Intussusception in a 6 year old

Images and text Genevieve Carbonatto A 6 year old girl presents to the Emergency department with dysuria and abdominal pain. The symptoms have been  intermittent until the morning of the presentation when the symptoms were constant and also associated with a left sided limp. She is unwilling to weight bear on her left leg. She Read more about Intussusception in a 6 year old[…]

Aortic Dissection

Ultrasound images and text Genevieve Carbonatto A 56 year old lady presents to the Emergency department with a history of severe abdominal pain. She woke up to go to the toilet and  while sitting developed  sudden  paraesthesia in both her thighs associated with severe back pain and abdominal pain. She noticed that her left leg Read more about Aortic Dissection[…]

Shock – Left Ventricular Outflow Obstruction

Echo images Tina Cullen, text Genevieve Carbonatto The Emergency phone rings directly from the paramedics. They have a  59 year old woman with acute onset chest pain. BP 75/40, diaphoretic. HR 110/min in atrial fibrillation. She has a past history of hypertension. The ECG is faxed through   Widespead ST depression and T wave inversion Read more about Shock – Left Ventricular Outflow Obstruction[…]

Amyloidosis

Images by Genevieve Carbonatto Parasternal long axis, (PLAX) of the left ventricle showing thickened LV walls and reduced ejection fraction.   Measurements of the interventricular septum, (IVS) and LV infero-lateral (posterior) wall (LVPW) should be measured in a straight line across the minor axis of the LV. The measurements should be performed at end diastole, the Read more about Amyloidosis[…]

Pericardial effusion and pleural effusion

Images by Genevieve Carbonatto Parasternal long axis, (PLAX) left ventricle showing a small circumferential pericardial effusion ending anteriorly to the descending thoracic aorta, (D.Th.A.).  The D.Th.A. is the anatomical landmark to differentiate between a pericardial and a pleural effusion.  The pericardial effusion is trivial anterior to the RV anterior wall. There is also a suggestion of Read more about Pericardial effusion and pleural effusion[…]

Pericardial effusion with fibrinous strands

Images by Genevieve Carbonatto  Frozen image of the apical 4-chamber view showing a moderate circumferential pericardial effusion containing fibrinous strands shown by the solid white arrow.  There are strands throughout the effusion. Parasternal long axis (PLAX) Left ventricle showing a moderate circumferential pericardial effusion. Apical 4-chamber view showing a moderate circumferential pericardial effusion containing fibrinous strands. Read more about Pericardial effusion with fibrinous strands[…]

Large pericardial effusion

Images by Genevieve Carbonatto  5 chamber view shows large pericardial effusion and right ventricular wall and right atrial wall collapse Parasternal long axis left ventricle showing a circumferential pericardial effusion. It is small anteriorly but moderate posteriorly. Parasternal short axis left ventricle at the  level of the papillary muscles with a large circumferential pericardial effusion. Parasternal Read more about Large pericardial effusion[…]

Pericardial Effusion

Images by Genevieve Carbonatto  Large circumferential pericardial effusion, best seen on moving clips Parasternal long axis of the left ventricle demonstrating a moderate circumferential pericardial effusion.  No echo evidence of cardiac tamponade on this view.  RV contracts in systole and relaxes in diastole, no collapse evident. Apical 4-chamber demonstrating circumferential pericardial effusion.  No definite echo signs Read more about Pericardial Effusion[…]

Pulmonary Embolus

Images by James Dent  McConnell’s sign is akinesis of the basal and mid segments of the RV free wall but apical preservation / hyperkinesis.  It is sensitive but not specific for pulmonary embolus Parasternal long axis of the left ventricle, (PLAX) demonstrating that the right ventricular, (RV) anterior wall is not contracting well.  The RV Read more about Pulmonary Embolus[…]