How to echo Flashcards
What equipment do we ned for echocardiography? (3)
- Cut out table
- Chair / stool
–correct height so you are comfortable!
•Correct probe choice for your patient
What 3 things are involved in the prep?
•Clipping
–Apex beat on both sides
–Midline in the most cranial abdomen
- Spirit
- Gel
What probe size do we use for:
- Cats/small dog
- Medium dog
- Large dog
- 7.5
- 5
- 2.5-3.5
What view is this?
Right parasternal long axis 4 chamber
What view?
Right parasternal long axis views
What view?
Right parasternal long axis (RPLA)
4 chamber view
Where do we go from the RPLA? Like how do we move to get the next view
- rotate the probe anticlockwise 20 degrees
- lift the wrist so the probe is angled more cranially
What view and what does the arrow show?
Right parasternal LA 5 chamber view
(aorta)
What is involved in the subjective assessment of the RPLA? (3)
–movement ventricles
–chamber dimensions
–valve morphology and motion
What is involved in the quantitative assessment of the RPLA? (2)
–left atrium diameter
–left ventricle
- wall thickness
- diameter / volume
What does this show?
LA size
What does this show?
LV dimensions
How do we get to the RSPA from RPLA?
From RPLA 4 chamber view turn thumb to bum and turn the probe 90o.
Tilt probe +/- slide probe up chest wall as necessary.
What view?
Right parasternal short axis views
What view is this and at what level?
Right parasternal short axis view
LV @ pap mm level
What view is this and at what level?
Right parasternal short axis @ chorda tendinae
What view and level is this?
Right parasternal short axis @ chorda tendinae
What view and level is this?
Right parasternal short axis @ mitral valve
What view and level is this?
Right parasternal short axis @ mitral valve
What view of this?
Right parasternal short axis views
What view and level is this?
Right parasternal short axis @ aortic valve
What view and level is this?
Right parasternal short axis @ aortic valve
Right parasternal short axis views
What do we subjectively assess? (3)
–movement ventricles
–chamber dimensions
–valve morphology and motion
Right parasternal short axis views
What do we quantitavely assess? (4)
–Left atrium diameter
–Aorta diameter
–Pulmonary artery diameter
–M-mode
- EPSS
- LV
What is the issue?
LA is big
What does M mode tell us?
What is happening along this line with time!
What is this?
M-Mode from RPSA view
Which modes can we make measurements in? (3)
•2DE, MM and Doppler studies
What should the LV:LA be in the RPLA view?
1:1
Which mode do we use in dogs and cats for measuring chamber size? What increases the accuracy?
- Usually use M-mode in dogs
- In cats 2DE sometimes better due to asymmetric hypertrophy
- If can’t get a good MM then using 2DE imaging is better than poor M-mode
- An ECG makes measuring more accurate
How do you measure using M mode?
Where should the cursor be?
- Always start from a right parasternal long axis view with a horizontal IVS
- Turn 90 degrees ‘thumb to bum’
- Ensure the LV is ROUND
- Ensure that the cursor is exactly in between the papillary muscles i.e. Transecting the LV into two equal halves
What % of dogs lie outside of measurement reference ranges?
5%
What can cause artefacts? (4)
- Usually poor contact
- Side-lobe artefact
- Reverberation artefact = mirror image
- Breathing
