Comprehensive Transthoracic Echocardiogram TTE Flashcards
Using ASE Guidelines and DeWitt Echocardiography
According to ASE Guidelines list 2 parameters for measuring the IVS and posterior wall in the parasternal long axis view.
-At End diastole or peak R wave,
-largest volume,
-interface of compacted myocardium excluding other inserting structures, -just below MV leaflet tips, same time
-level of LVED dimension, only compacted tissue measured.
How does one determine which pulmonic valve cusp is the right posterior cusp in the RVOT view?
The right posterior cusp of the PV is easily identified because it is the cusp adjacent to the aortic valve.
Define Perpendicular
a 90° angle or T
Identify which image a sonographer uses to estimate the right atrial pressure. Then explain what finding would indicate a right atrial pressure of 8mmHg.
Using the subcostal view the sonographer would assess the IVC. There are two parameters: IVC size and IVC collapsibility.
If one of these is abnormal and the other is normal, the RAP is estimated at 8mmHg.
Describe the method to measure the pulmonary artery from the parasternal short axis view.
Midway between the PV and the PA bifurcation using and inner edge to inner edge technique at end diastole.
When measuring the left ventricular posterior wall care must me made to not include which structure and why?
The MV apparatus including chordae tendinae and papillary muscle.
Describe the method for measuring leading-edge to leading-edge.
The measurement begins at the first depth where the structure is seen and continue until the last depth the structure is seen.
In the parasternal long axis view, the __________ is located within the myocardium, while the __________ is posterior to the left atrium and a separate structure.
coronary sinus, descending AO
The posterior mitral valve leaflet is shaded in which color?
yellow
Define Compacted Myocardium.
The border between the anechoic blood filled chamber and the myocardium once it is dense, excluding any trabeculations.
In the PSAX view at the base, what chamber is the most anterior visualized?
RV
At what point in the cardiac cycle should the aorta be measure?
End Diastole
In the right ventricular inflow view, the _________ lies between the coronary sinus and the inferior vena cava.
eustachian valve
The left coronary cusp is outlined in what color?
Purple
Which measurement is made using inner-edge to inner-edge technique in the PLAX window?
LVOT, Annulus
Describe laminar flow patters
smooth, organized with parabolic velocity profile (slower flow near walls, faster in the center)
Describe turbulent flow
irregular, chaotic with irregular velocities due to the disordered movement, random directions
What view is the RV basal diameter in (for measuring purposes)?
Apical RV focus
how do you measure the RV basal diameter in Apical RV focused view?
end diastole, near TV annulus, compacted myocardium to compacted myocardium from septal wall to lateral wall of the RV
What is the normal measurement for the RV basal diameter in women?
3.98cm (greater than that is dilated)
What view is the IVS (for measuring purposes)?
PLAX LV focus view
How do you measure the IVS in PLAX?
end diastole, leading edge to leading edge, at the interface where the RV cavity meets compacted IVS & where the IVS meets the LV cavity
What is the normal measurement for the IVS in women?
6-9mm
In what view is the LVID (left ventricular internal dimension) for measuring purposes?
PLAX
How do you measure the LVID (left ventricular internal dimension) in PLAX?
end diastole & end systole, leading edge to leading edge, compacted myocardium of the IVS to the compacted myocardium of the posterior wall, just below the MV leaflets
What is the normal measurement for the LVID in women? (end diastole)
LVIDd 38-52mm
What is the normal measurement for the LVID in women? (end systole)
LVIDs 22-35mm
In what view is the LVPW? (left ventricle posterior wall) for measuring purposes?
PLAX
How do you measure the LVPW in PLAX?
end diastole, leading edge to leading edge, compacted posterior wall of the LV cavity to the LVPW to the pericardial interface
What is the normal measurement of the LVPW in women?
27-38mm
In what view is the LVOT (for measuring purposes)?
