Background: Echocardiography has evolved significantly since its inception in the 18th century, with foundational contributions from Lazzaro Spallanzani and practical applications pioneered by Hertz and Edler in 1954. Initially reliant on M-mode imaging, the field has advanced to incorporate Doppler imaging, three-dimensional (3D) reconstruction, and contrast-enhanced techniques, making it a cornerstone of cardiac diagnostics. Echocardiography is now indispensable for assessing cardiac structure, function, and hemodynamics, offering real-time, non-invasive imaging without radiation exposure. Aim: This review aims to provide an updated overview of echocardiography techniques, focusing on modern advancements, innovations, and their clinical applications. It highlights the evolution from basic 2D imaging to advanced modalities like 3D echocardiography, speckle-tracking, and artificial intelligence (AI)-assisted imaging, emphasizing their role in improving diagnostic accuracy and patient outcomes. Methods: The review synthesizes historical developments, technological advancements, and clinical applications of echocardiography. It explores the principles of ultrasound physiology, imaging modes (M-mode, 2D, 3D, Doppler), and their integration into clinical practice. The article also discusses the indications, contraindications, and complications associated with transthoracic (TTE) and transesophageal echocardiography (TEE), as well as the equipment and personnel required for effective echocardiographic examinations. Results: Echocardiography has transformed cardiac diagnostics, offering unparalleled insights into cardiac anatomy and function. Innovations such as 3D imaging, speckle-tracking, and contrast-enhanced echocardiography have enhanced diagnostic precision, while AI and portable devices have improved accessibility and efficiency. TEE has become invaluable in surgical and interventional settings, despite its invasive nature and associated risks.
Conclusion: Echocardiography remains a vital tool in cardiology, with continuous advancements expanding its diagnostic and therapeutic applications. Its integration of modern technologies ensures its relevance in both routine and complex clinical scenarios, ultimately improving patient care and outcomes.