A4C 2D Protocol Flashcards
apical window may be anywhere from the _______ line to the _______ line (___/___ intercostal space)
anterior axillary
posterior axillary
4/5
PMI
point of maximal impulse
(feeling to find heart apex; never actually used)
apical probe points where on clock
2-3:00
if you are too medial the ____ will be sliced off; this is called ______
apex
foreshortening
what else do we enter for sait echo protocol for patient info
height/weight
biplane measurements means
from 2 different planes of imaging
2 biplane measurements in apical views
LA volume
Simpson’s EF (LV) (ejection fraction)
what is the method of disks
disks places throughout traced volumes at 5mm intervals
LA volume measurement is taken during (heart cycle)
end-systole (LA is the largest)
what two planes is LA volume taken in
A4C and A2C
LAVI
LA volume index
volume divided by patients’ BSA
LA volume calculation
Avg LA Vol = (A4C LA Vol + A2C LA Vol)/2
LAVI calculation
LA vol/BSA
LA trace from ____ side of MV ____ and around to the ____
medial
annulus
lateral
(LA trace)
align the vertical axis from the _____ of the MV annular diameter to the middle of the _____ of the LA
middle
roof
length of LA must be close in A4C and A2C; within ____ mm
5
LA volume index normal, mildly abnormal, moderately abnormal, and severely abnormal
less than or equal to 34
35-41
42-48
more than or equal to 48
Trace LV when for Simpson’s EF and what views
at end-diastole and again at end systole in A4C and A2C
is the pap muscle included in LV volume
yes
Simpson’s EF normal for male and female
M 52-72
F 54-74
Simpson’s EF severe
less than 30
LV EDV (M/F)
M ≤ 128
F ≤ 91
LV ESV (M/F)
M ≤ 51
F ≤ 35
in A4C 2D, if you see AV you are angled too ____
anteriorly
in A4C 2D, if you dont see enough LA, you are angled too _____
posteriorly
A4C 2D protocol images (9)
A4C 2D
A4C LA volume trace
A4C reduced depth
A4C LV trace (Simpson’s) end diastole
A4C LV trace (Simpson’s) end systole
A4C RV base dimension
A4C RA Vol Index
A4C Rt focus view
A4C RV TAPSE (m-mode)
Normal LAVI
less than or equal to 34 ml/m^2
what is the reason for A4C reduced depth
optimize LV walls to asses wall motion
A4C LV trace (Simpson’s) is done from what depth (both end diastole and end systole)
reduced depth
what do you have to remember when taking the EDV and ESV A4C LV trace (Simpson’s)
always take both on the same beat
normal EF of heart (Simpson’s) vs reduced EF
> 55%
vs
<55%
when do you measure RV base dimension and where
end diastole
basal 1/3 portion of RV (just inferior to TV leaflets)
RVIDd
RV internal dimension end-diastole
Normal RVIDd base
≤41mm/4.1cm
normal RVIDd mid
<35mm/3.5cm (don’t take this photo unless enlarged)
RV in the A4C views should be _____ the size of the LV
less than 2/3
RAVI
right atrium volume index
Normal RAVI (F/M)
F ≤27 mL/m^2
M ≤32 mL/m^2
to get from A4C to A4C Rt focus view how do you move
more laterally to use LV as window for RV
A4C RV TAPSE (Stands for)
tricuspid annular plane systolic excursion