PLAX zoomed/LVOT focused
How do you measure the LVOT in PLAX?
mid-systole, inner to inner, approx. 3-10mm from valve, compacted myocardium VS to anterior MV leaflet
What is the normal measurement for the LVOT in women?
18-22mm
In what view is the AO root (for measuring purposes)?
PLAX zoomed LVOT focused
How do you measure the AO root in PLAX?
mid-systole, inner to inner, right coronary & non coronary leaflet insertion points at maximal opening of the valve.
What is the normal measurement of the AO root in women?
23 +- 2mm
In what view is the ascending aorta (for measuring purposes)?
PLAX
ignore
In what view is the LA (for measuring purposes?)
PLAX
How do you measure the LA in PLAX?
end diastole, leading edge to leading edge, at the level of the SoVA of AO root to PW
What is the normal measurement of the LA in women?
27-38mm
In what view is the ascending AO (for measuring purposes)?
PLAX
How do you measure the ascending AO in PLAX?
end diastole, leading edge to leading edge, at the largest dimension above the AO sinus
What is the normal measurement of the ascending AO in women?
27 +- 4mm
What are the 3 equations for stroke volume (SV)?
1) SV = EDV-ESV
2) SV (cm ^3) = VTI (cm) x CSA (cm^2)
3) SV (mL) = Pi r ^2 (cm^2) x VTI (cm)
Define stroke volume (SV)
The volume of blood ejected by the LV during each contraction
What are some clinical applications in which you would use an equation for SV?
-valvular regurgitation
-post physiologic/pharmacologic interventions
-pulmonary to systemic blood flow for patients w/ intracardiac shunts
-cardiac function
-cardiac output
-LV function & volume
-valvular disease
Define the Velocity Pressure Relationship - Simplified Bernoulli Equation
Describes the relationship between the velocity of blood flow & the pressure gradient across a stenotic or regurgitant valve. An increase in velocity of a fluid results in a decrease in pressure.
What are some clinical applications for the velocity pressure relationship - simplified Bernoulli Equation?
-valvular stenosis
-valvular regurgitation
-artery pressures (pulmonary)
-septal defect
What is the Pressure Relationship - Simplified Bernoulli Equation?
ΔP = 4v²
ΔP = 1/2ρv² where ΔP is the pressure difference, ρ is the fluid density, and v is the velocity difference between two points in the flow
Define Preload
AKA end-diastolic pressure, the degree of stretch the ventricular myocytes stretch at the end of diastole.
What are some circumstances that influence Preload?
-venous return
-diastolic dysfunction
-mitral stenosis
-Anything that prevents blood from easily filling the ventricle.
Define Afterload
the resistance the heart must pump against in order to eject blood out of the ventricles
What are some circumstances that influence Afterload?
-valve hypertension
-valve stenosis
Using a PW Doppler to measure the flow area of the LVOT what view do I need to be in?
A4C or A5C
What normal flow pattern is this and in what view?
the flow pattern of a normal LVOT in A5C
What is the normal velocity range for the LVOT in A5C for a PW measurement?
0.7 - 1.1m/s
Using a PW Doppler to measure the flow area of the ascending AO forward flow through the AO valve, what view do I need to be in?
SSN through LV Apex
What normal flow pattern is this and in what view?
the ascending AO forward flow through the AOV, SSN-LV Apex view
What is the normal velocity range for the ascending AO forward flow through the AOV for a PW measurement?
(less than) < 2m/s
Using a PW Doppler to measure the flow area of the descending AO Thoracic, what view do I need to be in?
SSN, Subcostal
What normal flow pattern is this and in what view?
descending AO Thoracic, SSN/Subcostal
What is the normal velocity range for the descending AO Thoracic for a PW measurement?
100-140cm/sec
Using a PW Doppler to measure the flow area of the descending AO proximal abdominal, what view do I need to be in?
