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Flashcards in 3 - Cardiac US Deck (25):
1

gold standard for cardiac abnormals?

Echocardiography

2

Focused cardiac US?

Not to replace echo
Only to answer specific questions not detect all cardiac pathology

3

Ideal diagnostic tool for detecting life threatening cardiac conditons?

Focused transthoracic echocardiography

4

Primary indications for focused cardiac US?

- Cardiac arrest
- Pericardial effusion/tamponade
- Massive PE
- L ventricular structure and function
- Volume status and fluid responsiveness
- Unexplained HOTN
- Guidance of emergency cardiac pacing

5

Other Indications for cardiac US?

- Valvular abnormalities
- Proximal aortic dissection
- Myocardial ischemia and infarction

6

Basic goals of POC cardiac US?

- ID moderate/large PE
- ID gross cardiac activity or cardiac standstill
- Assess relative and gross chamber size
- Assess ejection fraction (2D estimate)
- Measure E-point septal separation (estimate ejection fx)
- Evaluate gross valvular motion
- Assess volume status by IVC size and collapsibility

7

Most useful view for POC cardiac US?

Subcostal views

8

Does scanning from the subcostal window interfere in resuscitative measures?

Nope

Doesnt interfere w
- thoracostomy
- CPR
- Subclavian line insertion
- ET intubation

9

Ways to improve subcostal 4 chamber view?

- more US gel
- more shallow angle
- move transducer to R to use Liver as window
- move off xiphoid and over lower intercostal space (barrel chested pt)

10

4 chamber view pics

Sized 12 - 15

11

How do you get a parasternal long-axis view?

Aligning the US plane aw the long axis of the L ventricle

- place transducer perpendicular to the chest wall at the 3rd or 4th intercostal space immediately to the left of the sternum w the transducer indicator directed to L hip

12

What can the parasternal long-axis view show you?

- R ventricular free wall
- R ventricular cavity
- Intraventrcular septum (IVS)
- L ventricular cavity
- Posterior L ventricular free wall


Prob will also see
- aortic and mitral valve
- proximal aorta
- L atrium

13

Parasternal long axis pics

18-23

14

What is the imaging plane for parasternal short-axis view?

Toward the R hip

3rd or 4th intercostal space (just L of sternum)

15

Where do you perform a parasternal short axis view?

Base of the heart (aortic valve level)
Level of mitral valve
Level of papillary muscles
Apex

16

Parasternal short axis pics

26-32

17

What is the apical 4 chamber view?

Cornal view of the heart that visualizes all 4 chambers in one plane

18

How to get a 4 chamber view?

Put pt in left lateral decubitus (if possible)

- Place transducer at PIM on L lateral chest wall

19

What does the apical 4 chamber view show

Advantageous for assessing L ventricular function and relative camber size
(L ventricle > R ventricle)

20

Apex 4 chamber pics

35-41

21

What is the IVC view?

Proximal IV (inferior Venal Cava) is the subcostal midline sagittal view as it courses posterior to the liver into the R atrium

22

What does the proximal IVC view give you?

Allows evaluation of the proximal IVC during expiration and inspiration

23

IVC view, normal (low) right sided filling pressure?

IVC view, collapse of > 50% during inspiration

24

IVC view pics

43-48

25

What do you call an argentinian with a rubber toe?

Roberto