About EchoRef
EchoRef is a free iOS ultrasonography educational reference covering point-of-care ultrasound (POCUS), transthoracic echocardiography (TTE), and transesophageal echocardiography (TEE). Additionally, it contains cardiac...
EchoRef is a free iOS ultrasonography educational reference covering point-of-care ultrasound (POCUS), transthoracic echocardiography (TTE), and transesophageal echocardiography (TEE). Additionally, it contains cardiac dimensions, native/prosthetic valve measurements, hemodynamic/ultrasound calculations, and lessons ranging from interventional procedures to mechanical circulatory support. This app is intended for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you may have regarding a medical condition, and never disregard or delay seeking professional advice because of information provided by this app. About Rishi Kumar, MD, FACC ("RK.MD") I'm an adult cardiothoracic anesthesiologist and cardiovascular ICU intensivist practicing in academic medicine. I'm passionate about teaching with free, open-access medical education. Learn more on my site: https://rk.md
Version History Added: Global search function (magnifying glass in top right) Added: LV thrombus POCUS case Added: On-X mitral valve with stuck leaflet and mitral PVL plug 3D TEE videos Added: Calculators for aortic pulsatility index (API) and Wilkins Score Updated: Small user interface tweaks, codebase optimizations 5.9 May 19 Added: Calculators for Aortic Valve Area (Continuity), Stroke Volume & CO (LVOT), E/e′ Ratio, RVSP Estimate, Bernoulli Gradient, A–a Gradient Updated: Calculator descriptions Updated: Restructured cardiac equations section Updated: Ultrasound physics and hemodynamic equations Updated: User interface fixes throughout the app Updated: Matomo SDK to 7.8.0 5.8 12/22/2025 Added: Hemodynamic and ultrasound equations Added: Highlighting text when searching Added: Slide to favorite or unfavorite calculations Added: iPad interface Update: Reduced boilerplate code Update: Fixed native mitral stenosis values Update: Restructured changelog scheme Update: More subtle liquid glass for references 5.7 11/10/2025 Updated: Complete re-write of the codebase to transition from Storyboard to SwiftUI Updated: Conform elements to iOS 26's liquid glass user interface 5.6 09/15/2025 ⁃ Added: Paravertebral nerve block video ⁃ Updated: Lossless compression of all media elements ⁃ Updated: Rewrote codebase to utilize single structured tuple-based arrays, eliminate unnecessary UI updates, streamline switch statements, etc. - Overall, EchoTools' compressed binary size decreased from 208.8 MB (version 5.4) to 84 MB (version 5.5). 5.5 03/10/2025 ⁃ Added: Dilated coronary sinus (PLSVC) TEE video ⁃ Updated: Matomo framework, consistency across strings 5.4 06/08/2024 ⁃ Added: Navitor and Evolut-R TAVR valves ⁃ Added: Pulmonary velocity acceleration time (PVAT) ⁃ Added: Concentric LVH, aortic dissection flap fenestration, and quadricuspid aortic valve TEE videos ⁃ Updated: TAVR valve information 5.3 02/18/2024 ⁃ Added: Air bronchograms, cardiac standstill, and transhepatic IVC POCUS videos ⁃ Added: Septal myectomy and P2 restriction (type III) TEE videos ⁃ Updated: 3D TEE tricuspid valve video, 3-point compression ultrasound for lower extremity DVT video 5.2 12/31/2023 ⁃ Added: Proximal lower extremity DVT compression, left pleural effusion, and Tetralogy of Fallot POCUS videos ⁃ Added: Perceval sutureless aortic valve ⁃ Added: Edwards Mitris bioprosthetic mitral valve ⁃ Added: SVC collapsibility index 5.1 10/12/2023 - Added: 3D TEE mitral annular calcification (MAC), serratus plane block, spinal cord TEE, and type B dissection POCUS videos ⁃ Added: IVC distensibility index (DI) ⁃ Updated: IMH TEE video, D-Sign POCUS video, IVC POCUS video 