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The use of echocardiography in the management of the unstable patient is not new.Hallmarks of the perioperative period include fluid shifts and constantly changing hemodynamics-both of which are very easily assessed using either form of echocardiography: transthoracic (TTE) or transesophageal (TEE).This lecture aims to provide the anesthesiologist a broad overview of some of the applications of echocardiography, (primarily transesophageal) in the assessment of the hemodynamically unstable patient.The eehocardiographic features of some of the most common causes of hypotension in the perioperative period will be reviewed.