Cardiac ultrasound: Difference between revisions

Revision as of 16:08, 7 March 2015

Parasternal Long
- Pointer to the L hip, probe at L 3rd/4th intercostal space adjacent to sternum
- Use to visualize global function and r/o pericardial effusion/tamponade
  - Can evaluate mitral valve, aortic valve, aortic root, LV squeeze

Parasternal Short
- Pointer to L shoulder, probe at L 3rd/4th intercostal space adjacent to sternum
- Tip: obtain parasternal long view, then rotate probe 90 degrees
- Use to evaluate LV squeeze, R ventricle
  - R heart strain = dilated R ventricle

Apical 4 chamber
- Pointer to Right, usually below nipple
- Use to visualize global function (Left and right ventricle, squeeze)

Subxyphoid
- Pointer to Right, subxyphoid with probe pointed toward head
- Use liver to as acoustic window to visualize heart

Suprasternal
- Pointer at 12 o'clock (cephalad) and place in sternal notch
- Move probe inferior and to the left to visualize aortic arch
- Rotate probe clockwise for further image optimization
  - Can evaluate for aortic dissections/aneurysms and aortic stenosis/regurg.

Disease	Cardiac	IVC	Lung (Phased Array)	Lung (Linear)
MI	Focal WMA Mod/Poor squeeze	↑	NL or B-lines	Sliding
Tamponade	RA collapse with filling RV collapse with filling	↑	NL	Sliding
PTX	NL or Hyperdynamic	↑	Lung point Consolidated lung	Absent lung sliding
Sepsis	Hyperdynamic squeeze	↓	NL (see pneumonia)	Sliding
Pneumonia	Hyperdynamic squeeze	NL or ↓	Unilateral B-lines	Sliding
Decompensated HF	Mod/Poor squeeze	↑	Bilateral B-lines	Sliding
PE	RV > LV McConnell's sign	↑	NL or Unilateral B-lines	Sliding

Sonosite Uptodate

Authors:

@@ Line 30: / Line 30: @@
 ==Measurements==
-Aorta
+===Aorta===
 *Normal aortic root is <3.8 cm (parasternal view w/ dot pointing to Lt arm)
+===Classic Ultrasound Findings For Critically Ill Patients===
+{| class="wikitable sortable"
+|-
+! Disease !! Cardiac !! IVC !! Lung (Phased Array) !! Lung (Linear)
+|-
+| [[MI]] || Focal WMA<br/>Mod/Poor squeeze || ↑ || NL or B-lines  || Sliding
+|-
+| [[Pericardial Effusion and Tamponade|Tamponade]] || RA collapse with filling<br/>RV collapse with filling || ↑ || NL || Sliding
+|-
+| [[PTX]] || NL or Hyperdynamic || ↑ || Lung point<br/>Consolidated lung || Absent lung sliding
+|-
+| [[Sepsis]] || Hyperdynamic squeeze || ↓ || NL (see pneumonia)  || Sliding
+|-
+| [[Pneumonia]] || Hyperdynamic squeeze || NL or ↓ || Unilateral B-lines || Sliding
+|-
+| [[Congestive heart failure|Decompensated HF]] || Mod/Poor squeeze || ↑ || Bilateral B-lines || Sliding
+|-
+| [[PE]] || RV > LV<br/>McConnell's sign || ↑ || NL or Unilateral B-lines || Sliding
+|}
 ==Pericardial Effusion==