5.0 06/06/2023 ⁃ Added: Femoral vascular, gastric, apical long-axis, apical two-chamber, apical five-chamber, and suprasternal aortic arch POCUS videos ⁃ Updated: POCUS subcostal TTE video 4.9 03/03/2023 - Added: LV diastology image for IVRT - Added: Libman-Sacks endocarditis TEE video - Added: Lung point and “D-sign” POCUS videos 4.8 01/08/2023 - Added: Calculators for regurgitant lesions (Valves → Native Valves → click top right calculator icon) - Added: Ebstein’s anomaly POCUS video - Added: Subclavian vein/artery vascular video - Added: Mitral valve leaflet perforation and primum ASD TEE videos 4.7 11/21/2022 ⁃ Added: Medtronic Avalus aortic valve ⁃ Added: RVAD MCS TEE video ⁃ Added: Pecto-Intercostal Fascial Block (PIFB) video ⁃ Updated: Combined Links and Sources 4.6 10/24/2022 ⁃ Added: Autosomal dominant polycystic kidney disease (ADPKD) POCUS video ⁃ Updated: Fixed AVPlayerViewController controls on videos ⁃ Updated: Standardized auto-layout constraints ⁃ Updated: Updated deprecated code for the in-app Review system 4.5 10/10/2022 ⁃ Added: Prosthesis Evaluation section for Prosthetic Valves ⁃ Added: Matomo SDK Integration (removed Firebase) ⁃ Updated: Higher resolution icons with lossless compression ⁃ Updated: Popups for references ⁃ Updated: Transitioned from CocoaPods to Swift Package Manager 4.4 09/27/2022 ⁃ Added: Pop-up framework containing references for prosthetic valve sections ⁃ Updated: Aortic, mitral, and tricuspid bioprosthetic valve information 4.3 06/30/2022 - Added: Ross procedure and intracardiac clot TEE videos - Added: Right heart catheterization (RHC) video - Added: Adductor canal peripheral nerve block video - Updated: Coronary angiography section - Updated: Standardized video sizes - Updated: UIButton to UIImageView elements under the Anatomy tab 4.2 06/06/2022 ⁃ Added: Coronary angiogram section (still under construction) ⁃ Added: Midesophageal left atrial appendage (LAA) and 5 chamber view videos ⁃ Updated: Changed autoresizing masks throughout the application to improve compatibility with smaller iPhones screen sizes 4.1 04/26/2022 ⁃ Added: Midesophageal ascending aorta (long/short axis), upper esophageal aortic arch (long/short axis), transgastric right ventricular inflow, and a few transgastric tricuspid TEE videos ⁃ Updated: Table icons for References tab 4.0 03/22/2022 Added: Midesophageal 2 chamber TEE video Added: Aortic intramural hematoma, fungal endocarditis, subaortic membrane, and paravalvular leak videos Updated: Combined “References” and “About” tabbed menu bar content to clean up the interface Updated: Prosthetic valve image transparency 3.9 02/23/2022 Added: Gallbladder and spleen (left upper quadrant) abdominal POCUS videos Added: New video framework to allow videos to be expanded and viewed in landscape orientation Added: Thumbnail icons to menus Added: Option to click on valve images to expand Updated: User interface elements 3.8 01/11/2022 Added: Ocular POCUS exam Updated: About section to utilize picker view UI element Updated: Beginning Equations section under References 3.7 12/12/2021 - Added: Carcinoid tricuspid valve, diaphragm M-mode POCUS, and abnormal bubble study videos - Updated: TAPSE and tricuspid regurgitation images 3.6 10/06/2021 - Added: References section (with sections for equations and links, both still under development) - Added: Separate sections for “About” - Author, Changelog, Contribute, Disclaimer & Terms, and References - Added: Images for PI jet and RA minor axis - Updated: Tab bar and social media icons 3.5 09/08/2021
Previous Versions
Here you can find the changelog of EchoRef since it was posted on our website on 2021-12-14 00:33:07.
The latest version is 5.9 and it was updated on 2026-06-10 23:55:24. See below the changes in each version.
