Dr Chris Harrington (FACEM) presents 2 cases for this month. Both demonstrate the importance of ECHO in the context of the deteriorating patient with heart failure. A 48F is referred to the Emergency department by her cardiologist with exacerbation of right heart failure and rapid AF PHx aortic valve repair (for congenital aortic stenosis) severe Read more about 2. Case of the month: FELS Right heart failure[…]
(Case and images courtesy of Jay Perera, text Jay Perera and Genevieve Carbonatto) Triage: 30F presents with 2/7 of worsening palpitations, worse post Salbutamol. She has a history of PTSD and anxiety. HR 78 regular. Further history: 3 years of fatigue and lethargy Complains of intermittent palpitations and dyspnoea. Trialled on Salbutamol by her GP Read more about 1. Case of the month: Focussed Echo in Life Support(FELS)[…]
Images James Dent An 80 year old had an unsuccessful cannulation for a CT scan. 4 days later she presented with bruising and tenderness of the left antecubital fossa and a palpable pulsating mass. This is the US of the area B mode sonography shows a large pseudoaneurysm . The aneurysm is connected to the Read more about Pseudoaneurysm[…]
Text Genevieve Carbonatto Specific examination ultrasound findings in COVID 19 are not unique to the disease. Lung findings include pleural line irregularities, pleural thickening, B lines and consolidations. What is striking is the remarkably similar distribution of lung pathology from patient to patient. The posterolateral areas are generally affected first bilaterally and then the disease Read more about Lung Ultrasound findings in COVID 19[…]
Text Genevieve Carbonatto Literature is coming out on the lung ultrasonography of novel coronavirus. This is a summary of the literature so far The features of lung ultrasound are not specific for COVID 19 pneumonitis or pneumonia but highly suggestive in patients presenting with a history suggestive of infection with novel coronavirus Lung ultrasound is Read more about Features of lung ultrasound in COVID 19 infection[…]
Kathryn Statham Aortic stenosis It is the most common valvular heart disease in developed countries It’s prevalence is increasing with our ageing population It is found in 3% of patients > 75 yrs It is the most common valve disease requiring surgical intervention in developed countries. TAVI is increasingly the treatment of choice for severe Read more about Causes of Aortic Stenosis[…]
Kathryn Statham, Genevieve Carbonatto AR is rarely physiological. If it is present then a cause needs to be found. ECHO is used to determine Aetiology Estimate severity Assess chronicity This is done first by imaging the heart with 2D echo and looking at: valves aortic root size LV cavity size (chronic vs acute) LV wall Read more about Assessment of aortic regurgitation[…]
Images Ava Ghalini text Genevieve Carbonatto A patient is referred by his GP to the Emergency Department for episodes of exertional upper chest pain over a period of 2 weeks. A troponin organised by his GP was 28. On arrival he is asymptomatic. BP 180/80, HR 100/min. A systolic and loud diastolic murmur is audible Read more about Aortopathy – Aortic root dilatation[…]
Images Bashir Chakar, text Genevieve Carbonatto A 36 year old lady presents with sudden onset of right lower quadrant pain lasting 20 minutes. One hour later she experiences further abdominal pain prompting her presentation to the Emergency Department. She has had 2 positive home pregnancy tests. On examination she is minimally tender in her right Read more about Ruptured ectopic, pseudosac[…]
Images Evy Panos, Text Genevieve Carbonatto A 32 year old lady presents by ambulance to the Emergency Department in shock. She describes having felt dizzy but not unwell and then suddenly collapsed. She remembers being escorted in a wheelchair into an ambulance. She is 19 weeks pregnant and has had a recent normal ultrasound scan. Read more about Heterotopic pregnancy[…]