We shall now further evaluate our patient's echocardiogram. This suprasternal notch view of the aortic arch identifies the coarctation site. Labels indicate the transverse aortic arch, left common carotid artery, the origin of the left subclavian artery, descending aorta and the coarctation site. Note the distance between the left subclavian artery and the coarctation.
Spectral wave Doppler - distinct diastolic runoff
This is a still-frame from the spectral wave Doppler echo in the suprasternal notch view. Note the systolic velocity of 3.75 m/sec, indicating a maximal instantaneous systolic pressure difference of 56 mmHg across the coarctation. Also note continuation of the signal throughout diastole, indicating persistent diastolic pressure difference. This diastolic runoff signal is characteristic of significant coarctation.
2-D echo - bicuspid aortic valve
This is still-frame of 2-dimensional echocardiogram in the parasternal short axis view from our patient. Note the presence of a bicuspid aortic valve. In this case, one leaflet is formed by the fusion of the right and left cusps. The other leaflet is the posterior cusp, identified by the arrows. In the real-time study that follows, note that the valve leaflets move well and that the orifice is central.
Color flow Doppler - mild aortic regurgitation
This color Doppler echocardiogram in the apical 4-chamber view demonstrates diastolic flow through the aortic valve into the left ventricle. The color pattern occurs in diastole and is predominantly orange-red, as it is directed toward the transducer that is located on the chest at the cardiac apex. The small size of this color map, its short excursion into the left ventricle and its short duration all reflect mild regurgitation. In this and other views, one can also assess left ventricular mass, septal and posterior wall thickness, as well as left ventricular volume and systolic function.