EchoRef version 5.9
Updated At: 2026-06-10
Changes: Version History Added: Global search function (magnifying glass in top right)
Added: LV thrombus POCUS case
Added: On-X mitral valve with stuck leaflet and mitral PVL plug 3D TEE videos
Added: Calculators for aortic pulsatility index (API) and Wilkins Score
Updated: Small user interface tweaks, codebase optimizations 5.9 May 19 Added: Calculators for Aortic Valve Area (Continuity), Stroke Volume & CO (LVOT), E/e′ Ratio, RVSP Estimate, Bernoulli Gradient, A–a Gradient
Updated: Calculator descriptions
Updated: Restructured cardiac equations section
Updated: Ultrasound physics and hemodynamic equations
Updated: User interface fixes throughout the app
Updated: Matomo SDK to 7.8.0 5.8 12/22/2025 Added: Hemodynamic and ultrasound equations
Added: Highlighting text when searching
Added: Slide to favorite or unfavorite calculations
Added: iPad interface
Update: Reduced boilerplate code
Update: Fixed native mitral stenosis values
Update: Restructured changelog scheme
Update: More subtle liquid glass for references 5.7 11/10/2025 Updated: Complete re-write of the codebase to transition from Storyboard to SwiftUI
Updated: Conform elements to iOS 26's liquid glass user interface 5.6 09/15/2025 ⁃ Added: Paravertebral nerve block video
⁃ Updated: Lossless compression of all media elements
⁃ Updated: Rewrote codebase to utilize single structured tuple-based arrays, eliminate unnecessary UI updates, streamline switch statements, etc.
- Overall, EchoTools' compressed binary size decreased from 208.8 MB (version 5.4) to 84 MB (version 5.5). 5.5 03/10/2025 ⁃ Added: Dilated coronary sinus (PLSVC) TEE video
⁃ Updated: Matomo framework, consistency across strings 5.4 06/08/2024 ⁃ Added: Navitor and Evolut-R TAVR valves
⁃ Added: Pulmonary velocity acceleration time (PVAT)
⁃ Added: Concentric LVH, aortic dissection flap fenestration, and quadricuspid aortic valve TEE videos
⁃ Updated: TAVR valve information 5.3 02/18/2024 ⁃ Added: Air bronchograms, cardiac standstill, and transhepatic IVC POCUS videos
⁃ Added: Septal myectomy and P2 restriction (type III) TEE videos
⁃ Updated: 3D TEE tricuspid valve video, 3-point compression ultrasound for lower extremity DVT video 5.2 12/31/2023 ⁃ Added: Proximal lower extremity DVT compression, left pleural effusion, and Tetralogy of Fallot POCUS videos
⁃ Added: Perceval sutureless aortic valve
⁃ Added: Edwards Mitris bioprosthetic mitral valve
⁃ Added: SVC collapsibility index 5.1 10/12/2023 - Added: 3D TEE mitral annular calcification (MAC), serratus plane block, spinal cord TEE, and type B dissection POCUS videos
⁃ Added: IVC distensibility index (DI)
⁃ Updated: IMH TEE video, D-Sign POCUS video, IVC POCUS video 5.0 06/06/2023 ⁃ Added: Femoral vascular, gastric, apical long-axis, apical two-chamber, apical five-chamber, and suprasternal aortic arch POCUS videos
⁃ Updated: POCUS subcostal TTE video 4.9 03/03/2023 - Added: LV diastology image for IVRT
- Added: Libman-Sacks endocarditis TEE video
- Added: Lung point and “D-sign” POCUS videos 4.8 01/08/2023 - Added: Calculators for regurgitant lesions (Valves → Native Valves → click top right calculator icon)
- Added: Ebstein’s anomaly POCUS video
- Added: Subclavian vein/artery vascular video
- Added: Mitral valve leaflet perforation and primum ASD TEE videos 4.7 11/21/2022 ⁃ Added: Medtronic Avalus aortic valve
⁃ Added: RVAD MCS TEE video
⁃ Added: Pecto-Intercostal Fascial Block (PIFB) video
⁃ Updated: Combined Links and Sources 4.6 10/24/2022 ⁃ Added: Autosomal dominant polycystic kidney disease (ADPKD) POCUS video
⁃ Updated: Fixed AVPlayerViewController controls on videos
⁃ Updated: Standardized auto-layout constraints
