If You Don’t Look, You Don’t Know!


Welcome to our lecture series!  Our team is passionate about sharing our enthusiasm for perioperative ultrasound with students at every level around the world.  There are already enough barriers to implementing these techniques, so we provide our content completely free of charge.  BUT!!  We need to justify the upkeep of this site to our institution.  If you value this content please let me know, just a quick note from each of you (to joshua.zimmerman@hsc.utah.edu) will help!  Also, if you’re interesting in knowing when new talks are posted you can follow us on Twitter (@Periop_Echo).  You can also sign up for my free clip of the day here (https://lists.hsc.utah.edu/wws/info/periop-echo).  Cheers!

       The links below are to our “Basics of Perioperative Echocardiography” lecture series.  These talks are weekly half-hour lectures given by our faculty of expert echocardiographers.  We begin with basic normal imaging, move on to assessment of ventricular and valvular function, and end with more advanced topics.  The movies should play on your desktop, iPad, or iPhone.  To reinforce the content of each lecture there will be image-based clip quizzes on our quiz site.  Please send your feedback, suggestions, or comments to me at joshua.zimmerman@hsc.utah.edu.  Enjoy!

Hocus PoCUS? Yep, it’s definitely magic!

  • OK, before we get on with the lecture series I just wanted to double check that you’re on the right page. The content below is our TEE-heavy resident lecture series.  It forms the core of our TEE curriculum and while it does contain a number of non-TEE lectures if you’re looking for that content I suggest you follow this PoCUS link.  This is a growing series of lectures designed to introduce concepts of focused cardiac ultrasound (FoCUS) and non-TEE point-of-care ultrasound (PoCUS) in general.  If you’re taking one of our FoCUS workshops, this is the content you’ll need to review prior to arriving.  Check back frequently as this content is growing rapidly!

Introduction to the Lecture Series

  • This is the so called “Echo Pep Rally!” and represents the introduction to our department’s new year of echo festivities.  Not a content heavy lecture, but you’re still welcome to watch it.

Cardiac Anatomy for the New Echocardiographer

  • We all know lots of cardiac anatomy, but there is always more to learn.  Before you begin the journey that will lead you to echocardiographic excellence, take a few minutes to review the basics of cardiac anatomy.

TEE – The Good, the Bad, and the Ugly

  • Got your attention?  This talk will give an overview of indications, contraindications, and complications of TEE as well as tips on probe placement in the awake and anesthetized patient.

You Put the Probe Where?! TEE Safety

  • If you think this topic is boring, think again!  Watch this talk from Dr. Gnadinger and avoid the dreaded ‘echo probe winds up in the surgical field’ syndrome.  This is a more detailed discussion of the risks of TEE as well as a discussion of probe cleaning and maintenance.  Important stuff!

Basic TEE

  • This covers what we’ll call the “University of Utah Basic TEE Exam”, which is a focused perioperative evaluation designed to answer basic questions about valvular function, ventricular function, and to identify causes of hemodynamic instability.  This is nice introduction to normal TEE anatomy and includes both a live recording and a studio version.  (Test your knowledge here!)

Basic TEE Exam Sheet

  • This is a link to our basic TEE exam sheet.  Feel free to print this out and share it with your friends and colleagues!

Comprehensive TEE Exam

  • This lecture will review the views from the ASE’s guideline on performing a comprehensive TEE that are not included in the basic exam.  Some of these will certainly come up in later lectures and in your clinical practice (and some may not, and there are some that they didn’t include that I wish they had.  Oh well!)

Basic TTE – Why

  • Here we will discuss the value of transthoracic echo in the hands of perioperative physicians in a case-based review.  This is one of my favorite talks, and it can be considered another, TTE-focused pep rally.

Basic TTE – How

  • This talk serves as a review of the basic transthoracic images (both performance and interpretation) that are most important to the perioperative physician.  Another set of both live and studio versions. (Test your knowledge here!)

How-To TTE Live Version

  • OK, this is a preliminary version but I’m excited about the possibilities here!  What you’ll see is me performing and describing a limited TTE exam in real time, with a screen showing probe position on the patient as well as the live image.

Basic Doppler Ultrasound

  • Dr. Jen Decou provides an excellent introduction to Doppler ultrasound concepts.  This is not a comprehensive review of ultrasound physics (that comes later) but rather a basic nuts and bolts overview.  (Test your knowledge here!)

