Cardiac ultrasound, also known as echocardiography or echocardiogram, is used to provide several different levels and types of heart testing. Cardiac ultrasound utilizes the same ultrasound principles as used for obstetric and gynecologic evaluations of pregnant women, gallbladder ultrasound and other abdominal structures.
The ultrasound is directed out of a hand held probe which can be moved to image the heart from different positions. Additionally, so that heart events can be timed, ECG leads are placed on the chest. The reflected wave is converted into an actual image of the heart and displayed in a real-time mode or M-mode ultrasound format. M-mode recordings permit measurement of cardiac dimensions and detailed analysis of complex motion patterns depending on transducer angulations. Also the time relationships with other physiological variables such as ECG, heart sounds, and pulse tracings, can be recorded simultaneously. A stress echocardiogram provides information about the cardiac performance.
Two-dimensional tomographic images of selected cardiac sections give more information than M-mode about the shape of the heart and also show the spatial relationships of its structures during the cardiac cycle (diastole to systole).

See also M-Mode Echocardiography, and Myocardial Contrast Echocardiography.

Conventional, CT and MR imaging technologies are limited in their availability, to depict soft tissue, or to show dynamic activity, like cardiac muscle contractility and blood flow. Easy applicability, real-time sonography and biopsy facilitation are important advantages in veterinarian medicine. Veterinary ultrasound has a very high sensitivity to show the composition of soft tissues, but the low specificity is a disadvantage. High ultrasound system performance includes Doppler techniques, contrast enhanced ultrasound, 3D ultrasound, and tissue harmonic imaging to improve resolution.
Technical and physical requirements of veterinary ultrasound are the same as in human ultrasonography. The higher the sound frequency, the better the possible resolution, but the poorer the tissue penetration. Image quality is depended of the ultrasound equipment. For example, a 10 MHz transducer is excellent for imaging of superficial structures; a 3.5 or 5.0 megahertz transducer allows sufficient penetration to see inner structures like the liver or the heart. In addition, the preparation and performing of the examination is similar to that of humans. The sound beam penetrates soft tissue and fat well, but gas and bone impede the ultrasonic power. Fluid filled organs like the bladder are often used as an acoustic window, and an ultrasound gel is used to conduct the sound beam.

Duplex ultrasonography (duplex scan) consists of two ultrasound modalities to study blood flow and the perivascular tissue. This includes B-mode / gray scale imaging used in combination with spectral Doppler / pulsed-wave Doppler.
The real-time visualization of the vessels and tissue by the B-mode component improves the PW Doppler positioning and the direction of blood flow can be inferred. The angle between the direction of the PW Doppler signal and the estimated direction of blood flow can be measured.
Duplex techniques are available on phased array, linear array, and mechanical scanners. A phased array probe is able to create nearly simultaneous images and flow information. A linear array transducer can also do this if the Doppler probe is attached separately to one end of the scanhead. A mechanical transducer freeze the image; the crystals must be static to produce a Doppler image. The first two transducers are therefore the best choice for Duplex.

See also Compound B-Mode, and Duplex Scanner.

Harmonic imaging relies on detection of harmonics of the transmitted frequency produced by bubble oscillation. This method is widely available on ultrasound scanners and uses the same array transducers as conventional imaging. A major limitation of the use of ultrasound contrast agents is the problem that signals from the microbubbles are mixed with those from tissue. Echoes from solid tissue and red blood cells are suppressed by harmonic imaging.
In harmonic mode, the system transmits at one frequency, but is tuned to receive echoes preferentially at double that frequency, and the second harmonic echoes from the place of the bubble. Typically, the transmit frequency lies between 1.5 and 3 MHz and the receive frequency is selected by means of a bandpass filter whose center frequency lies between 3 and 6 MHz.
Color Doppler and real-time harmonic spectral Doppler modes have also been implemented and show a level of tissue motion suppression not available in conventional modes.

See also Harmonic B-Mode Imaging, and Harmonic Power Doppler.

Most usual ultrasound machines are 2D real-time systems. This types of ultrasound scanners allow to assess both motion and anatomy, including the motion of heart valves, the movement of intestines and lungs and also to guide interventions, like for example a biopsy or a laparoscopic ultrasound.
A standard real-time scanner consists of a mobile console with the monitor on the top and rows of small containers at the bottom to accommodate a variety of scanner probes. The linear, curved or phased array transducers are usually equipped with multiple crystals or in some cases with a moving crystal. A real-time scanner may be e.g., a mechanical scanner or electronic array scanner.

See also Musculoskeletal and Joint Ultrasound.