SSN/subcostal
What normal flow pattern is this and in what view?
descending AO proximal abdominal
SSN/subcostal
What is the normal velocity range for the descending AO proximal abdominal for a PW measurement?
60 - 100cm/sec
Using a PW Doppler to measure the flow area of the LV Inflow (mitral) what view do I need to be in?
A3C, A4C, APICAL LAX
What normal flow pattern is this and in what view?
LV inflow (mitral), A4C
What’s the E Wave characteristics for LV Inflow of the A4C view?
-early diastole
-passive filling of the LV
-usually 1cm/sec
What’s the A Wave characteristics for LV Inflow of the A4C view?
-flow from atrial contraction
-varies by many conditions
Using a PW Doppler to measure the flow area of the RVOT & what view do I need to be in?
PLAX, PSAX (AV level), SUB Short-Axis
What normal flow pattern is this and in what view?
RVOT, PSAX
What is the normal velocity range for the RVOT for a PW measurement?
0.5 - 1.3m/s
Using a PW Doppler to measure the flow area of the RVIT Tricuspid TV Inflow & TV regurgitation what view do I need to be in?
A3C
What normal flow pattern is this and in what view?
RVIT Tricuspid TV Inflow & TV regurgitation, A3C
What is the normal velocity range for the RVIT Tricuspid TV Inflow & TV regurgitation for a PW measurement?
0.3 - 0.7m/s
Using a PW Doppler to measure the flow area of the LA Inflow Pulmonary Valve, what view do I need to be in?
A4C
What normal flow pattern is this and in what view?
LA Inflow Pulmonary Valve, A4C
What is the normal velocity range for the LA Inflow Pulmonary Valve for a PW measurement?
0.5m/s
Using a PW Doppler to measure the flow area of the RA Inflow (Hepatic veins) what view do I need to be in?
SSN/Subcostal
What normal flow pattern is this and in what view?
RA Inflow (Hepatic veins), Subcostal
What is the key factor to obtain accurate color flow doppler and spectral doppler?
Making sure your angle is 0 degrees/ parallel to flow
What is the appropriate color Nyquist limit setting for Adult Echos?
60cm/sec
What is the appropriate sweep speed setting for measuring elements of time on the spectral doppler graph?
100mm/sec
What normal flow pattern is this and in what view?
RVOT, PSAX
List some RV characteristics
-thin
-most arteries chamber
-moderator band
-complex crescent shape
What is the wall thickness of the RV?
1-5mm
When do you measure RVOT?
end-diastole
When do you measure the IVS?
end-diastole
Which valve has an E & A wave?
Mitral
When does the E & A wave happen?
during systole
What vessel has an S,D, & A Wave?
Pulmonary valve
What is the P Wave?
the atrial kick
What 2 structures have similar flow?
Pulmonary valve & IVC
Why is the tricuspid the biggest?
because it works at lower pressure
Which valve is the biggest?
Tricuspid
What 3 things drain into the RA?
-coronary sinus
-IVC
-SVC
What 4 things drain into the LA?
-right 7 left pulmonary valves
-Superior & inferior pulmonary valves
What is an indication that the IVC is dilated?
RA pressure is too high
What does ET mean and when does it happen?
ejection time, during systole
When do you measure the AO diameter?
end-diastole
When in A2C what do you NOT want to see?
the RV
How do you get to A2C?
90 degrees from A4C then turn another 30 degrees
What does the arrow reveal?
Moderator band
What does the arrow reveal?
LV false tendon
In the PLAX LV what 12 things do we document?
-RV wall
-RVOT prox
-IVS
-LVIDd
-LVIDs
-PWT
-LA
-LVOT
-AOV annulus
-SoVa
-Sinotubular junction
-Prox. AAO
What 8 structures in the PLAX LV do we measure at End-diastole?
-RV wall
-RVOT prox
-IVS
-LVIDd
-PWT
-SoVa
-Sinotubular Junction
-Prox. AAO
What 2 structures in the PLAX LV do we measure at End-systole?
