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Overview
One-dimensional or M-mode echocardiography is one beam of ultrasound directed toward the heart.
Historical Perspectives
- One of the first modes available
- Excellent resolution
Keys to interpretation
- What structure is being imaged?
- Where is the cursor?
- Size
- Septum in HOCM
- Timing
- Tamponade - diastolic collapse
- Density
- Myxomatous leaflets, masses
Technology
A single crystal rapidly alternates between transmission and receiver modes with rapid updating result, rapidly moving structures (eg, valve leaflets) can be monitored for their characteristic motion very high temporal resolution
Specific Structures
- During systole do the aortic valve leaflets oppose the aorta?
- Are the leaflets thick and calcified (bright)?
- Possible to have normal appearance on m-mode if non-calcific
- Are leaflets open throughout systole - HOCM, low-output state
- Anterior leaflet with E/A appearance of diastology
- Decreased EF slope in MS
- Scalloping of leaflet tip in end systole in prolapse
Ventricular M-mode
- Ventricular Wall Thickness
- Ventricular Chamber Size
- Intraventricular Masses
M Mode Pathologic States
- Thickened, calcified leaflets
- Dense, persistent echoes replacing the normal motion patterns
- Post-stenotic aortic root dilation (> 35mm)
- LVH
- Eccentrically placed diastolic closure line (BAV)
- Systolic bowing of the posterior mitral valve leaflet
- Septal hypertrophy
- Systolic anterior motion (SAM) of the anterior mitral valve leaflet
- Mid-systolic (premature) closure of the aortic valve due to outflow track obstruction
 HOCM Mid Systolic AV Closure |
- Leaflet tips bright (calcified) and thickened
- E/F slope decreased
- Diastolic collapse of the right ventricle
- Increased duration between E and A peaks
- Fluttering of the anterior mitral valve leaflet due to AI jet turbulence
- Clinical setting to decide mechanism
 Aortic Regurgitation M Mode |
Other M Mode Findings
B Bump
- Elevated left ventricular end diastolic pressure
- Thickened leaflets
- Good motion
- Mass
- Clinical scenario likely to give clue - dialysis patient, etc.
 Aortic Valve Endocarditis M Mode |
- Bright hyperdensity in mitral orifice throughout cardiac cycle
- Functional MS
 Left Atrial Myxoma M Mode |
- M-mode of pulmonary valve - W appearance indicates elevated pulmonary pressures
 Hypertensive Heart Disease M Mode |
 MItral Valve Prolapse.jpg M Mode |
 Flail Posterior Mitral Leaflet M Mode |
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Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