⁃ Updated: Updated deprecated code for the in-app Review system 4.5 10/10/2022 ⁃ Added: Prosthesis Evaluation section for Prosthetic Valves
⁃ Added: Matomo SDK Integration (removed Firebase)
⁃ Updated: Higher resolution icons with lossless compression
⁃ Updated: Popups for references
⁃ Updated: Transitioned from CocoaPods to Swift Package Manager 4.4 09/27/2022 ⁃ Added: Pop-up framework containing references for prosthetic valve sections
⁃ Updated: Aortic, mitral, and tricuspid bioprosthetic valve information 4.3 06/30/2022 - Added: Ross procedure and intracardiac clot TEE videos
- Added: Right heart catheterization (RHC) video
- Added: Adductor canal peripheral nerve block video
- Updated: Coronary angiography section
- Updated: Standardized video sizes
- Updated: UIButton to UIImageView elements under the Anatomy tab 4.2 06/06/2022 ⁃ Added: Coronary angiogram section (still under construction)
⁃ Added: Midesophageal left atrial appendage (LAA) and 5 chamber view videos
⁃ Updated: Changed autoresizing masks throughout the application to improve compatibility with smaller iPhones screen sizes 4.1 04/26/2022 ⁃ Added: Midesophageal ascending aorta (long/short axis), upper esophageal aortic arch (long/short axis), transgastric right ventricular inflow, and a few transgastric tricuspid TEE videos
⁃ Updated: Table icons for References tab 4.0 03/22/2022 Added: Midesophageal 2 chamber TEE video
Added: Aortic intramural hematoma, fungal endocarditis, subaortic membrane, and paravalvular leak videos
Updated: Combined “References” and “About” tabbed menu bar content to clean up the interface
Updated: Prosthetic valve image transparency 3.9 02/23/2022 Added: Gallbladder and spleen (left upper quadrant) abdominal POCUS videos
Added: New video framework to allow videos to be expanded and viewed in landscape orientation
Added: Thumbnail icons to menus
Added: Option to click on valve images to expand
Updated: User interface elements 3.8 01/11/2022 Added: Ocular POCUS exam
Updated: About section to utilize picker view UI element
Updated: Beginning Equations section under References 3.7 12/12/2021 - Added: Carcinoid tricuspid valve, diaphragm M-mode POCUS, and abnormal bubble study videos
- Updated: TAPSE and tricuspid regurgitation images 3.6 10/06/2021 - Added: References section (with sections for equations and links, both still under development)
- Added: Separate sections for “About” - Author, Changelog, Contribute, Disclaimer & Terms, and References
- Added: Images for PI jet and RA minor axis
- Updated: Tab bar and social media icons 3.5 09/08/2021
EchoRef version 5.8
Updated At: 2026-05-08
Changes: Version History Added: Calculators for Aortic Valve Area (Continuity), Stroke Volume & CO (LVOT), E/e′ Ratio, RVSP Estimate, Bernoulli Gradient, A–a Gradient
Updated: Calculator descriptions
Updated: Restructured cardiac equations section
Updated: Ultrasound physics and hemodynamic equations
Updated: User interface fixes throughout the app
Updated: Matomo SDK to 7.8.0 5.8 12/22/2025 Added: Hemodynamic and ultrasound equations
Added: Highlighting text when searching
Added: Slide to favorite or unfavorite calculations
Added: iPad interface
Update: Reduced boilerplate code
Update: Fixed native mitral stenosis values
Update: Restructured changelog scheme
Update: More subtle liquid glass for references 5.7 11/10/2025 Updated: Complete re-write of the codebase to transition from Storyboard to SwiftUI
Updated: Conform elements to iOS 26's liquid glass user interface 5.6 09/15/2025 ⁃ Added: Paravertebral nerve block video
⁃ Updated: Lossless compression of all media elements
⁃ Updated: Rewrote codebase to utilize single structured tuple-based arrays, eliminate unnecessary UI updates, streamline switch statements, etc.
