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
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
The video clips 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
Pulmonary edema – typical clinical conditions
Should be considered in particular with the following conditions:
– All respiratory compromising conditions
– All conditions with hemodynamic instabillity
– All cardiac failure patients
– COPD exacercabtion
– Shortness of breath, especially if arterial hypertension or hypotension is present
– Volume overload, verified or suspected
– Renal failure
Different presentations of aortic valve sclerosis (white arrows) in the parasternal long axis view
Only image B has normal LV function
Findings in patient with endocarditis affecting the aortic valves
All 4 video clips are from the same patient
A, B, C are all apical views for optimal display of the pedunculated mass
D is the corresponding TEE mid-esophageal 4 chamber view
Findings in patient with endocarditis affecting the mitral valves
The video clips are from 4 different patients
A, B, C are all apical views for optimal display of the pedunculated mass
D is the corresponding TEE mid-esophageal long axis view with pedunculated mass on the anterior mitral leaflet
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 originates from low flow areas, atrial appendages, areas with
reduced myocardial movement, or aneurysms
– Exerts their
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 colour 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)
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
