Consider hypertrophic LV diastolic dysfunction when the following is present:

– Aortic valve stenosis
– Arterial hypertension
– LV-outflow tract obstruction
– Hypertrophic cardiomyopathy
– Myocardial deposit disease

Hypertrophic left ventricle

2D echocardiographic characteristics:

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

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

The 2D echocardiographic characteristics

Notice if:

– LV dimensions are increased
– The myocardial wall is thin
– Myocardial movement is reduced
– Mitral septal separation is increased
– Left atrium is enlarged
– Mitral valve is incompetent
– MAPSE is reduced

Video clips of the parasternal long axis view

Notice:

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

Video clips of the parasternal short axis view

Notice:

– Reduced myocardial thickening
– Reduced endocardial movement
– The myocardial wall may appear thin

Evaluation of cardiac function is one of the key elements of FATE

This lesson has given you an overview of the simplest way of assessment of right and left ventricular function based on greyscale imaging (2D and M-mode)

Qualitative methods (eyeballing) and semi-quantitative methods (ejection fraction (EF), fractional shortening (FS), mitral septal separation (MSS), MAPSE = mitral annular plane systolic excursion (LV), TAPSE = tricuspid annular plane systolic excursion (RV)) have been employed as measures of left and right ventricular function in the focused approach to the assessment of cardiac function

It should be emphasised that all four cardiac chambers contribute to the overall cardiac function and should be evaluated together

Cardiac function and ventricular function in particular should always be considered together with significant pathological conditions (hypovolaemia, pericardial effusion, pulmonary embolus, pendulating processes etc)

This is the end of the cardiac function lesson. When you feel confident, test yourself in the lesson quiz, before moving on to the next lesson: the FATE findings concerning important pathologies

In this lesson you will learn the ultrasound features of:

The FATE card provides the normal cardiac and pleural target images, as well as images of the most important cardiac pathologies and their presentation in the different FATE views

You will be guided through all the relevant cardiac pathologies

Page 3 on the FATE card – which visualises important pathology – is seen below

Sonographic recognition of pathological conditions in real time at the bedside facilitates good patient care

Ultrasound can visualise cardiac and pleural pathology directly and in real time at the bedside

Recognition of relevant pathology is a key competency in the FATE examination

In this module you will see and learn how to recognise the relevant pathology using the standard FATE examination

You can download the FATE card from: usabcd.org/FATE-card