Cardiac ultrasound

Pericardial effusion – PSAX view

Video clips showing examples of pericardial effusion obtained in the parasternal short axis view

Notice:

– PSAX views
– Pericardial fluid collection (white arrows)

Compression of the right-sided cavities in diastole is not obvious in these video clips

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Hypertrophic LV – PLAX view


Long axis view showing a hypertrophic left ventricle

Notice:

– Myocardial wall thickness is increased
– LV dimensions are often decreased
– Left atrium is often enlarged
– LV function is variable

Image C shows severely reduced LV dysfunction

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Hypertrophic LV – A4CH view


Apical 4 chamber view showing a hypertrophic left ventricle

Notice:

– Myocardial wall thickness is increased
– LV dimensions are often decreased
– Left atrium is often enlarged
– LV function is variable

Image C shows severe reduced LV function

The arrows in image D point to concomitant pericardial effusion

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Dilated, poorly functioning LV – A4CH view

Video clips from the apical 4 chamber viewNotice:

– LV is enlarged
– LA is enlarged
– Anterior mitral leaflet opening is compromised; MSS increased
– The myocardial wall may appear thin
– Reduced contractility
– MAPSE is reduced

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Dilated, poorly functioning LV – S4CH view

Video clips from the subcostal 4 chamber viewNotice:

– LV is enlarged
– LA is enlarged
– Anterior mitral leaflet opening is compromised; MSS increased
– The myocardial wall may appear thin
– Reduced contractility

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Hypertrophic LV diastolic dysfunction


Hypertrophic left ventricle

2D echocardiographic characteristics:

– Myocardial wall thickness is increased
– LV dimensions are decreased
– LA is often enlarged
– MAPSE is often slightly reduced

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Dilated, poorly functioning LV – typical clinical conditions


Consider dilated and poor functioning left ventricle

Particularly with the following conditions:

– Ischaemic heart disease
– Dilated cardiomyopathy
– Sepsis
– Volume overload
– Aortic valve stenosis (end stage)
– Aortic and mitral valve insufficiency (LV function is often normal or hyperdynamic

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