Echocardiography (echo) is an intimidating discipline that many clinicians avoid assuming it is too complex to acquire and interpret images. It is true that a comprehensive, ‘formal’ study is time consuming and requires a significant degree of expertise and training to be performed accurately. However, focused echo differs to departmental studies as only a few images need to be acquired to answer key clinical questions (Table 2.1). This reduces the inter-user variability, subjective bias and transforms echo into a diagnostic tool that is simple, accessible and easier to achieve the required competence and confidence.