Applying ultrasound

The initial applications for ultrasound mainly focused on the development of tracking systems such as SONAR, meaning its use in a clinical setting didn’t begin to be explored until the 1940’s. It was first tested for medical diagnosis by Dr Karl Dussik who was interested in using ultrasound to image the brain. By the 1950’s the technology had progressed significantly enough for Dr Inger Edler and  Dr Carl Helmuth Hertz to experiment with the use of ultrasound in imaging the heart for the first time.

The first echocardiogram

Driven by the need for more accurate pre-surgery diagnoses, in 1953 Edler and Hertz borrowed a commercial ‘ultrasonic reflectoscope’, originally used to find cracks in metals, from a local shipyard and set about their task to image the heart. The first patient to be examined was Hertz himself. The pair began identifying the signals the instrument received from the body and linking them to the different structures and mechanisms of the heart. They produced exceptional diagrams of the changes in position of different structures, enabling doctors to have an insight into the heart’s workings prior to surgery, something that had not been so easily achieved before this development. This earned Edler the title of ‘Father of Echocardiography’.

Developing the technology

Despite the success of Edler and Hertz’s work, much more progression was to come. Scientists were keen to develop the basic diagrams produced by Edler and Hertz’s system into recognisable ‘pictures’ of the heart.

The next major chapter in the history of echocardiography was therefore the advent of real-time two-dimensional imaging. Physicists and clinicians worked tirelessly to develop echo instruments that could produce reliable 2D images of the heart and its motion. Somer was one of the first to find success in 1968 when he produced the first ever electronic phased-array scanner, a technology which would turn out to be the basis of most scanners for many years to come.

Unfortunately many of these devices were bulky and impractical, restricting their use in the clinic. However by the 1970’s the first commercially successful 2D echocardiogram was born out of Reggie Eggleton’s innovative adaptation of an electric toothbrush! This was the dawning of a new era for miniaturisation of the devices we are familiar with today used to direct ultrasound waves to the body.

Since then, input from other areas of science has contributed to the continued development of echocardiogram systems. This includes knowledge of Doppler frequency shifts being used and combined to measure and image blood flow through the heart, as well as the evolution of the different echocardiography applications we see today.

So, there it is! A brief history of the echocardiogram. From bat hearing to complex images of our hearts in motion there’s been a lot of progress made and all of us at HeartScan are pretty sure the development and innovation isn’t going to stop there!