Module 14 : Subcostal and Suprasternal Echo Flashcards
subcostal 4CH structures - right heart
- RV
- RV inferior wall
- TV
+ posterior and septal - IVS
- RA
- IAS
subcostal 4CH structures - left heart
- LV
- IVS
- MV
- LA
which way to angle to get RVOT/PV/PA
- anterior
what is best view to see IAS defect
- subcostal 4 chamber
- blood flows toward probe
what can we measure better in subcostal 4 than others
- IVS thickness
- using axial resolution
normal color of IAS
- no blood flow shunting across septum
- zoom to see holes better
what 2 things always done on IAS picture
- zoom
- lower scale to 40cm/s
SVC flow
- can look like IAS so make sure to put color flow on and zoom
subcostal color IVS
- don’t need to lower color scale on this image
+ if lots of color on both sides
subcostal short axis - used when
- no parasternal window due to disease such as COPD
- when particular structures were not seen very well in other views
- part of routine paediatric echo scan
subcostal SAX ciews
- all 6 views on PSAX can be seen in subcostal
most often used subcostal SAX views
- intertrial septum
- interventricular septum
- tricuspid valve
- pulmonary valve and branches
subcostal IVC
- rotate probe to the 12:30
- sweep inferior from subcostal heart
- adjust depth to show IVC and RA
- probe almost vertical and slightly tilted superior
- done fore sniff test measurement
where to measure IVC sniff test
- 1-2cm inferior to hepatic vein only
abdominal aorta 2D and color
- pulsatile flow
- older patients walls are brighter and thicker
abdominal aorta PW doppler
- triphasic wave form
- place SV as far superior in vessel as you can
- should see a little reversal
subcostal PV/PA view
- really good for doppler
- best view for regurge and stenosis
- angle anterior from subcostal 4 chamber
suprasternal notch long axis (SSN)
- lace probe in suprasternal nitch
- ask patient to move chin up
- may also remove pillow and put under shoulders
- angle DEEP
- probat a 1-2 position
SSN LAX structures visible
- SVC
- ascending aorta
- descending aorta
- right pulmonary artery
- aortic branches
+ brachiocephalic BSA
+ left common carotid LCC
+ left subclavian LSA
PW ascending aorta
- use PW unless too high of velocity
color descending aorta
- put color on both ascending and descending FR as important
- redice color gain inf bleeding occurs
alternative SSN views
- SSN short axis (trans) \+ to look at PA/AO relationship \+ PA long AO short - SSN crab view \+ to look at the pulmonary vein and LA \+ used often in peds
SSN crab view
- used to see LA and 4 pulmonary veins
