Submassive Pulmonary Embolism – a critical care ECHO skill?

Images and Text Genevieve Carbonatto If we consider that there are different levels of expertise in the acquisition of knowledge of echocardiography for the Critical Care Physician, the recognition of acute cor pulmonale which we see with  submassive pulmonary embolus has been described as a Level II skill, level I being the minimal level of Read more about Submassive Pulmonary Embolism – a critical care ECHO skill?[…]

Ice cardiomyopathy, apical thrombus

Images Sarah Vaughan, text Genevieve Carbonatto A 38 year old man presents to the Emergency department with shortness of breath which he has had for 4 weeks. His symptoms have worsened  over the past 3 days. He can no longer go up 2 flights of steps to his apartment  and he has noticed his  ankles Read more about Ice cardiomyopathy, apical thrombus[…]

Takotsubo cardiomyopathy

Images and text Genevieve Carbonatto A 52 year old lady presents to the Emergency Department with chest pain. After an argument with her husband about his spending she developed acute severe central chest pain radiating down her right arm. She is mildly SOB. There is no past history of note, notably no cardiovascular risk factors. Read more about Takotsubo cardiomyopathy[…]

Biliary Obstruction: Double Barrel sign, Monkey Puzzle sign

Images and text Genevieve Carbonatto A 73 year old man presents to the emergency department jaundiced. He says he has not been feeling unwell but that over  the past 4 days  the white of his eyes have turned yellow as well as the skin of his face. His urine turned very yellow 4 days ago Read more about Biliary Obstruction: Double Barrel sign, Monkey Puzzle sign[…]

ECHO : image optimisation

Images and text Genevieve Carbonatto The most difficult and frustrating ultrasound examination in the Emergency department must be the ECHO exam. What can we do to optimise our images ? Here are some tips and tricks. 1. Positioning the patient Some of our patients in the Emergency Department cannot be moved because of body habitus Read more about ECHO : image optimisation[…]

Type A dissection – Full house

Images Bashir Antoine Chakar (Emergency registrar) Text Genevieve Carbonatto You get a BAT call. The ambulance are bringing in a 65 year old lady who developed acute onset chest pain radiating to her back. The paramedics tell you that she was found to be diaphoretic with a systolic BP of 130. Thinking this was an Read more about Type A dissection – Full house[…]

Normal gut ultrasound

Images and text Genevieve Carbonatto. I would like to thank the IBUS group , in no particular order, Torsten Kucharzik, Christian Masser,Giovanni Maconi, Frauke Petersen, Kim Nylund, Ruediger Goertz, Emma Calbrese, Anil Kumar Asthana, Kerri Kovak, Rune Wilkens and Stefania Carmagnola for their fantastic course on gut ultrasound which has spurred the following post and Read more about Normal gut ultrasound[…]

Crohn’s disease – Bowel obstuction

Images and text Genevieve Carbonatto. A 48 year old man presents to the Emergency  department with severe abdominal pain. He has Crohn’s disease and frequently presents with abdominal pain. He has had a previous entero-enteric anastomosis.  He is also self employed and hard working and always waits until his pain is unbearable before he presents Read more about Crohn’s disease – Bowel obstuction[…]