May 4, 2026 — A new guideline from the American Society of Echocardiography (ASE) provides guidance for cardiovascular ultrasound imaging professionals to better recognize and understand cardiac ultrasound artifacts, aiming to enhance diagnostic accuracy and patient safety.
Despite advancements in ultrasound imaging technologies, artifacts remain prevalent across all echocardiographic modes, including two-dimensional, spectral Doppler, color Doppler and three-dimensional echocardiography. These artifacts, which are misleading or false image features, arise from the inherent physical properties of ultrasound and can occur due to interference from external equipment and devices producing ultrasound waves. They can contribute to misdiagnoses and have potentially serious clinical consequences.
“Recommendations for the Identification and Mitigation of Cardiac Ultrasound Artifacts” offers a structured approach to identifying and managing ultrasound artifacts. The document details the visual characteristics of common artifacts, explains the mechanisms behind their generation, and outlines their potential impact on clinical interpretation and patient diagnosis and management. It also includes real case examples and strategies to assist clinicians in avoiding and mitigating artifacts.
“This new ASE guideline is the first document published by an imaging society focused exclusively on cardiac ultrasound artifacts,” said Guideline Chair Dr. Muhamed Saric, director of echocardiography and professor of medicine at New York University Langone, New York. “It is essential for cardiac sonographers and clinicians to recognize these common ‘Achilles’ heels’ in ultrasound to reduce the risk of misdiagnosing critical conditions such as aortic dissection and ventricular thrombus, and to help optimize patient care.”
Developed by a global team of ultrasound practitioners, the guideline features an extensive and unique collection of figures and videos for easy reference to support learning and clinical application.
“While innovations in ultrasound imaging hardware and software are promising to minimize the generation of artifacts, operator education remains essential. Everyone involved in performing or interpreting cardiac ultrasound should be familiar with artifacts and their potential for misdiagnosis,” said Guideline Co-Chair Dr. Anita Sadeghpour, an advanced cardiac imager at MedStar Health Research Institute and associate professor of medicine (Cardiology) at Georgetown University in Washington, D.C.
The complete guideline document and all guidelines published by ASE are available at ASEcho.org/Guidelines.
April 30, 2026 
