Module 9 : PSAX 2D Views and Measurements Flashcards
Parasternal short axis views
- imaged at 6 different levels
- the beam is swept from base to apex
- fro PLAX rotate 90’ clockwise
PSAX levels
1) PV/PA level (pulmonary valve and artery)
2) bse (AV) level - widest part of heart
3) MV level (mitral valve)
4) LV base level
5) LV mid (pap) level
6) LV apex
- 4, 5 & 6 is where wall motion is assessed
PSAX PA level structures
- almost identical to PLAX RVOT view \+ RVOT \+ PV - left posterior pulmonary cusp - right posterior pulmonary cusp \+ Main pulmonary artery - right pulmonary artery - left pulmonary artery occasionally AV and TV
PSAX base (AV) level structures
- main focus is AV and MUST SEE ALL 3 LEAFLETS
- superior vena cava
- right atrium
- tricuspid valve
+ septal and anterior leaflets - right ventricle
- pulmonary valve
+ LPC & RPC - pulmonary artery (maybe branches)
- AV
+ RCC, LCC, NCC - left atrium
PSAX MV level structures
- RV free wall (any part not touching septum)
- RV chamber
- IVS
- anterior mitral leaflet
- posterior mitral leaflet
- MV annulus
MV scallops
- anterior leaflet numbered first from lateral to medial
- posterior scallops numbered according to corresponding anterior leaflet
wall motion assessment at MV level
WALL MOTION NOT ASSESSED AT THIS LEVEL BECAUSE WALL DOES NOT MOVE SYMMETRICALLY
PSAX LV base
- level is millimetres below the MV level at the level of the chordae tendonae
- if you see MV leaflets to high/superior
- if you see pap muscles attached to wall to low/inferior
- show see chordae and conversion of chordae
wall motion assessment at LV base level
YOU CAN ASSESS WALL MOTION AT THIS LEVEL
PSAX Mid (pap) level structures
- RV free wall
- RV chamber
- IVS
- 2 pap muscles attached to LV wall
- pericardium
- ALL WALLS OF THE LV SIMULTANEOUSLY
wall motion assessment at pap level
CAN ASSES WALL MOTION AT THIS LEVEL
PSAX apical level structures
- inferior to pap muscles so none should be seen
+ all walls of the LV at the apical level
+ a sliver of the RV
+ excellent for viewing pericardial effusions
LV segments short axis - base
FROM ANTERIOR CLOCKWISE
anterior > anterolateral > inferolateral > inferior > inferoseptal > anteroseptal
LV segments short axis - mid
FROM ANTERIOR CLOCKWISE
anterior > anterolateral > inferolateral > inferior > inferoseptal > anteroseptal
LV segments short axis - apex
FROM ANTERIOR CLOCKWISE
anterior > later > inferior > septal