Ao-
Desc, descending aorta; RA, right atrium; LA,
left atrium; RV, right ventricle; LV, left
ventricle; PA, pulmonary artery; RPA, right
pulmonary artery

11. • FIGURE 19-5 ■ Normal cardiac anatomy on transverse
black-blood acquisitions. Ao-Asc, ascending aorta; Ao-
Arch, aortic arch; Ao-Desc, descending aorta; RA, right
atrium; LA, left atrium; RV, right ventricle; LV, left ventricle;
RVOT, right ventricular outflow tract; ; PA, main pulmonary
artery; RPA, right pulmonary artery; LPA, left pulmonary
artery; LAA, left atrial appendage; TV, tricuspid valve; MV,
mitral valve; P, papillary muscle; LAD, left anterior
descending coronary artery; cs, coronary sinus; pc,
pericardium; T, trachea; C, carina; IVC, inferior vena cava;
SVC, superior vena cava

12. • FIGURE 19-5 ■ Normal cardiac anatomy on transverse
black-blood acquisitions. Ao-Asc, ascending aorta; Ao-
Arch, aortic arch; Ao-Desc, descending aorta; RA, right
atrium; LA, left atrium; RV, right ventricle; LV, left
ventricle; RVOT, right ventricular outflow tract; ; PA,
main pulmonary artery; RPA, right pulmonary artery;
LPA, left pulmonary artery; LAA, left atrial appendage;
TV, tricuspid valve; MV, mitral valve; P, papillary
muscle; LAD, left anterior descending coronary artery;
cs, coronary sinus; pc, pericardium; T, trachea; C,
carina; IVC, inferior vena cava; SVC, superior vena cava

13. • FIGURE 19-5 ■ Normal cardiac anatomy on transverse black-blood
acquisitions. Ao-Asc, ascending aorta; Ao-Arch, aortic arch;
Ao-Desc, descending aorta; RA, right atrium; LA, left atrium; RV,
right ventricle; LV, left ventricle; RVOT, right ventricular outflow
tract; ; PA, main pulmonary artery; RPA, right pulmonary artery;
LPA, left pulmonary artery; LAA, left atrial appendage; TV, tricuspid
valve; MV, mitral valve; P, papillary muscle; LAD, left anterior
descending coronary artery; cs, coronary sinus; pc, pericardium; T,
trachea; C, carina; IVC, inferior vena cava; SVC, superior vena cava.

14. • FIGURE 19-5 ■ Normal cardiac anatomy on transverse black-blood
acquisitions. Ao-Asc, ascending aorta; Ao-Arch, aortic arch; Ao-
Desc, descending aorta; RA, right atrium; LA, left atrium; RV, right
ventricle; LV, left ventricle; RVOT, right ventricular outflow tract; ;
PA, main pulmonary artery; RPA, right pulmonary artery; LPA, left
pulmonary artery; LAA, left atrial appendage; TV, tricuspid valve;
MV, mitral valve; P, papillary muscle; LAD, left anterior descending
coronary artery; cs, coronary sinus; pc, pericardium; T, trachea; C,
carina; IVC, inferior vena cava; SVC, superior vena cava.

15. • FIGURE 19-5 ■ Normal cardiac anatomy on transverse black-blood
acquisitions. Ao-Asc, ascending aorta; Ao-Arch, aortic arch; Ao-
Desc, descending aorta; RA, right atrium; LA, left atrium; RV, right
ventricle; LV, left ventricle; RVOT, right ventricular outflow tract; ;
PA, main pulmonary artery; RPA, right pulmonary artery; LPA, left
pulmonary artery; LAA, left atrial appendage; TV, tricuspid valve;
MV, mitral valve; P, papillary muscle; LAD, left anterior descending
coronary artery; cs, coronary sinus; pc, pericardium; T, trachea; C,
carina; IVC, inferior vena cava; SVC, superior vena cava.

