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 where intermittent until the morning of the presentation when the symptoms were constant and also associated with a left sided limp. She was unwilling to weight bear on her left leg. She had Read more about Intussusception in a 6 year old[…]

Aortic Dissection – almost missed diagnosis!

Ultrasound images and text Genevieve Carbonatto You get a handover from the overnight registrar who has had an extremely busy shift. After you get handed over several patients he describes  a 56 year old lady who woke up in the morning to go the toilet. While she was sitting , she suddely felt some paraesthesia in Read more about Aortic Dissection – almost missed diagnosis![…]

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[…]


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[…]