- Overall, EchoTools' compressed binary size decreased from 208.8 MB (version 5.4) to 84 MB (version 5.5). 5.5 03/10/2025 ⁃ Added: Dilated coronary sinus (PLSVC) TEE video
⁃ Updated: Matomo framework, consistency across strings 5.4 06/08/2024 ⁃ Added: Navitor and Evolut-R TAVR valves
⁃ Added: Pulmonary velocity acceleration time (PVAT)
⁃ Added: Concentric LVH, aortic dissection flap fenestration, and quadricuspid aortic valve TEE videos
⁃ Updated: TAVR valve information 5.3 02/18/2024 ⁃ Added: Air bronchograms, cardiac standstill, and transhepatic IVC POCUS videos
⁃ Added: Septal myectomy and P2 restriction (type III) TEE videos
⁃ Updated: 3D TEE tricuspid valve video, 3-point compression ultrasound for lower extremity DVT video 5.2 12/31/2023 ⁃ Added: Proximal lower extremity DVT compression, left pleural effusion, and Tetralogy of Fallot POCUS videos
⁃ Added: Perceval sutureless aortic valve
⁃ Added: Edwards Mitris bioprosthetic mitral valve
⁃ Added: SVC collapsibility index 5.1 10/12/2023 - Added: 3D TEE mitral annular calcification (MAC), serratus plane block, spinal cord TEE, and type B dissection POCUS videos
⁃ Added: IVC distensibility index (DI)
⁃ Updated: IMH TEE video, D-Sign POCUS video, IVC POCUS video 5.0 06/06/2023 ⁃ Added: Femoral vascular, gastric, apical long-axis, apical two-chamber, apical five-chamber, and suprasternal aortic arch POCUS videos
⁃ Updated: POCUS subcostal TTE video 4.9 03/03/2023 - Added: LV diastology image for IVRT
- Added: Libman-Sacks endocarditis TEE video
- Added: Lung point and “D-sign” POCUS videos 4.8 01/08/2023 - Added: Calculators for regurgitant lesions (Valves → Native Valves → click top right calculator icon)
- Added: Ebstein’s anomaly POCUS video
- Added: Subclavian vein/artery vascular video
- Added: Mitral valve leaflet perforation and primum ASD TEE videos 4.7 11/21/2022 ⁃ Added: Medtronic Avalus aortic valve
⁃ Added: RVAD MCS TEE video
⁃ Added: Pecto-Intercostal Fascial Block (PIFB) video
⁃ Updated: Combined Links and Sources 4.6 10/24/2022 ⁃ Added: Autosomal dominant polycystic kidney disease (ADPKD) POCUS video
⁃ Updated: Fixed AVPlayerViewController controls on videos
⁃ Updated: Standardized auto-layout constraints
⁃ Updated: Updated deprecated code for the in-app Review system 4.5 10/10/2022 ⁃ Added: Prosthesis Evaluation section for Prosthetic Valves
⁃ Added: Matomo SDK Integration (removed Firebase)
⁃ Updated: Higher resolution icons with lossless compression
⁃ Updated: Popups for references
⁃ Updated: Transitioned from CocoaPods to Swift Package Manager 4.4 09/27/2022 ⁃ Added: Pop-up framework containing references for prosthetic valve sections
⁃ Updated: Aortic, mitral, and tricuspid bioprosthetic valve information 4.3 06/30/2022 - Added: Ross procedure and intracardiac clot TEE videos
- Added: Right heart catheterization (RHC) video
- Added: Adductor canal peripheral nerve block video
- Updated: Coronary angiography section
- Updated: Standardized video sizes
- Updated: UIButton to UIImageView elements under the Anatomy tab 4.2 06/06/2022 ⁃ Added: Coronary angiogram section (still under construction)
⁃ Added: Midesophageal left atrial appendage (LAA) and 5 chamber view videos
⁃ Updated: Changed autoresizing masks throughout the application to improve compatibility with smaller iPhones screen sizes 4.1 04/26/2022 ⁃ Added: Midesophageal ascending aorta (long/short axis), upper esophageal aortic arch (long/short axis), transgastric right ventricular inflow, and a few transgastric tricuspid TEE videos
⁃ Updated: Table icons for References tab 4.0 03/22/2022 Added: Midesophageal 2 chamber TEE video
Added: Aortic intramural hematoma, fungal endocarditis, subaortic membrane, and paravalvular leak videos
