Cross‐sectional Echocardiographic Evaluation of Changes in Ventricular Shape in the Ischaemic and Non Ischaemic Left Ventricle

SUMMARY M‐mode echocardiography is a useful method for estimating left ventricular volumes and determining multiple parameters of left ventricular function in the symmetrically contracting, normally shaped ventricle. In many clinical situations, however, the shape of the ventricle may be altered or distorted in such a way that the basic M‐mode diameter or dimension of the ventricle is no longer reflective of overall left ventricular volume or function. Cross‐sectional echocardiography is a valuable method for detecting abnormalities in left ventricular shape and thereby defining those cases in which the M‐mode method may not accurately reflect ventricular size or performance. In this report two examples of abnormalities in ventricular shape are described. These include the marked alteration in left ventricular conformation which occurs when aneurysm formation complicates ischemic heart disease and the more subtle changes in ventricular shape seen in patients with both absolute and relative right ventricular volume overload, due to alteration in septal position. These examples illustrate the value of cross‐sectional echocardiography in defining abnormalities of left ventricular shape, indicating situations in which the M‐mode ehocardiographic determinations of ventricular volume and function may be misleading and explaining changes in the patterns of wall motion observed by M‐mode echocardiography which are due to alterations in the shape of the left ventricle.