16. • FIGURE 19-6 ■ Normal cardiac anatomy on
bright-blood two-, four- and three-chamber
views. RA, right atrium; LA, left atrium; RV, right
ventricle; LV, left ventricle; P, papillary muscle; TV,
tricuspid valve; MV, mitral valve; AV, aortic valve;
Ao, aorta; M, moderator band; ch, chordae
tendineae

17. • FIGURE 19-6 ■ Normal cardiac anatomy on
bright-blood two-, four- and three-chamber
views. RA, right atrium; LA, left atrium; RV, right
ventricle; LV, left ventricle; P, papillary muscle; TV,
tricuspid valve; MV, mitral valve; AV, aortic valve;
Ao, aorta; M, moderator band; ch, chordae
tendineae

18. • FIGURE 19-7 ■ Transverse black-blood (A) and bright-
blood (B) acquisition illustrating the moderator band
in the right ventricle. RA, right atrium; RV, right
ventricle; LV, left ventricle; TV, tricuspid valve; M,
moderator band; Ao-Desc, descending aorta.

19. • FIGURE 19-7 ■ Transverse black-blood (A) and bright-
blood (B) acquisition illustrating the moderator band
in the right ventricle. RA, right atrium; RV, right
ventricle; LV, left ventricle; TV, tricuspid valve; M,
moderator band; Ao-Desc, descending aorta.

20. • FIGURE 19-8 ■ A segmented gradient-echo acquisition
of the aortic valve. In (A, B), the planning of the
acquisition plane is presented in black-blood coronal
view of the aorta during end diastole (A) and bright-
blood at peak systole (B). In (C), a closed normal valve
at end diastole and in (D), an opened normal valve with
three cusps at peak systole is presented (L, left
coronary cusp; R, right coronary cusp; N, non-coronary
cusp). In (E), a bicuspid aortic valve is presented, with a
fused non-coronary and right coronary cusp.

21. • FIGURE 19-8 ■ A segmented gradient-echo acquisition of the
aortic valve. In (A, B), the planning of the acquisition plane is
presented in black-blood coronal view of the aorta during end
diastole (A) and bright-blood at peak systole (B). In (C), a closed
normal valve at end diastole and in (D), an opened normal valve
with three cusps at peak systole is presented (L, left coronary cusp;
R, right coronary cusp; N, non-coronary cusp). In (E), a bicuspid
aortic valve is presented, with a fused non-coronary and right
coronary cusp.

22. • FIGURE 19-8 ■ A segmented gradient-echo acquisition of
the aortic valve. In (A, B), the planning of the acquisition
plane is presented in black-blood coronal view of the aorta
during end diastole (A) and bright-blood at peak systole (B).
In (C), a closed normal valve at end diastole and in (D), an
opened normal valve with three cusps at peak systole is
presented (L, left coronary cusp; R, right coronary cusp; N,
non-coronary cusp). In (E), a bicuspid aortic valve is
presented, with a fused non-coronary and right coronary
cusp.

23. • FIGURE 19-9 ■ Right ventricle. Transverse
reconstruction showing the right ventricle (RV).
Ao-Desc, descending aorta; FO, fossa ovalis; LA,
left atrium; LV, left ventricle; M, moderator band;
MV, mitral valve; RA, right atrium; RCA, right
coronary artery; P, papillary muscle

24. • FIGURE 19-10 ■ Left ventricular orientation.
Longitudinal two-chamber (A), three-
chamber (B), and four-chamber (C)
reconstructions. Left ventricular short-axis
reconstructions at the base (D), mid
ventricular (E) and apical level (F). Ao, aorta;
LA, left atrium; RA, right atrium; LV, left
ventricle; RV, right ventricle.

25. • FIGURE 19-10 ■ Left ventricular orientation.
Longitudinal two-chamber (A), three-chamber
(B), and four-chamber (C) reconstructions. Left
ventricular short-axis reconstructions at the base
(D), mid ventricular (E) and apical level (F). Ao,
aorta; LA, left atrium; RA, right atrium; LV, left
ventricle; RV, right ventricle.

26. • FIGURE 19-10 ■ Left ventricular orientation.
Longitudinal two-chamber (A), three-chamber
(B), and four-chamber (C) reconstructions. Left
ventricular short-axis reconstructions at the base
(D), mid ventricular (E) and apical level (F). Ao,
aorta; LA, left atrium; RA, right atrium; LV, left
ventricle; RV, right ventricle.