Echo – Beyond the Basics

  • This excellent lecture by Dr. Morrissey will take us beyond the basic TTE and TEE exams, showing us additional valuable views to obtain in our studies.

Lung Ultrasound for “Air”

  • Dr. Griffee introduces us to perioperative lung ultrasound, reviews normal anatomy, image acquisition, and diagnosis/exclusion of pneumothorax.

Lung Ultrasound for “Water”

  • An awesome topic and very relevant for perioperative physicians!  In this talk Dr. Griffee reviews the use of ultrasound for pleural effusion and pulmonary edema.

FAST Exam for Anesthesiologists

  • Dr. Jimmy Fair, emergency medicine ultrasound guru, reviews the FAST exam with a focus on the value of these techniques for anesthesiologists.  If you don’t think this applies to you, remember that every surgery is penetrating trauma!

“Complete” TTE

  • In this lecture I will cover the normal 2D, color flow, and spectral doppler images seen in a more comprehensive transthoracic echocardiogram.

Echo to the Rescue – Condensed Version

  • This is a couple different single-lecture versions of rescue echo.  This is a big topic, probably not appropriate for a single talk, but I’ve tried my best.  If you just want to dip your toe in the rescue water with a brief introduction, here you go.  (Test your knowledge here!)

Echo to the Rescue, Now We’re Talkin’!  – Part I, Volume and Afterload

  • Now this is more like it!  I’ve made a giant rescue echo talk, almost 120 slides, but to avoid echo overload I’ll break it down into four bite-sized pieces.  This first round is an introduction to the concept as well as a discussion of hypovolemia and low afterload.

Even More Rescue Echo, Part II – Dynamic Obstruction and Pulmonary Embolism

  • Ready for more?  This lecture will highlight evaluation of dynamic obstruction and PE.  When should you consider these diagnoses?  Every time you image!

Rescue Echo, Gotta Love It! – Part III, Tamponade and Ventricular Failure

  • Three meaty topics to be sure.  Is LV failure the cause or the result of hemodynamic instability?  Isn’t the RV just a passive conduit?  The answers are here!

Rescue Echo, Can’t Get Enough! – Part IV, Valve Disease, PTX, Arrhythmia

  • Stay with me!  This is the home stretch for rescue echo and includes some super important concepts.  If you’re not looking at the lungs, are you really doing a complete rescue study?  Hmm.  And what’s this talk about pseudo-PEA?

Global LV Function

  • Drs Zimmerman and  Bledsoe discuss the evaluation of global left ventricular function, focused primarily on transesophageal imaging, including 2D, 3D, and Doppler.  (Test your knowledge here!)

LV Ischemia

  • In this talk Dr. Michelle Curtis will review myocardial ischemia and LV regional wall motion.

Basic Aortic Valve Anatomy and Assessment

  • Dr. Montzingo introduces us to the anatomy of the aortic valve and the best views from which to assess it.  These are the basics, you can never review them too much.

Aortic Stenosis

  • Dr. Heath reviews evaluation and quantificaiton of AS, one of the most common cardiovascular diseases we’ll encounter.  This is our bread and butter!  (Test your knowledge here!)

Aortic Insufficiency

  • Another excellent lecture by Dr. Bledsoe, need I say more?  OK, fine, this one’s about evaluation of aortic insufficiency.  Happy now?  Just watch it.  (Test your knowledge here!)

Aortic Valve Replacement Case Review

  • Dr. Gera will review a case of aortic valve replacement, from preoperative assessment to postoperative complications

Anatomy of the Mitral Apparatus

  • Every year I seem to put in more mitral valve talks, and now I’ve decided we need a separate lecture just about the anatomy of this fantastically complex system before we delve into the echo assessment.  So sue me!

Basic Mitral Valve Imaging, Intro to 2D

  • Now that we’ve discussed the basic anatomy of the mitral valve, let’s briefly review the 2D assessment of the mitral valve with TEE.

Mitral Regurgitation

  • Dr. Birgenheier reviews for us basic concepts of valvular regurgitation, and applies them the the mitral valve in this two part lecture.  This is a very high-yield topic, and should be reviewed frequently.  (Test your knowledge here!)

