[The status of echocardiography within the scope of routine cardiologic diagnosis]

In particular since the introduction of the two-dimensional approach, echocardiography as a non-invasive and easily repeatable bedside-technique without side-effects plays a central role within the diagnostic tools of cardiology. The following applications of cardiac ultrasound are commonly accepted and sufficiently validated: Assessment of the size of cardiac chambers including qualitative and quantitative evaluation of left ventricular function, detection of pericardial effusion, diagnosis of intra- and extracardiac tumors and thrombi, analysis of complex congenital diseases. Without the use of Doppler, valvular regurgitations can only be suspected by indirect parameters; in contrast, stenotic lesions as well as a variety of other valve abnormalities (calcifications/partial rupture/prolapse/vegetations) can be diagnosed with a high accuracy. Transesophageal echocardiography guarantees not only an optimal imaging quality in virtually all patients, in addition, the technique allows the routine visualization of the thoracic descending aorta and the left atrial appendage which is of importance for the diagnosis of aortic dissection and isolated left atrial appendage thrombi. Transesophageal echocardiography is also superior to the conventional precordial approach concerning the assessment of prosthetic valve malfunction (in particular in mitral position) and endocarditis-associated abscesses. Today, the echocardiographic visualization of coronary arteries is without clinical relevance.