27. • FIGURE 19-11 ■ Coronary dominance. Three-dimensional volume-
rendered images with frontal view and view from below showing right
dominant coronary artery circulation (A) and left dominant coronary
artery circulation (B). In right dominant coronary artery circulation, the
posterior descending artery (PD) arises from the right coronary artery
(RCA). In left dominant coronary artery circulation, the PD arises from the
circumflex artery (Cx) (B). Note the short RCA with empty right
atrioventricular groove (RAVG) which is normal in left dominant coronary
artery circulation, and should not be confused with RCA occlusion. Side
branches visualised: AM, acute marginal branch; D, diagonal branch; OM,
obtuse marginal branch; PL, posterolateral branch; LV, left ventricle.

28. • FIGURE 19-11 ■ Coronary dominance. Three-dimensional volume-
rendered images with frontal view and view from below showing right
dominant coronary artery circulation (A) and left dominant coronary
artery circulation (B). In right dominant coronary artery circulation, the
posterior descending artery (PD) arises from the right coronary artery
(RCA). In left dominant coronary artery circulation, the PD arises from the
circumflex artery (Cx) (B). Note the short RCA with empty right
atrioventricular groove (RAVG) which is normal in left dominant coronary
artery circulation, and should not be confused with RCA occlusion. Side
branches visualised: AM, acute marginal branch; D, diagonal branch; OM,
obtuse marginal branch; PL, posterolateral branch; LV, left ventricle.

29. • FIGURE 19-12 ■ Coronary anatomy; segments. Transverse
reconstructions showing (A) the left main coronary artery (LM);
(B) proximal right coronary artery (RCA), proximal left anterior
descending artery (LAD) with diagonal side branch (D), and proximal
circumflex artery (Cx) with obtuse marginal branch (OM); (C) mid-
LAD, mid-RCA and mid-Cx/OM; (D) distal-RCA and posterior
descending branch (PD), distal-LAD. Pericardium is visualised as a
thin line (arrows in D). Visualised pulmonary veins: LIPV, left inferior
pulmonary vein; RMPV, right middle pulmonary vein; RSPV, right
superior pulmonary vein. LA, left atrium; LAA, left atrium
appendage; LV, left ventricle.

30. • FIGURE 19-12 ■ Coronary anatomy; segments. Transverse
reconstructions showing (A) the left main coronary artery (LM); (B)
proximal right coronary artery (RCA), proximal left anterior descending
artery (LAD) with diagonal side branch (D), and proximal circumflex artery
(Cx) with obtuse marginal branch (OM); (C) mid-LAD, mid-RCA and mid-
Cx/OM; (D) distal-RCA and posterior descending branch (PD), distal-LAD.
Pericardium is visualised as a thin line (arrows in D). Visualised pulmonary
veins: LIPV, left inferior pulmonary vein; RMPV, right middle pulmonary
vein; RSPV, right superior pulmonary vein. LA, left atrium; LAA, left atrium
appendage; LV, left ventricle.

31. • FIGURE 19-13 ■ Coronary arteries and cardiac veins. Volume-rendered
reconstructions for coronary artery and cardiac venous anatomy. Coronary
arteries and side branches: AM, acute marginal branch of RCA (A); Cx, circumflex
artery (B, C); D1 and D2, first and second diagonal branch (B); LAD, left anterior
descending artery (B); LM, left main coronary artery (B); OM, obtuse marginal
branch (B, C); PD, posterior descending branch (D); PL, posterolateral branch from
RCA (D); RCA, right coronary artery (A, D); RVB, right ventricle branch (running to
distal part of posterior interventricular groove, A, D). Cardiac veins: AIV, anterior
interventricular vein (B); CS, Coronary sinus (D); GCV, great cardiac vein (C, D);
LMV, left marginal vein (C); PIV, posterior interventricular vein (D); PLVV, posterior
left ventricular vein (C, D); RAV, right atrial vein draining directly into right atrium
(A).