-LVIDs
-LA
What 2 structures in the PLAX LV do we measure mid-systole?
-LVOT
-AOV annulus
What is LVEF?
a measurement of how much blood is pumped out of the LV chamber per contraction or heartbeat
What is FS?
a % of the LV size reduction from diastole to systole as measure from the basal segments via M-mode or 2D linear measurements
What is the best method of measurement to acquire the LV volume and LVEF?
2D biplane method of disk summation
Describe the RV
-thin
-squeezes concentrically during systole
-smaller
-more trabeculated
-complex crescent (triangular) shape
What is the most anterior chamber?
The RV
What is the RVOT prox normal range?
20 - 30mm
RVOT can be measure in what 2 planes?
PLAX & PSAX base
What 2 structures are 1:1 ratio in thickness?
the IVS & LVPW
What 2 structures are thicker than the RV wall?
the IVS & LVPW
When do you acquire the IVS dimension in PLAX?
end-diastole
When do you acquire the PWT (posterior wall thickness) in PLAX?
end-diastole
what is the normal range in both male and female for the IVS & PWT?
females: 6 - 9mm
males: 6 - 10mm
What is the largest chamber?
the LV
Where is the LV located?
posterior and lateral to the RV
Describe the LV
-longer than RV
-less trabeculated than RV
-may possess false tendon
-ellipsoid in shape
What are the normal ranges for LV dimensions for end-diastole?
females: 38 - 52mm
males: 42 - 58mm
What are the normal ranges for the LV dimensions for end-systole?
females: 22 - 35mm
males: 25 - 40mm
What does the LVOT do?
allows laminar flow from the LV out to the aorta
What is the normal range for the LVOT diameter?
18 - 22mm
How far do you measure the LVOT from the aortic orifice?
5 - 10mm
Where do you measure the LVOT?
inner edge to inner edge of the septal endocardium to the inner edge of the anterior mitral valve leaflet, proximal and parallel to the plane of the AOV
What is the AMVL (anterior mitral valve leaflet) part of?
it is continuous with the posterior wall oof the aorta
Which is more liable with an unrestricted opening? The AMVL or the PMVL?
AMVL
Does the MV prolapse beyond the annular place into the LA?
no
What is the most posterior chamber?
the LA
Which chamber is the reservoir that receives pulmonary Venus return?
the LA
Which chamber is a contractile pump?
the LA
Is the LA gender dependent?
yes
In PLAX when do you acquire the LA linear dimension?
end-systole
Where do you acquire the LA linear dimensions? (how do you measure)
perpendicular to the AO root, at the level of the AO sinuses using the leading edge to leading edge technique
Does the PLAX provide the most accurate assessment of the LA size?
no
What’s another method that could be used to assess the LA size?
LAVi (LA volume index)
What 2 structures can be seen within the myocardium of the SAX view?
the coronary sinus & DAO
Where is the CS and DAO located in the SAX view?
posterior to the left atrioventricular junction (LA-LV junction)
When does the CS diameter narrow?
during atrial contraction
In what other planes can the CS be visualized?
the A4C & A2C
What is the arrow pointing to?
AMVL continuity
In the PLAX plane what 2 AO cusps are visualized?
the RCC & NCC
Which AO cusp is not visualized in the PLAX view?
the LCC
Are the LVOT and AOV annulus systolic or diastolic measurements?
systolic
Do you acquire the AOV annulus during end diastole?
no
Which technique do you use to measure the AOV annulus diameter in PLAX?
