Present day cardiology is in great need of non invasive, non toxic, and inexpensive devices which permit the delineation and visualization of normal and abnormal intracardiac structures, the calculation of intra cardiac volumes and study of contractility of the cardiac muscle. All of these may become within our reach if the principles outlined in this book and the preliminary clinical experience can be validated in general cardiac practise. The gist of one of the devices (visualization of the in vivo moving heart recorded on a short motion picture) is available to the interested reader on a 16 mm filmstrip. Rotterdam, June 1972 P. G. Hugenholtz Professor of Cardiology CONTENTS CHAPTER I INTRODUCTION TO ECHOCARDIOGRAPHY 9 1. General remarks 9 2. Purpose of this study 10 CHAPTER II PRINCIPLES OF ULTRASOUND 12 The piezo-electric effect 1- 12 2. Some physical properties of ultrasound 13 a. Attenuation 13 b. Reflection of sound 13 c. Near and far field 13 3. Scanning and recording techniques 15 a. Example of depth sonar 15 b. A-scan and Time-Motion recording 17 c. Single element 8-scan techniques 17 4. The Doppler effect 17 CHAPTER III PRESENT APPLICATIONS IN CARDIOLOGY 19 1. General remarks 19 2. Mitral stenosis 20 3. Pericardial effusion 23 4. Other applications 26 a. Mitral insufficiency 26 b. Tricuspid stenosis 26 c. Idiopathic hypertrophic subaortic stenosis 26 d. Aortic valve study 26 e. Internal dimensions 27 5. On the use of Doppler 28 6.