32. • FIGURE 19-13 ■ Coronary arteries and cardiac veins. Volume-rendered
reconstructions for coronary artery and cardiac venous anatomy. Coronary
arteries and side branches: AM, acute marginal branch of RCA (A); Cx, circumflex
artery (B, C); D1 and D2, first and second diagonal branch (B); LAD, left anterior
descending artery (B); LM, left main coronary artery (B); OM, obtuse marginal
branch (B, C); PD, posterior descending branch (D); PL, posterolateral branch from
RCA (D); RCA, right coronary artery (A, D); RVB, right ventricle branch (running to
distal part of posterior interventricular groove, A, D). Cardiac veins: AIV, anterior
interventricular vein (B); CS, Coronary sinus (D); GCV, great cardiac vein (C, D);
LMV, left marginal vein (C); PIV, posterior interventricular vein (D); PLVV, posterior
left ventricular vein (C, D); RAV, right atrial vein draining directly into right atrium
(A).

33. • FIGURE 19-14 ■ Absent left main. Double
oblique orientation parallel to the aortic root
showing separate coronary ostia of left anterior
descending artery (LAD) and circumflex artery
(Cx). The left main artery is absent. Right
coronary artery (RCA) with conus branch (CB).

34. • FIGURE 19-15 ■ Full-length display of coronary arteries. Three-
dimensional volume-rendered reconstructions in right anterior
oblique (A) and left anterior oblique (D) view and curved
multiplanar reconstructions (B, C, E, F) showing each coronary
artery in two longitudinal perpendicular directions: the right
coronary artery (RCA, in B), left anterior descending coronary artery
(LAD, in C), circumflex artery (Cx, in E) and obtuse marginal branch
(OM, in F). Note that the OM is much larger than the Cx (E) itself,
which is usuallythe case. LM, Left main

35. • FIGURE 19-15 ■ Full-length display of coronary arteries.
Three-dimensional volume-rendered reconstructions in
right anterior oblique (A) and left anterior oblique (D) view
and curved multiplanar reconstructions (B, C, E, F) showing
each coronary artery in two longitudinal perpendicular
directions: the right coronary artery (RCA, in B), left
anterior descending coronary artery (LAD, in C), circumflex
artery (Cx, in E) and obtuse marginal branch (OM, in F).
Note that the OM is much larger than the Cx (E) itself,
which is usuallythe case. LM, Left main

36. • FIGURE 19-15 ■ Full-length display of coronary arteries. Three-
dimensional volume-rendered reconstructions in right anterior
oblique (A) and left anterior oblique (D) view and curved
multiplanar reconstructions (B, C, E, F) showing each coronary
artery in two longitudinal perpendicular directions: the right
coronary artery (RCA, in B), left anterior descending coronary artery
(LAD, in C), circumflex artery (Cx, in E) and obtuse marginal branch
(OM, in F). Note that the OM is much larger than the Cx (E) itself,
which is usuallythe case. LM, Left main

37. • FIGURE 19-16 ■ Invasive coronary angiography
of the right coronary artery (RCA) in two
different directions (left panel, left anterior
oblique 45°; right panel, right anterior oblique
35°). RV, right ventricular branch; RDP, right
posterior descending branch; RPL, right
posterolateral branch; conus, conus branch.

38. • FIGURE 19-17 ■ Invasive coronary angiography of the left coronary
artery in two different directions (left panel, right anterior oblique
30°, 25° caudal angulation; right panel, left anterior oblique 50°,
25° cranial angulation). LM, left main coronary artery; LAD, left
anterior descending coronary artery; Cx, circumflex coronary artery;
OM, obtuse marginal branch; LPL, left posterolateral branch, S-
branches, septal branches; D-branches, diagonal branches.

39. • FIGURE 19-18 ■ Aortic valve. Multiplanar
reconstructions at mid-diastole showing the
closed aortic valve (AV) in coronal view (A),
three-chamber view (B) and short-axis parallel
to the aortic valve (C). S, sinus of Valsalva; MV,
mitral valve; LV, left ventricle; LA, left atrium.
Arrows in (C) point at the commissures.

40. • FIGURE 19-18 ■ Aortic valve. Multiplanar
reconstructions at mid-diastole showing the
closed aortic valve (AV) in coronal view (A),
three-chamber view (B) and short-axis parallel
to the aortic valve (C). S, sinus of Valsalva; MV,
mitral valve; LV, left ventricle; LA, left atrium.
Arrows in (C) point at the commissures.

