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 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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BCC4: Sharon Kay on Cardiac Crises Revealed in Echo

  1. 1. The Focused Echocardiographic Examination Sharon Kay PhD MSc (Perfusion) MSc (echocardiography) BSc
  2. 2. The Heart revealed • 5 different tools / modalities are used in every day cardiac echo
  3. 3. 3D echo Spectral Doppler Colour Doppler 2D echo Strain / speckle track
  4. 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. 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. 6. The Heart revealed - EFOCUS EFOCUS FEEL LIMITED ECHOWINFOCUS FATE RACE EFAST BEDSIDE SONO
  7. 7. FATE CARD - Android / IPhone
  8. 8. FATE
  9. 9. Subcostal long axis
  10. 10. Subxiphoid long axis
  11. 11. Subxiphoid Short
  12. 12. Subxiphoid IVC
  13. 13. Parasternal long axis
  14. 14.  Parasternal short axis - LV
  15. 15. Parasternal short axis - Valves
  16. 16. Apical 4 chamber
  17. 17. The Heart revealed S Size M Movement A Artefacts C Comparison C Consistency
  18. 18. Normal Dilated
  19. 19.  RV Dilated  LV Dilated
  20. 20. Subcostal Aorta
  21. 21. LVEF Mildly reduced
  22. 22. Moderate global dysfunction
  23. 23. Severely reduced
  24. 24. AMI - segmental Inferolateral MI
  25. 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. 26. CHAMBERS • Size • Wall thickness (or thinness) • Hypertrophy – hypertension systemic or pulmonary • Deposits – sarcoid / amyloid / HOCM
  27. 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. 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. 29. Apical 5 chamber
  30. 30. Apical 2 chamber
  31. 31. Apical long axis
  32. 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. 33. Pericardial effusion
  34. 34. Pulmonary hypertension
  35. 35.  Haematoma
  36. 36. Masses LA myxoma
  37. 37. VALVES Stenosis - Movement Artifact Are the leaflets mobile – Comparison moving similar to same Lunar valves and AV valve
  38. 38. Aortic stenosis
  39. 39. Mitral stenosis
  40. 40. CASE STUDY
  41. 41. CASE STUDY
  42. 42. The heart revealed S – Size M - Movement A - Artefacts C - Comparison C - Consistency

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