Inner edge to inner edge
Which technique do you use to measure the SoVa, Sinotubular junction & Prox. AAO?
leading edge to leading edge
When do you measure the SoVa, Sinotubular junction & Prox. AAO?
end-diastole
Where do you point the beam to get the LAX RVIT?
inferior
Where are the anterior and posterior tricuspid valves?
between RA & RV
Which TV leaflet is not visualized in the PLAX view of the RVIT?
the medial/septal TV
What is a normal embryonic remnant located at the junction of the IVC and RA?
the eustachian valve
What network is a normal embryonic remnant that originates from either the eustachian valve or the basin valve and may extend too the fossa ovalis?
the Chiari network
Is it normal to have a trace to mild TR?
yes
Where do you place the gate to acquire TV inflow with the PWD?
between the tips of the TV leaflets in the RVIT
Which wave form is this? is it PW or CW?
TV Inflow, PW
Which wave form is this? is it PW or CW?
TV & Peak TRV, CW
What is used to estimate the RVSP (right ventricular systolic pressure?) & the degree of PH (pulmonary hypertension)?
the peak TRV (TR velocity) & mean RA pressure (RAP)
What = SPAP (systolic pulmonary artery pressure)?
RVSP (right ventricular systolic pressure)
What is RVSP dependent on?
-age
-weight
-stroke vol.
-BP
How do you calculate the RV-RA PG?
using the Bernoulli equation 4V^2 (where V) = peak TRV
What does the RAP equal to in patients with a central venous line?
central venous pressure (CVP)
What method is used when an increased RAP leads to a dilated IVC w/ diminished inspiratory collapse?
3/8/15 method
What is a normal IVC & collapse % upon inspiration/sniff test?
IVC < 2.1cm & collapses > 50% upon inspiration/sniff test
What is considered a normal RVSP for the PH scale?
18 - 25mmHg
Where do you aim the beam to get the LAX RVOT?
Superior & lateral (toward patient’s L shoulder)
How would you describe the ROVT anterior wall?
thin
What’s another name for the conus arteriosus?
Infundibulum
How would you describe the infundibulum?
-smooth-walled
-no trabeculations
-funnel shaped
Where is the infundibulum located?
part of the RVOT at the entrance of the pulmonary trunk
How would you describe the PV cusps?
thin, delicate, pliable
Which PV cusp is not visualized from the LAX view of the RVOT?
the anterior PV cusp
Which is smaller the AO for the PA?
PA
Where does the main Pulmonary Artery splits? and into what?
at the PA bifurcation into the R & L PA
Where do you measure to diameter of the PA in the LAX view?
midway between the PV & PA bifurcation
What is this M-mode showing?
PV
When doing an M-mode of the PV does it show 1 or 2 cusps?
1
What does this show?
a normal PV a-wave
What does this show?
Absent PV a-wave & flying W which means PH
What does the arrow show?
LA Appendage
What plane and is it diastole or systole?
PSAX, systole
Label including the *
- Anteritor TV leaflet
- Medial TV leaflet
- AOV RCC
- AOV LCC
- AOV NCC
- Right posterior PV cusp
- Anterior PV cusp
* NCC is always adjacent to the IAS
When do you acquire BOTH the proximal and distal RVOT diameter?
end-diastole
What does this show and in what plane?
PSAX, Trileaflet AOV
Where does the IAS normally bow toward?
the RA
Why does the IAS bow toward the RA?
because the LAP (pressure) is slightly greater than the RAP
How do you acquire the SAX Basal/MV view?
angling the transducer more lateral/inferior towards the apex from the SAX base
What waveform is this and is it PW or CW?
PV & PR, CW
What Color Doppler is this of?
RVOT
What color doppler is this of?
RVIT
What color doppler is this of?
AOV
What does this show? In what view? Systole or Diastole?
MV leaflets, PSAX basal/MV view, systole
What does this show? In what plane? Systole or Diastole?
MV leaflets, PSAX basal/MV view, diastole
Label
- Anterior MV leaflet
- Posterior MV leaflet
- Basal Anteroseptal wall
- Basal Anterior wall
- Basal anterolateral wall
- Basal inferolateral wall
- Basal inferior wall
- Basal inferoseptal wall
What does this show? In what plane? Systole or Diastole?