41. • FIGURE 19-19 ■ Bicuspid aortic valve. ‘Short-axis’ double oblique
transverse images parallel to the aortic valve, showing bicuspid
aortic valve at diastole (A, closed) and at systole (B, slit-like opening
due to fusion of left and right coronary cusp). Note the difference in
noise level between the images, caused by ECG-dose modulation
with full dose at diastole (during the cardiac rest phase for sharp
imaging of the coronary arteries), and lower radiation dose at
systole to save radiation dose.

42. • FIGURE 19-20 ■ Mitral valve. Multiplanar
reconstructions at mid-diastole showing the mitral
valve (MV) in longitudinal two-chamber view (A),
three-chamber view (B), four-chamber view (C) and
short-axis view (D). Anterior mitral leaflet (arrow),
posterior mitral leaflet (arrowhead). P, papillary
muscles; Ch, chordae tendineae; AV, aortic valve; LV,
left ventricle.

43. • FIGURE 19-20 ■ Mitral valve. Multiplanar
reconstructions at mid-diastole showing the mitral
valve (MV) in longitudinal two-chamber view (A),
three-chamber view (B), four-chamber view (C) and
short-axis view (D). Anterior mitral leaflet (arrow),
posterior mitral leaflet (arrowhead). P, papillary
muscles; Ch, chordae tendineae; AV, aortic valve; LV,
left ventricle.

44. • FIGURE 19-21 ■ Pulmonary valve. Coronal
(A), sagittal (B) and multiplanar
reconstruction parallel to the pulmonary
valve (C) showing the pulmonary valve
(arrows). AV, aortic valve; LA, left atrium; LV,
left ventricle; RV, right ventricle.

45. • FIGURE 19-21 ■ Pulmonary valve. Coronal
(A), sagittal (B) and multiplanar
reconstruction parallel to the pulmonary
valve (C) showing the pulmonary valve
(arrows). AV, aortic valve; LA, left atrium; LV,
left ventricle; RV, right ventricle.

46. • FIGURE 19-22 ■ Tricuspid valve. Transverse
reconstruction (A) and short-axis reconstruction
parallel to the tricuspid valve (B), showing the
tricuspid valve (arrows). LV, left ventricle; RV, right
ventricle; MV, mitral valve; PV, pulmonary valve.
Note that the tricuspid valve is difficult to
recognise as compared to the mitral valve (B).

47. • FIGURE 19-23 ■ Pulmonary veins. Volume-
rendered (A) and maximum intensity projection
(B) reconstructions, dorsal view (A) and frontal
view (B). LA, left atrium; LIPV, left inferior
pulmonary vein; LSPV, left superior pulmonary
vein; RIPV, right inferior pulmonary vein; RSPV,
right superior pulmonary vein

48. • FIGURE 19-24 ■ Parasternal long-axis view.
LV, left ventricle; LA, left atrium; RVOT, right
ventricular outflow tract; Ao, aorta; AV, aortic
valve; MV, mitral valve.

49. • FIGURE 19-25 ■ Parasternal short-axis aorta
view. RA, right atrium; LA, left atrium; IAS,
interatrial septum; RVOT, right ventricular
outflow tract; AV, aortic valve; TV, tricuspid valve;
PV, pulmonary valve; LPV, left pulmonary veins.

50. • FIGURE 19-26 ■ Parasternal short-axis
pulmonary artery view. RVOT, right
ventricular outflow tract; AV, aortic valve; PV,
pulmonary valve; PA, main pulmonary artery;
RPA, right pulmonary artery; LPA, left
pulmonary artery.

51. • FIGURE 19-27 ■ Parasternal short-axis basal
left ventricle view. LV, left ventricle; MV,
mitral valve; MV aml, anterior leaflet mitral
valve; MV pml, posterior leaflet mitral valve;
RV, right ventricle; M, moderator band.

52. • FIGURE 19-28 ■ Parasternal short-axis mid
left ventricle view. LV, left ventricle; RV, right
ventricle; AP, anterior papillary muscle; PP,
posterior papillary muscle.

53. • FIGURE 19-29 ■ Parasternal short-axis apex
left ventricle. A, apex left ventricle; RV, right
ventricle.

