The images and the video clip show 4 examples of pleural effusion
Notice:
– Black (or greyish) fluid collection in the thoracic cavity above the diaphragm
– Atelectasis of the lung
– Diaphragm is clearly visible
– Lung sliding is absent in the phrenicocostal sinus
Multiple B-lines in a patient with pulmonary edema
Notice that the B-lines start from the pleural line and extends to the far end of the screen = 30 cm in depth
The presence of lung or pleural sliding during positive pressure ventilation on both sides ensures correct placement of the endotrachial tube
The evaluation can take place anywhere on the thorax wall
The recording shows lung or pleural sliding in position 4
Notice: B-lines are present in D (normal finding in position 4 even in healthy people)
Findings in patient with endocarditis affecting the tricuspid valves. The video clips A and D are from the same patient
A, C and D are subcostal views for optimal display of the pedunculated masses
B is a modified 4-chamber view for optimal display of the pedunculated masses
The 2D echocardiographic characteristics of pleural effusion
Look for:
– Black fluid in the thoracic cavity – above the diaphragm (fluid can appear greyish)
– Atelectasis of the lung
– Diaphragm unusually clearly visible
– Lung sliding is absent in the phrenicocostal sinus
Pleural effusion – typical clinical conditions
Should be considered in particular with the following conditions:
– All respiratory compromising conditions
– All conditions with hemodynamic instabillity
– All ICU patients
– All cardiac failure patients
– Cardio-thoracic surgery patients
– Infection
– Renal failure
Different presentations of aortic valve sclerosis (white arrows) in the parasternal long axis view
Only image B has normal LV function
Pedunculated masses – 2D echocardiography
The characteristics:
– Abnormal pedunculated masses
– The vegetations often originate from valve leaflets but may originate from any
cardiac or vascular structure
– Myxomas often originate from the left atrium
– Thrombus mainly originate from low flow areas, atrial appendages, areas with
reduced myocardial movement, or aneurysms
– Exerts their
Video clips of the parasternal long axis view
Notice:
– Enlarged RV (arrows)
– RV size >2/3 of LV size except in D where there is a concomitant dilated and dysfunctioning LV
Right ventricle enlargement and myocardial dysfunction is seen in right side myocardial infarction and pressure increase (pulmonary embolism and chronic pulmonary hypertension)
Often a tricuspidal regurgitation is seen on colour Doppler and continuous wave Doppler will disclose a RV pressure increase (advanced FATE level)
Video clips of the subcostal 4 chamber view
Notice:
– Enlarged RV (arrows)
– RV size >2/3 of LV size
– Paradoxial movement of the interventricular septum
Right ventricle enlargement and myocardial dysfunction is seen in right side myocardial infarction and pressure increase (pulmonary embolus and chronic pulmonary hypertension)
Often a tricuspidal regurgitation is seen on color Doppler (advanced FATE level)
This view is not suitable for pressure measurement with continuous wave Doppler across the tricuspidal valve due to the angle of insonation (advanced FATE level)