Updated: Combined “References” and “About” tabbed menu bar content to clean up the interface
Updated: Prosthetic valve image transparency 3.9 02/23/2022 Added: Gallbladder and spleen (left upper quadrant) abdominal POCUS videos
Added: New video framework to allow videos to be expanded and viewed in landscape orientation
Added: Thumbnail icons to menus
Added: Option to click on valve images to expand
Updated: User interface elements 3.8 01/11/2022 Added: Ocular POCUS exam
Updated: About section to utilize picker view UI element
Updated: Beginning Equations section under References 3.7 12/12/2021 - Added: Carcinoid tricuspid valve, diaphragm M-mode POCUS, and abnormal bubble study videos
- Updated: TAPSE and tricuspid regurgitation images 3.6 10/06/2021 - Added: References section (with sections for equations and links, both still under development)
- Added: Separate sections for “About” - Author, Changelog, Contribute, Disclaimer & Terms, and References
- Added: Images for PI jet and RA minor axis
- Updated: Tab bar and social media icons 3.5 09/08/2021 - Added: Initial dark mode framework
- Added: IJ clot and color 3D GlassVue aortic valve videos 3.4 07/24/2021
EchoRef version 5.8
Updated At: 2025-12-22
Changes: Added: Calculators for Aortic Valve Area (Continuity), Stroke Volume & CO (LVOT), E/e′ Ratio, RVSP Estimate, Bernoulli Gradient, A–a Gradient
Updated: Calculator descriptions
Updated: Restructured cardiac equations section
Updated: Ultrasound physics and hemodynamic equations
Updated: User interface fixes throughout the app
Updated: Matomo SDK to 7.8.0
EchoRef version 5.6
Updated At: 2025-09-15
Changes: Sep 15, 2025
Version 5.6
Updated: Complete re-write of the codebase to transition from Storyboard to SwiftUI
Updated: Conform elements to iOS 26's liquid glass user interface
EchoRef version 5.5
Updated At: 2025-03-10
Changes: Mar 10, 2025
Version 5.5
⁃ Added: Paravertebral nerve block video
⁃ Updated: Lossless compression of all media elements
⁃ Updated: Rewrote codebase to utilize single structured tuple-based arrays, eliminate unnecessary UI updates, streamline switch statements, etc.
- Overall, EchoTools' compressed binary size decreased from 208.8 MB (version 5.4) to 84 MB (version 5.5).
EchoRef version 5.4
Updated At: 2024-06-08
Changes: Jun 8, 2024
Version 5.4
⁃ Added: Dilated coronary sinus (PLSVC) TEE video
⁃ Updated: Matomo framework, consistency across strings
EchoRef version 5.3
Updated At: 2024-02-18
Changes: Feb 18, 2024
Version 5.3
⁃ Added: Navitor and Evolut-R TAVR valves
⁃ Added: Pulmonary velocity acceleration time (PVAT)
⁃ Added: Concentric LVH, aortic dissection flap fenestration, and quadricuspid aortic valve TEE videos
⁃ Updated: TAVR valve information
EchoRef version 5.2
Updated At: 2023-12-31
Changes: Dec 31, 2023
Version 5.2
⁃ Added: Air bronchograms, cardiac standstill, and transhepatic IVC POCUS videos
⁃ Added: Septal myectomy and P2 restriction (type III) TEE videos
⁃ Updated: 3D TEE tricuspid valve video, 3-point compression ultrasound for lower extremity DVT video
EchoRef version 5.1
Updated At: 2023-10-12
Changes: Oct 12, 2023
Version 5.1
⁃ Added: Proximal lower extremity DVT compression, left pleural effusion, and Tetralogy of Fallot POCUS videos
⁃ Added: Perceval sutureless aortic valve
⁃ Added: Edwards Mitris bioprosthetic mitral valve
⁃ Added: SVC collapsibility index
EchoRef version 5.0
Updated At: 2023-06-06
Changes: Jun 6, 2023
Version 5.0
- Added: 3D TEE mitral annular calcification (MAC), serratus plane block, spinal cord TEE, and type B dissection POCUS videos
⁃ Added: IVC distensibility index (DI)
⁃ Updated: IMH TEE video, D-Sign POCUS video, IVC POCUS video
Disclaimer
Official App Store Link
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