54. • FIGURE 19-30 ■ (A) Apical
four-chamber view. LV,
left ventricle; S, septal
myocardium; L, lateral
myocardium; RV, right
ventricle; LA, left atrium;
RA, right atrium; MV,
mitral valve; TV, tricuspid
valve; M, moderator band;
LPV, left pulmonary vein;
IAS, inter-atrial septum;
(B) detail of the inter-atrial
septum. PS, primary
septum; FO/SS, fossa
ovalis/secondary septum

55. • FIGURE 19-31 ■ Apical two-chamber view. LV,
left ventricle; A, anterior myocardium; I,
inferior myocardium; LA, left atrium; MV,
mitral valve.

56. • FIGURE 19-32 ■ Apical five-chamber view. LV,
left ventricle; AS, anteroseptal myocardium; IL-P,
inferolateral-posterior myocardium; LA, left
atrium; MV, mitral valve; RV, right ventricle; RA,
right atrium; AV, aortic valve; LVOT, left
ventricular outflow tract; Ao, aorta-ascendens.

57. • FIGURE 19-33 ■ Apical right ventricle view.
RV, right ventricle; RA, right atrium; TV,
tricuspid valve; S, septal myocardium; RV-L,
right ventricle lateral myocardium.

58. • FIGURE 19-34 ■ Subcostal four-chamber
view. LV, left ventricle; RV, right ventricle; LA,
left atrium; RA, right atrium; MV, mitral valve;
TV, tricuspid valve; pc, pericardium.

59. • FIGURE 19-35 ■ Subcostal inferior vena cava
view. L, liver; IVC, inferior vena cava; RA, right
atrium.

60. • FIGURE 19-36 ■ Suprasternal view. Ao-Asc,
ascending aorta; Ao-Arch, aortic arch; Ao-
Desc, descending aorta; AC, common carotid
artery; LSA, left subclavian artery; RPA, right
pulmonary artery.

61. • FIGURE 19-37 ■ Aortic
valve short-axis.
Normal aortic valve
with right coronary
cusp (R), left coronary
cusp (L) and non-
coronary cusp (N) in
closed (upper panel)
and open position
(lower panel).

62. • FIGURE 19-38 ■
Bicuspid aortic valve.
Functionally bicuspid
aortic valve with non-
coronary cusp (N), and
fusion (raphe) of the
right coronary cusp (R)
and left coronary cusp
(L). Upper panel shows
the aortic valve in
closed and lower panel
in open position.

63. • FIGURE 19-39 ■ Transoesophageal
echocardiographic view of the aortic valve in
transverse/short-axis view (left panel) and
longitudinal view (right panel). N, non-coronary
cusp; R, right coronary cusp; L, left coronary
cusp; LA, left atrium; LAA, left atrial appendage;
RVOT, right ventricular outflow tract; LV, left
ventricle; AV, aortic valve; Ao, ascending aor

64. • FIGURE 19-40 ■ Transoesophageal
echocardiographic views of the mitral valve.
With multiplanar views, the different parts of
the anterior mitral valve leaflet (A1, A 2, A3)
and the posterior leaflet (P1, P2, P3) can be
visualised

65. • FIGURE 19-40 ■ Transoesophageal
echocardiographic views of the mitral valve.
With multiplanar views, the different parts of
the anterior mitral valve leaflet (A1, A 2, A3)
and the posterior leaflet (P1, P2, P3) can be
visualised

66. • FIGURE 19-41 ■ Three-
dimensional view of
the aortic valve in
closed (upper panel)
and in open position
(lower panel). The
image is obtained with
transoesophageal
echocardiography. N,
non-coronary cusp; R,
right coronary cusp; L,
left coronary cusp.

67. • FIGURE 19-42 ■ Three-
dimensional view of the
mitral valve with anterior
leaflet and posterior
leaflet in closed (upper
panel) and in open
position (lower panel).
The image is obtained
with transoesophageal
echocardiography and the
valve is seen from the left
atrium. The different parts
of the anterior mitral
valve leaflet (A1, A 2, A3)
and the posterior leaflet
(P1, P2, P3) can be
determined.

68. THANK
YOU