Sharon Kay: Echo for Everyone: 5 Things Never to Miss

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Sharon Kay puts SMACC front and centre while polishing up your echo skills.

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Sharon Kay: Echo for Everyone: 5 Things Never to Miss

  1. 1. The Focused Echocardiographic Examination Sharon Kay PhD MSc (Perfusion) MSc (echocardiography) BSc (Med)
  2. 2. Echocardiography echocardiography describes the use of ultrasound in to assess the heart v v due to diagnostic potential, echo is widely used as common cardiac investigation safe, non-invasive, cost effective, most frequently used imaging procedure in the diagnosis of heart disease v
  3. 3. v 2D echo v Spectral Doppler v Colour Doppler
  4. 4. 5 things to look for v S - Size v M - Movement v A - Artefacts v C - Consistency v C - Conclusion
  5. 5. v Subcostal long axis
  6. 6. v Subcostal long axis
  7. 7. v RV Dilated v LV Dilated
  8. 8. v Subcostal Short
  9. 9. v Subcostal IVC
  10. 10. • Normal • Dilated
  11. 11. Subcostal Aorta
  12. 12. v Parasternal long axis
  13. 13. v Parasternal short axis - LV
  14. 14. Parasternal short axis - Valves
  15. 15. Apical 4 chamber
  16. 16. Apical 5 chamber
  17. 17. Apical 2 chamber
  18. 18. Apical long axis
  19. 19. Suprasternal – aortic arch
  20. 20. Diastology - What does it all Mean?? • • 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 E>A PV a reversal Inflow swing
  21. 21. Chambers • Size • All 4 chambers remodel in size depending on pathology present • eg: PHT / Aortic incompetence
  22. 22. Chambers • Movement - Function • Fractional shortening – the squeeze of the Ventricle • Global – Cardiomyopathy – • • • ETOH Athletes – Segmental – AMI / IHD / Tako Tsubo
  23. 23. Wall thickness • • Size (or thinness) • Hypertrophy – hypertension systemic or pulmonary • Deposits – sarcoid / amyloid / HOCM
  24. 24. v • Mildly reduced LVEF
  25. 25. v AMI Inferolateral MI
  26. 26. Pericardial effusion
  27. 27. v Haematoma
  28. 28. Pulmonary hypertension
  29. 29. Cardiomyopathy
  30. 30. • Hypertensive • HOCM
  31. 31. Chambers • • • The atria • Size ( LA – dilated ? why) • Diastolic dysfunction ? IAS – hypermobile / aneurysmal / PFO / Not just filling pressure …… Movement Masses • Thrombus / SEC / myxoma / Artifact
  32. 32. Masses LA myxoma
  33. 33. Valves v Regurgitation v SIZE of chamber and jet
  34. 34. v Mitral regurgitation
  35. 35. Valves v v v Stenosis - Movement Artifact Are the leaflets mobile – Consistently mobile to the other similar valve vLunar valves and AV valve
  36. 36. Aortic stenosis
  37. 37. Mitral stenosis
  38. 38. CASE study
  39. 39. AV
  40. 40. Extra systolic
  41. 41. 5 things SMACC v S - Size v M - Movement v A - Artefacts v C - Consistency v C - Conclusion

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