BCC4: Sharon Kay on Cardiac Crises Revealed in Echo

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Enrich your knowledge of cardiac ultrasound with the help from experienced sonographer, Sharon Kay. Sharon covers a focused cardiac ultrasound of the heart, and gives examples of emergency cardiac …

Enrich your knowledge of cardiac ultrasound with the help from experienced sonographer, Sharon Kay. Sharon covers a focused cardiac ultrasound of the heart, and gives examples of emergency cardiac conditions that can be detected with this versatile modality. This talk was recorded at Bedside Critical Care Conference 4. For the full post and other BCC4 posts, head over to www.intensivecarenetwork.com

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  • 1. The Focused Echocardiographic Examination Sharon Kay PhD MSc (Perfusion) MSc (echocardiography) BSc
  • 2. The Heart revealed • 5 different tools / modalities are used in every day cardiac echo
  • 3. 3D echo Spectral Doppler Colour Doppler 2D echo Strain / speckle track
  • 4. The Heart revealed • 5 different tools / modalities are used in every day cardiac echo • It will take years of training > 5, multiple scans > 4000 to become an expert and be able to exclude things • THIS IS NOT WHAT BCC / EFOCUS / Rapid cardiac assessment IS!
  • 5. The Heart revealed - EFOCUS Arm to your clinical medicine – BE A DR Helping strengthen your impressions Not a diagnostic tool or fishing expedition
  • 6. The Heart revealed - EFOCUS EFOCUS FEEL LIMITED ECHOWINFOCUS FATE RACE EFAST BEDSIDE SONO
  • 7. FATE CARD - Android / IPhone
  • 8. FATE
  • 9. Subcostal long axis
  • 10. Subxiphoid long axis
  • 11. Subxiphoid Short
  • 12. Subxiphoid IVC
  • 13. Parasternal long axis
  • 14.  Parasternal short axis - LV
  • 15. Parasternal short axis - Valves
  • 16. Apical 4 chamber
  • 17. The Heart revealed S Size M Movement A Artefacts C Comparison C Consistency
  • 18. Normal Dilated
  • 19.  RV Dilated  LV Dilated
  • 20. Subcostal Aorta
  • 21. LVEF Mildly reduced
  • 22. Moderate global dysfunction
  • 23. Severely reduced
  • 24. AMI - segmental Inferolateral MI
  • 25. CHAMBERS • Size • Compare chambers LV to RV • Ventricles to atria • All 4 chambers remodel in size depending on pathology present • eg: PHT / Aortic incompetence / pressure
  • 26. CHAMBERS • Size • Wall thickness (or thinness) • Hypertrophy – hypertension systemic or pulmonary • Deposits – sarcoid / amyloid / HOCM
  • 27. CHAMBERS • Movement – Function Compare • Fractional shortening – the squeeze of the Ventricle • Global – Cardiomyopathy – • ETOH / myocarditis • Athletes • Segmental – AMI / IHD / • Tako Tsubo (not without and Cath)
  • 28. CHAMBERS • The atria • Size ( LA – dilated ? why) • Diastolic dysfunction / regurgitation / stenosis / PVR? • IAS – hypermobile / aneurysmal / PFO / Not just filling pressure …… Movement • Masses • Thrombus / SEC / myxoma / Artifact
  • 29. Apical 5 chamber
  • 30. Apical 2 chamber
  • 31. Apical long axis
  • 32. DIASTOLOGY - FILLING PRESSURES • Diastology • Normal • Normal for age, without LA dilatation • Impaired relaxation with normal filling pressures • Impaired relaxation with elevated filling pressures • Decrease in LV compliance • Pseudo normalization - Moderate • Reversible restrictive - Marked • Irreversible restrictive – Severe • Constrictive
  • 33. Pericardial effusion
  • 34. Pulmonary hypertension
  • 35.  Haematoma
  • 36. Masses LA myxoma
  • 37. VALVES Stenosis - Movement Artifact Are the leaflets mobile – Comparison moving similar to same Lunar valves and AV valve
  • 38. Aortic stenosis
  • 39. Mitral stenosis
  • 40. CASE STUDY
  • 41. CASE STUDY
  • 42. The heart revealed S – Size M - Movement A - Artefacts C - Comparison C - Consistency