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Question 5: septic shock

Describe the echocardiographic features not uncommonly seen in the patient with septic shock 1. ECHO exam may be normal 2. Septic cardiomyopathy: Left ventricular dilatation : if  LV EDD > 5.5cm however dependent of size of patient. If patient is an athlete LVEDD may be increased and normal.   Measure in PLAX view using calipers – Read more about Question 5: septic shock[…]

Question 6: Right heart strain

Question 6 A pt presents with breathlessness : Describe the ultrasound findings that would suggest right heart strain and what features would suggest the findings is either acute or chronic ECHO findings suggestive of Right heart strain is TR velocity > 3.4m/s SPAP > 50 MmHg with or without additional echocardiographic variable suggestive of PH Read more about Question 6: Right heart strain[…]

Question 7 : Pericardial effusion

Question 7 Describe the possible echo findings in a patient with pericardial effusion 1. Distribution Circumferential Loculated 2. Echogenicity Anechoic Echoic depending on it’s composition (blood may be echoic, pus also) May be associated with fibrin strains if chronic 3. Size small < 1cm moderate 1 cm – 2 cm large > 2 mm Measurement Read more about Question 7 : Pericardial effusion[…]

Question 8 : ECHO 2 days post AMI

Question 8 A 50 year old man presents 2 days post AMI with hypotension. You are about to scan him looking for a cause. Outline possible ultrasound findings 1. Global LV regional abnormality Reduced fractional shortening of LV . Not accurate in regional wall abnormalities/aneurysms/ LBBB Simpson’s method 4 and 2 chamber views assesses cardiac Read more about Question 8 : ECHO 2 days post AMI[…]

Question 9: Assessment of LV function

Question 9 How can  ECHO be used to assess LV function? LV function can be assessed in the following ways Fractional shortening “Eyeballing“ of LVF Ejection fraction (EF) – Simpson method Stroke volume Systolic index of contractility dP/dt Longitudinal contraction using tissue Doppler  MAPSE 1. Fractional shortening: Measures the “squeeze “ of the LV . Read more about Question 9: Assessment of LV function[…]

Question 10: Ultrasound in cardiac arrest

A 45 year old patient presents in cardiac arrest . What is the ultrasound approach to this patient? The approach to the patient in cardiac arrest is based on assessment of the 4 F’s  (fluid, form, function and filling) of the heart to assess for potentially reversible causes of cardiac arrest, to assess prognosis and Read more about Question 10: Ultrasound in cardiac arrest[…]