Mitral Stenosis

Tricuspid and Pulmonic Valves

  • A lot to cover in one lecture, but in this talk we’ll discuss tricuspid and pulmonic imaging and will make a few comments on quantification of these forgotten valves.

Evaluation of Bioprosthetic Valves

  • In part 1 of the prosthetic valve discussion, Dr. Decou reviews the echocardiographic evaluation of bioprosthetic valves, a common task for the  perioperative echocardiographer.

Mechanical Valve Assessment

  • More key content from Dr. Decou for part 2 of the prosthetic valve fest

Prosthetic Valve Assessment

  • This talk is a nice review of the assessment of both mechanical and bioprosthetic valves by Dr. Smith

Right Ventricular Function

  • The critical concepts of right ventricular structure and function are reviewed in these two exceptional talks by Drs. Silverton and Bledsoe, enjoy!

Echo in Systemic Diseases

  • Thanks to Dr. Bledsoe for this excellent talk about the echocardiographic findings of both common and rare systemic diseases.


  • Dr. Birgenheier reviews the wonderful and complex world of echocardiography in the assessment of diastolic function.  A must-watch!  (Test your knowledge here!)

 Echo in Dilated Cardiomyopathy

  • In this talk I’ll introduce the concept of cardiomyopathy, and review the echocardiographic characteristics of dilated cardiomyopathy.  I was in a TTE mood when I made this, so most of the images are transthoracic.

Echo for “Non-Dilated” Cardiomyopathy

  • In this lecture Dr. Morgan will review the evaluation and echocardiographic characteristics of the remaining types of cardiomyopathy.

TEE Evaluation of LVAD

  • As discussed in the cardiomyopathy lectures, heart failure is everywhere and transplants are not.  Whatever your practice it will be hard to avoid LVAD patients in the future.  Dr. Pulsipher reviews the history and echocardiographic assessment of these complex devices.

Case Presentation – Cardiomyopathy

  • Stodgy lecture content is fine, but it’s important to put it all together with real-life discussions.  In this talk Dr. Curtis review’s cardiomyopathy in a case-based format.

Echo in Pulmonary HTN / RV Failure

  • Fantastic lecture by Dr. Matthew Griffee on echo assessment of the struggling right ventricle.

Echo in Organ Transplantation

  • Dr. Pelegrin reviews the use of TEE in patient’s undergoing heart, lung, and liver transplant

More Excellent Cases!

  • Two different case review lectures by Dr. Heath and Dr. Griffee.  This is the practical application of echo and represent very high yield, practical discussions.

Aorta Part 1: Atherosclerosis

  • One of my very favorite topics, the oft-overlooked and frequently under-appreciated thoracic aorta.  Enjoy!

Aorta Part 2:  All the Rest

  • Dr. Curtis delves into the fascinating world of dissection and aneurysm

Quantitative Hemodynamics

  • This talk is a nice overview of the use of cardiac ultrasound for quantitative assessment.  Bread and butter, but very important!

Congenital Heart Disease, Part I

  • Dr. Morgan provides an excellent introduction to the complex topic of echo for the patient with congenital cardiac disease.

Congenital Heart Disease, Part II

  • Dr. Morgan follows up last week’s excellent talk with this review of echo in disorders of septation.

Ultrasound Physics Part I

Ultrasound Physics Part II

Ultrasound Physics Part III

  • In this 3 part series, Dr. Decou delivers the most interesting series of ultrasound physics lectures every heard by man or beast.  Seriously, this is an important topic, and her review is top notch!  (Test your knowledge here!)

Peribypass Complications

  • We love it when things go well, of course, but that isn’t always the case, right?  In this talk, Dr. Pelegrin will review a number of the problems we should keep in mind.

Echo for TAVR

  • Dr. Morgan’s excellent talk will review the use of echo to assess patients before, during, and after TAVR.  Don’t do these cases?  You will soon!

Intro to 3D Echo

  • 3D echo is the topic for an entire lecture series by itself, but in this talk Dr. Montzingo will when our appetite for this growing area of perioperative echo.

Perioperative Echo in Endocarditis

  • Who doesn’t love looking at echo images of endocarditis?  Dr. Pelegrin’s lecture will be full of them!  (Test your knowledge here!)

Cool (Non-cardiac) Stuff You Should Ultrasound!

  • Dr. Silverton’s excellent talk gives us a number of new ideas for things to ultrasound, check it out.