Echocardiographic signs in acute cardiovascular conditions

1. Signs in acute cardiovascular conditions
Echocardiography

2. Thumbnails
Systolic heart failure
Heart failure with preserved left ventricular ejection
Pulmonary embolism
Tamponade

3. Explanation
• E: early mitral inflow velocity
• e′: early diastolic mitral annular velocity
• A: duration of the pulmonary flow reversal
• Ar: duration of the A-wave
• DT: deceleration time

4. Systolic heart failure
1. LVEF<45–50%
2. LVEDD >55 mm and/or > 32 mm/m²
3. LVESD >45 mm and/or 25 mm/m²
4. LVEDV > 97 ml/m²
5. LVESV > 43 ml/m²
6. Abnormal wall motion(Global or RWMA)
7. Functional MR and/or TR
8. Peak tricuspid velocity >3 m/s
9. Aortic time velocity integral <15 cm
10. Diastolic dysfunction
11. E/A ≥ 2 + DT < 150 ms indicates increased LV filling pressures

5. Heart failure with preserved left ventricular ejection
1. LVEF ≥ 50%
2. LVEDV< 97 ml/m²
3. LVESV< 43 ml/m²
4. E/e′ ≥13
5. Ar – A ≥ 30 ms
6. LA volume ≥ 34 ml/m²
7. Peak tricuspid velocity > 3 m/s
8. Ultrasound lung cometsc + signs and symptoms of heart failure

6. Pulmonary embolism
1. Thrombus in right chambers
2. Abnormal septal motion
3. Dilatation RA, RV
4. End diastolic RV/LV diameter > 0.6 or area > 1.0
5. Global RV hypokinesia
6. McConnell sign
7. Mild to severe TR
8. PAH:40–50 mmHg (>60 mmHg in the case of pre-existing pulmonary
hypertension)

7. Tamponade
1. Small in acute & large in chronic pericardial effusion
2. Swinging heart(frog in the well)
3. RA collapse (rarely LA)
4. Diastolic collapse of the anterior RV-free wall (rarely LV)
5. IVC dilatation (no collapse with inspiration)
6. TV flow increases and MV flow decreases during inspiration
(reverse in expiration):Very good couple
7. Systolic and diastolic flows are reduced in systemic veins in
expiration and reverse flow with atrial contraction is increased

8. Cute little