PM, PSAX, mid systole
What does this show? In what plane?
Apex, PSAX
What is SALI an acronym for?
the LV walls
Septal
Anterior
Lateral
Inferior
Label
- anterior TV leaflet
- medial TV leaflet
- anterior MV leaflet
- posterior MV leaflet
- basal inferoseptal wall
- mid inferoseptal wall
- apical septal wall
- apical cap
- apical lateral wall
- mid anterolateral wall
- basal anterolateral wall
- IAS
- MV
- TV
- PV4
- IVS
Label
- basal inferior wall
- mid inferior wall
- apical inferior wall
- apical cap
- apical anterior wall
- mid anterior wall
- basal anterior wall
- LAA
- PV4
- DAO
what does TAPSE stand for?
Tricuspid
Annular
Plane
Systolic
Excursion
What does TAPSE provide?
a simple but good estimate of global RV systolic function
How does TAPSE measure?
measures the longitudinal systolic performance of the RV wall.
Is TAPSE angle dependent?
yes
What does this M-mode depict?
TAPSE
Where do you put the cursor to acquire TAPSE?
through the RV & RA through the lateral TV annulus, the cursor should be perpendicular to the annulus and parallel to the movement
What do you measure TAPSE on the M-mode image?
the peak systolic longitudinal motion of the TV annular motion from end diastole to end systole
What is different about the RV compared to the LV?
-RV chamber is no more than 2/3s the size of the LV
-has more trabeculations
-has a moderator band
What does this image show and in what window?
prominent moderator band, A4C
Do you need to compare RV size with LV size? if so, when?
yes, always
What does this image show? what window?
RV linear dimensions:
basal (blue)
mid (red)
longitudinal (yellow)
A4C RV focused
What is the normal range for the RAV (RA volume)?
females: 21 +- 6mL/m^2
males: 25 +- 7mL/m^2
When do you measure the RA single plane?
end-systole
What is the normal range for the RA area for single plane?
< 18cm^2
What does this image show?
Single-plane RAV-RA area (red) Major (yellow)
What does this image show?
RA area (red) major (yellow) minor (blue)
What is this equation and what is it used for?
single plane volume, ONLY for RA
What is the arrow showing?
ICD wire in RA
What is the arrow pointing at?
dilated CS
What does the LV form?
the apex
What is the Biplane Method of Disk?
measures the LVEF. provides an estimate of the LV volume through a process of dividing the cavity into multiple disks with equal height.
What is the number of disks determined (in the biplane method of disks)?
determined by the length of the cavity and the disk volumes
What are the disk volumes determined by (in the biplane method of disks)?
determined by the length and width of each disk
What does this image depict?
biplane method of disks
What does the blue and red depict?
EDV & ESV (blue) LV length (red)
Where do you acquire the LV dimensions for the biplane method of disks?
the calipers placed at the interface between the compacted (solid, homogenous wall separate from the trabeculated) and noncompacted myocardium
What is the equation for the LAVi (LA volume index)
LAVi = LAV/BSA
What is the equation for the LVEF%?
LVEF% = (EDV - ESV) / EDV x 100
What does this image show? is it PW or CW?
MV Inflow, PW
What does this image show? What kind of Doppler?
MV Annulus, Tissue Doppler Imaging (TDI)
What does this image show? is it PW or CW?
PV4, PW
What does this image show? Diastole or Systole? End?
A5C, end-systole
What does this image show? What window?
Zoom AOV & LVOT, A5C
When should you calculate peak velocity, mean PG, and AOV area (AVA)? (hint* A5C)
-suspected of AO stenosis
-if patient has undergone an AOV repair/replacement w/ a prosthetic valve
What is the normal range of the LVOT in the A5C?
0.8 - 1m/s
If LVOT peak velocity is > 2m/s what does this indicate?
