PLAX 2D Anatomy and Protocol Flashcards
PLAX sides of screen
anterior
inferolateral (Lt hip), superomedial (Rt shoulder)
posterior
PLAX arm position is LLD
drop right shoulder back to open up intercostal spaces
PLAX marker pointed towards
patients rt shoulder
PLAX 2D increased depth should have depth/focus where
15-25 cm
heart should take up about 1/2 the depth
focus=mid
what are you looking for on PLAX 2D increased depth
pericardial/pleural effusions
pericardial mass
PLAX 2D depth
just behind DA
PLAX 2D should have what structures clear
LV/RV endocardium, LA, MV, AV, AO, aortic sinus
LV walls should be _____ in PLAX 2D
perpendicular
PLAX 2D end-systolic measurement taken when
end of T wave
just after AV closes and LV chamber is smallest
PLAX 2D Mmts (ED)
IVSd
LVIDd
LVPWd (post wall)
normal IVSd/LVPWd
men: ≤10mm
women: ≤9mm
total ≤11mm
Normal LVIDd
men: ≤58mm
women: ≤52mm
PLAX 2D Mmts (ES)
LVIDs
LAs
normal LAs
men: ≤40mm
women: ≤38mm
to see more of asc aorta in PLAX 2D, we must ___
slide superiorly, tilt medially
aortic root anatomy Mmts
aortic annulus
sinus of Valsalva
Sino-tubular junction
Ascending aorta
(we only do 2/4)
when do we switch from inner to inner to LE-LE for aortic Mmts
after the AV
PLAX Asc Ao is measure ___ from ___ and is taken during
2cm
ST junction
end-diastole
PLAX sinus of Valsalva measure during
end-diastole
normal asc ao
≤3.4cm
normal S of V
≤3.7cm
PLAX 2D AV Zoom should include
LVOT
both AV cusps (during S+D)
some ao
some LA
PLAX LVOT measured during and where
mid-systole (after AV opens fully)
just before AV annulus
PLAX LVOT usually needs us to ____
decrease gains
Normal LVOT
18-22mm (avg.=20mm)
PLAX 2D MV zoom image should show
Both MV leaflet tips
most of LA
part of basal IVS
From PLAX, angle _____ to get to RT inflow (TV) View
towards right hip
if struggling to get RT Inflow (TV) View what should you do
slide laterally (or go one rib space lower), then angle medially
From PLAX, angle _____ to get to PV View (RVOT)
towards patients LT shoulder
what way should you slide in PV View (RVOT) if too much lung present
medially
PV (RVOT) view focus is the
PV or MPA
PLAX Mmts tell us about _____ and shape of the ___
LV systolic function
LV
fractional shortening (what/equation)
linear calculation that gives info about the systolic function of the heart
FS= )(LVIDd -LVIDs)/LVIDd)x100
Ejection fraction - linear
measurement used to asses systolic function by calculating the % of blood exiting the heart with each contraction
EF is reasonably accurate if there are no ____/___
wall abnormalities
callipers properly placed
assumptions of EF estimation (3)
- ventricle is a prolapse ellipse shape
- long axis is twice the short axis
- symmetric contracility
normal Teichholz EF
≥ 55%
Linear EF formula
same as fractional shortening but each value is cubed and mm becomes cm
(LVIDd-LVIDs)/LVIDd x 100 (but cube each measurement)
LV mass formula
epicardial volume - endocardial volume = myocardial volume
LV mass index formula and normal values
LV mass/BSA
men ≤ 115g/m^2
women ≤ 95g/m^2
relative wall thickness formula and normal
RWT = (2 x LVPWd)/LVIDd
0.22-0.42
natural geometry
normal LV mass index and RWT
concentric remodelling
normal LV mass index but increased RWT
concentric hypertrophy
increased LV mass index and RWT
eccentric geometry
increased LV mass index and normal RWT
