STEEPLECHASE ECHOCARDIOGRAPHY Flashcards
Indications
- Heart murmurs
- ECG abnormalities - electrocardiogram
- Radiography abnormalities
- Hypertension - heart disease
- Dyspnoea e.g. cats - respiratory or cardiac disease
- Syncope
- Arterial thromboembolism - clots
- Identification phenotypically normal animals prior to breeding - CKCS, mitral valve disease
Positioning + patient prep
- Patient in lateral recumbency, but may be performed standing if patient dyspnoeic (having difficulty breathing)
- Avoid sedation if possible as may alter cardiac function
- Right side views used for general exam, but may need to scan both left and right sides
- Air interferes with passage of ultrasound waves so preparation of patient is important
- Clip over palpable apex beat – both left and right sides
- Clean area
- Apply ultrasound gel to ensure good contact
- Place patient on cardiac table in right lateral recumbency initially
- Heart drops with gravity and will lie perpendicular to the beam in R lateral; lower lung will be less inflated and therefore will create less interference
R side
3rd - 6th ICS
L side
5th - 7th ICS
3 modes
- B mode
- M mode
- Doppler - colour flow doppler!
B mode
M mode
Doppler mode (colour flow doppler)
B mode - standard views
- Right parasternal long axis 4 chamber view
- Right parasternal long axis 5 chamber view
- Right parasternal short axis view at level of papillary muscles
- Right parasternal short view at level of mitral valve
- Right parasternal short axis view at level of left atrium and aorta
Convention is to view base of heart on right of screen, apex of heart on left of screen
B mode - right parasternal long axis 4 chamber view
B mode - right parasternal long axis 5 chamber view
B mode - right parasternal short axis - papillary muscles (mushroom)
B mode - parasternal short axis mitral valve (fish mouth)
- B mode - right parasternal short axis left atrium + aorta (Mercedes Benz)
- Able to calculate diastolic LA : normal aorta ratio (< 1.6)
M mode
- One dimensional, used for taking measurements e.g. ventricular wall thickness in DCM/HCM
- Motion mode - movement of e.g. left ventricular free wall
- Short axis view for contractibility
B mode - right parasternal long axis 4 chamber view
B mode - right parasternal long axis 5 chamber view
B mode - right parasternal short axis - papillary muscles (mushroom)
B mode - parasternal short axis mitral valve (fish mouth)
- B mode - right parasternal short axis left atrium + aorta (Mercedes Benz)
- Able to calculate diastolic LA : normal aorta ratio (< 1.6)
M mode
M mode
Colour flow doppler - ventricular septal defect
Colour flow doppler - atrioventricular valve diseae
Colour flow doppler
- Measures flow rate + direction
For assessing - Ventricular septal defects
- Patent ductus arteriosus
- Atrioventricular valve disease
- BART, blue = away, red = towards
- Right parasternal short axis view at the level of the LA and aorta
- Atrial fibrillation
- Severe dilation of the left atrium (LA : Ao, should be 1.6)
- Overall globoid appearance of the heart
- Mitral valve leaflets are distorted
