[Echocardiography--a stethoscope of the 21st century]

The goal of this article is to provide a report of a current potential of an ultrasound examination of heart and to outline future development of echocardiography and its use in clinical practice. Since echocardiography appearance in the middle of the 20th century till today, the method has undergone a very dynamic development. From a simple one-dimensional image (M-mode), through two-dimensional image (2D) complemented with Doppler imaging of blood flows, echocardiography developed into currently up to date methods such as contrast echocardiography, tissue Doppler imaging, assessment of myocardial strain and strain rate, methods based on detection of ultrasonic backscatter (acoustic densitometry, automated border detection, colored image of wall motion--"color kinesis") and others. Possibility of an ultrasonic assessment of heart significantly supplemented transesophageal echocardiography and newly emerging three-dimensional imaging of heart structures. As a routine method to prove myocardial ischemia and viability a stress echocardiography is currently used. Its results significantly improved after technical innovations enabling simultaneous monitoring and evaluation of images at various projection displays and at various levels of stress. A big promise for further bigger use of echocardiography has become a miniaturisation of devices enabling one man to carry the device to a patient outside a health care facility. These small, more affordable ultrasound devices can soon become real stethoscopes of the 21st century.