ECHO views and identifying anatomic structures

what are some end diastolic measurements for LV view for PLAX?

1. RV

2. IVS

3. LV

4. LVPW

5. RVOT proximal portion

what are some end systolic measurements for PLAX?

1. LV

2. LA (widest point)

how do you measure LVOT?

inner edge to inner edge at mid systole

how do you measure the sinus of valsalva?

leading edge to leading edge end diastole

when do you do your aortic measurements?

end diastole

RVOT proximal and distal are measured at

end diastole

the pulmonary artery is measured

midway between the pulmonary valve and the bifurcation into the Rt and LT pulmonary arteries at end diastole (inner edge to inner edge)

the LA and RA volumes are traces at

end systole

RV ventricle diameters are measured at

end diastole

the RV are is measured by

tracing the compacted myocardium border in end diastole and end systole to calculate the FAC

trabecular and papillary muscles are considered part of the

RV cavity

recommended sweep speed for M-mode for PLAX

100mm/sec

useful to see the timing of structure movement, recommend for TAPSE, maybe for IVC diameter changes with respiration and for evaluation of AV leaflet motion in individuals with LV assist devices

M-mode

End diastole can be defined as

the onset of the QRS complex, the first frame after MV closure or the frame on the cardiac cycle in which the cardiac chamber dimension is largest

End systole can be defined as

after AV closure or the time in the cardiac cycle in which the cardiac chamber dimension is smallest but for atria is the largest

what valves can be heard in the 2nd intercostal space

aortic and pulmonic

what valves can be heard in the 5th intercostal space

tricuspid and mitral

what cardiac pathology is associated with bicuspid aortic valve?

coarction of the aorta

where do most aortic corrections occur?

the aortic isthmus

which windows do you use to look for the secondary findings in bicuspid valves?

supranatural arch

the coronary arteries come off the

sinus of valsalva

from the left parasternal window which of the following are you most likely to get accurate velocity measurements?

pulmonary artery

which aortic leaflet is the superior one in the PLAX view?

RCC

which aortic leaflet is the posterior one in PLAX?

NCC

LAD lies in

anterior inter ventricular groove or sulcus

name the tricuspid leaflets

anterior, posterior, septal

what are the vessels coming off the aorta in SSN

innominate artery (brachiocephalic), LCC (left common carotid), left subclavian artery

name the aortic valve cusps

left, right, noncaronary cusp

how do you obtain the RVIT view

point the probe toward the patients hip

what view is the only view that evaluates the posterior TV leaflet

RVIT

why do we obtain the RVIT

• check for endocarditis

• good view to assess TR and to get PASP/RVSP

• check for thrombus in the IVC, Ram or RV

• visualization of the coronary sinus and eustachian valve

• assessment of pacemaker.ICD wire

• central line confirmation

how do you angle in 4 chamber to visualize the coronary sinus?

tilt the probe posteriorly/inferiorly ( tail toward the patient’s spine/feet)

what walls are in the apical 2 chamber?

inferior and anterior

one of the most important factors in frame rate

depth

what happens when receiver gain is increased?

it will amplify weak signals and decrease image resolution

what are some signs that tell if the gain is too high?

• washed out image (screen appears too white)

• false echoes/artifacts (fluid filled structures appear filled with echoes)

• poor contrast (you cannot clearly distinguish between the myocardium and surrounding tissue)

• loss of detail (subtle structures, small vessels, or valvular details become hard to differentiate)

  • over-amplifies background: acoustic noise increases along with the image signal

how to fix if gain is too high

• reduce overall gain

• adjust TGC

• for color flow, increase gain until noise appears, then reduce it until the noise disappears

what valve sits at the opening of the coronary sinus?

thebesian valve

where the chiari network located?

within the right atrium

what S/D ratio indicates diastolic dysfunction?

elevated S/D (D>S) indicated increased LV filling pressures

what valve regurgitation can cause reversal of the S wave for the pulmonary veins?

MR

what congenital abnormality causes abnormal flow for pulmonary veins

total anomalous pulmonary venous return