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PLAX beginning to LVIDd-LVIDs
2D max depth to visualize any possible effusions
2D normal depth — highest window possible
2D measurements- frame of IVS, LVID, PW at end-diastole at the MV tips
2D measurement- frame of LVID at end-systole at MV tips
What to do in PLAX if aligned properly?
Obtain M-Mode imaging of:
Left ventricle
Mitral valve
Aortic valve
When and how is IVS measured?
Interventricular septal thickness (end-diastole)
Inner edge to inner edge
IVS measurement
0.6 - 1.1 cm
When and how is LVIDd measured?
Left ventricular internal dimesion (end-diastole) at mitral valve leaflet tips
Inner edge to inner edge
LVIDd measurement
3.4 - 5.6 cm
When and how is PW measured?
Posterior wall thickness (end-diastole)
Inner edge to inner edge
PW measurement
0.6 - 1.1 cm
When and how is LVIDs measured?
Left ventricular internal dimesion (end-systole) at mitral valve leaflet tips
Inner edge to inner edge
LVIDs measurement
2.3 - 4.0 cm
PLAX mitral valve
2D of mitral valve in Zoom/RES
Color Doppler loop of mitral valve
Color Doppler loop of mitral regurgitation vena contracta, if present — use Zoom/RES
When and how is LVOT measured?
Early-systole at leaflet insertion
Inner to inner edge
LVOT measurement
2.0 - 2.2 cm
PLAX aortic valve/aorta
2D of aortic valve in Zoom/RES
Color Doppler loop of aortic valve in Zoom/RES, if aortic insufficiency is present
2D measurement of annulus in Zoom/RES at mid-systole (inner edge)
2D measurement- frame of aorta (sinuses) in Zoom/RES at end-diastole (leading edge to leading edge)
2D of ascending aorta (separate) in Zoom/RES at end-diastole (leading edge to leading edge)
Aorta measurement
2.1 - 3.9 cm
When and how is annulus measured?
Between hinge points of AV leaflets (early to mid-systole)
Inner edge to inner edge
Annulus measurement
1.4 - 2.6 cm
When and how is aortic root measured?
Aortic root at the Sinus of Valsava (end-diastole)
Leading edge to leading edge
Aortic root measurement
2.1 - 3.5 cm
When and how is STJ measured?
Sinotubular junction (end-diastole)
Inner edge to Inner edge
Sinotubular junction measurement
1.7 - 3.4 cm
When and how is ascending aorta measured?
End-diastole
Leading edge to leading edge
Ascending aorta measurement
2.1 - 3.4 cm
PLAX left atrium
2D of the left atrium in Zoom/RES
2D measurement- frame of left atrium at end-systole (inner edge to inner edge)
When and how is the LA measured?
Left atrium (end-systole)
Leading edge to leading edge
Left atrium measurement
2.3 - 3.9 cm
PLAX RVIT
2D RVIT (no left-sided structures should be visualized) - use Zoom/RES as needed for endocarditis
Color Doppler loop of RVIT
Continuous-wave Doppler frame of tricuspid regurgitation if present
PLAX RVOT
2D RVOT
Color Doppler loop
Pulsed-wave and continuous Doppler frame, if needed
PSAX aortic valve
2D at aortic valve level
2D valve in Zoom/RES demonstrating three leaflets
Color Doppler loop of aortic valve
PSAX AVL tricuspid valve
2D of tricuspid valve - use Zoom/RES with highest resolution setting as needed for endocarditis
Color Doppler loop of tricuspid valve
Continous-wave Doppler frame of tricuspid regurgitation if present
PSAX AVL pulmonic valve
2D of the pulmonic valve and pulmonary artery (with branches) - use Zoom/RES with highest resolution setting, as needed for endocarditis
Color Doppler loop of pulmonic valve
Pulsed-wave Doppler frame of RVOT (before the pulmonic valve)
Continous-wave Doppler frame of the pulmonic valve
PSAX left ventricular views
2D of the left ventricle at the mitral valve level (basal level)
2D of the left ventricle at the papillary muscle level
2D of the left ventricle below the papillary muscles (apex)