LVOTO
If LVOTO is present what do you need to switch PW to and acquire?
CW and acquire the peak velocity and PG
What does this image show? What window?
LA, MV, LV, LVOT, AOV in A5C
What does this image show? What window?
Focus AOV & IVRT, A5C
What does this image show? PW or CW?
AOV, CW
What does this image show? PW or CW?
IVRT, CW
What does this image show? PW or CW?
AR & AS, CW
What does this image show? What window?
Gate LVOT, A5C
What does this image show? PW or CW?
LVOT, PW
What does this image show? PW or CW?
LVOTO, CW
What does the LAA act as?
a decompression chamber
What does the LAA decompression chamber do?
helps decrease LAP whenever elevated or during normal LV systole
What does this image depict? In what window? systole or diastole?
A2C, systole
What is the arrow showing, what window?
LAA & PV4 in A2C
What does this image show? What window?
DAO, A2C
How do you get to A2C?
rotate transducer ~60 - 90 degrees counter clockwise from the A4C
How do you get to A3C?
rotate transducer ~30 - 60 degrees counter clockwise from A2C
What’s another name for the A3C?
Apical LAX
What does this image show? What window? diastole or systole?
LA, MV, LV, LVOT, AOV, AO root, A3C, systole
What does this image show? What window?
LA, MV, LV, LVOT, AOV, AO root, A3C
Label
- basal inferolateral wall
- mid inferolateral wall
- apical lateral wall
- apical cap
- apical septal wall
- mid anteroseptal wall
- basal anteroseotal wall
Which direction do you angle the beam to get A3C RVIT?
medial and inferior from the A3C
What is the A3C useful for the RVIT?
it yields the optimal doppler angle and absolute peak TRV for the RVSP calculation
What does this image depict? In what window?
A3C, OFF-AXIS
What does this image depict? In what window?
RVIT, A3C
What does this image depict? In what window?
TR, A3C
What does this image show? PW or CW? from what window?
TV & PEAK TRV, A3C, CW
Why are subcostal views vital to the pediatric and adult echos exam?
because they provide visualization anterior and posterior to the heart and lay out the relationship between the heart and surrounding structures
What does this image depict? In what window?
RV wall thickness, SUB 4C
What does this image depict? In what window?
RV, Sub 4C
What does this image depict? In what window?
lipomatous hypertrophy of the IAS (LHIS)
What does the arrow show? In what window?
Chiari network, sub 4c
lipomatous hypertrophy of the IAS (LHIS)?
a fatty infiltration of the IAS sparring the fossa ovalis giving it s dumb-bell shape
How do you get to a Sub SAX Window?
rotate transducer ~60 - 90 counter clockwise from the SUB 4C
What’s another name for Sub SAX?
Subcostal short axis
What views from the SUB SAX are similar to the left PSAX?
- the base
- MV
- LV
What window is occasionally the only window with quality images particularly with patients with Chronic Obstructive Pulmonary Disease? (COPD)
SUB SAX
What angle does the transducer need to go in order to get the subcostal inferior vena cava?
more medial from the SUB SAX BASE
In addition to the IVC who other structures can be seen from the SUB IVC view?
liver
hepatic vein
SVC
RVIT
What view would I use to check the hepatic vein for dilation?
SUB IVC
What does the “sniff test” do?
helps visualize the collapse of the IVC by estimating the mean RAP
What structure should be acquired always but especially those with abdominal pain?
the DAO
What does the DAO need to be evaluated?
to see if there is any indication of AO dissectioon
What should the general diameter of the DAO be?
< 3cm
What structures can be view in the SUPRA LAX window?
-AAO
-AO arch with branches
-thoracic DAO
What is the normal velocity of the AAO?
< 2m/s
What is the normal velocity of the thoracic DAO?
< 2m/s
What structures can be seen in the SUPRA SAX window?
-AO arch
-RPA
-SVC
-L/R innominate vein
-PV4
