1 / 31

Basic Echocardiography

Basic Echocardiography. Wendy Blount, DVM Nacogdoches TX. Echo Technique - Anatomy. Tricuspid valve Septal leaflet Parietal leaflet Pulmonic Valve Right cusp Left cusp Intermediate cusp. Mitral valve Leaflets are less distinct Aortic Valve Right cusp Left cusp Septal cusp.

cheche
Download Presentation

Basic Echocardiography

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Basic Echocardiography Wendy Blount, DVM Nacogdoches TX

  2. Echo Technique - Anatomy Tricuspid valve • Septal leaflet • Parietal leaflet Pulmonic Valve • Right cusp • Left cusp • Intermediate cusp • Mitral valve • Leaflets are less distinct • Aortic Valve • Right cusp • Left cusp • Septal cusp

  3. Echo Technique - Anatomy RV • Conus arteriosus • 3 papillary muscles LV • 2 papillary muscles

  4. Echocardiography Equipment • Transducer – small footprint • Fan-shaped beam or sector • High frequency for small animals • Low frequency for large animals • Machines range from 2.5-10 Mhz • 5-7 MHz will work fine for most dogs and cats for echo

  5. Echocardiography Equipment • Double window with simultaneous B and M modes (video) • Can do measurements on B-mode or M-mode • Need a cursor which can measure mm, or cm marks on the images • Ability to capture images is important

  6. Echocardiography Preparation • Thin coated animals – alcohol, part the hairs, gel • Thick coated animals – shave the window – at the sternum, just behind the elbow • Sedation only if needed • Acepromazine – 0.025 mg/lb (max 1 mg) • Buprenex – 0.01-0.02 mg/kg • Or butorphanol 0.1 mg/lb • Mix together and give IV (handout)

  7. Echocardiography Positioning for 8 standard views • Right lateral recumbency • Cardiac table is nice but not necessary • Sonographer needs a stool or chair • Placement of probe: • Feel the apical beat, and put your probe there (probe marker cranial) • Imagine the longitudinal axis of the heart, probe at 90o (short axis views) • Adjust 1 intercostal space Cr or Cd PRN • Rarely move the probe head – just fan and twist (video)

  8. 1. Short Axis – Left Ventricle • Fan from base to apex, until you have just passed the mitral valve, and the LV papillary muscles appear (mushroom view) • Rotate until PM are the same size • If you are getting a rib shadow, try one intercostal space cranial or caudal • Fan cranial and caudal to center the heart on the screen

  9. 1. Short Axis – Left Ventricle Abbreviations - Structures • P – pericardium • RV – right ventricle • IVS – intraventricular septum • LV – left ventricle • PPM – posterior papillary muscle • APM – anterior papillary muscle

  10. 1. Short Axis – Left Ventricle Measurements • IVSTd- IntraVentricular Septum Diastole • LVIDd - LV Inner Diameter Diastole • LVPWd – LV Posterior Wall Diastole • IVSTs- IntraVentricular Septum Systole • LVIDs - LV Inner Diameter Systole • LVPWs – LV Posterior Wall Systole

  11. 1. Short Axis – Left Ventricle Measurements • IVSTd =IVSd =VSd • LVIDd=LVd =LVLd • LVPWd=LVFWd=LVWd • IVSTs =IVSs =VSs • LVIDs=LVs =LVLs • LVPWs=LVFWs=LVWs

  12. 1. Short Axis – Left Ventricle Measurements - Calculated • FS – fractional shortening (LVIDd – LVIDs) LVIDd • Assumes perpendicular to myocardium • Assumes contractility is uniform in the LV • Extremes in preload and afterload can affect FS, as well as myocardial function

  13. 1. Short Axis – Left Ventricle Measurements - Calculated • FS – fractional shortening • AKA shortening fraction (SF) • >30% in the dog • >40% in the cat • >45% if MR is compensated

  14. 1. Short Axis – Left Ventricle Measurements - Tips • Make sure you don’t include PM in the LVPW measurement • If you do, your LVPW will be artifactually thicker • Clue – check for this if LVPW is much thicker than IVS • Make sure you are not too far apical • If you are, your LVID will be artifactually small • And LVPW will be artifactually thick

  15. 1. Short Axis – Left Ventricle Measurements - Tips • Measure three times • Take the average • Throw out any outliers • Several sets of normals published • 1-2mm outside normal may not always be significant

  16. 2. Short Axis – Apex Structures • Pericardium • May or may not see RV • LV apical lumen No measurements here

  17. 3. Short Axis – Chordae Tendinae Structures • Pericardium • RV • LV • CH - Chordae Tendinae (posterior & anterior) No measurements here

  18. 4. Short Axis – Mitral Valve Structures • Pericardium • RV • RV Papillary Muscles • LV • MV - Mitral Valve (Posterior & Anterior)

  19. 4. Short Axis – Mitral Valve Measurement • EPSS – E-Point to Septal Separation • Can denote decreased LV systolic function • Less than 6 mm in large dogs • Less than 3-5 mm in small dogs and cats

  20. 5. Short Axis – Aortic Valve Structures • RVOT – Right Ventricular Outflow Tract • TV – Tricuspid Valve • PV – Pulmonic Valve • Ao – Aortic Valve • LA – Left Atrium

  21. 5. Short Axis – Aortic Valve Measurements • Ao – at largest dimension (systole) • LA – at largest dimension (diastole) • LA:Ao – • 0.8 to 1.3 in dogs • 0.8 to 1.4 in cats

  22. 6. Short Axis – Pulmonary Artery Structures • RA – Right Atrium • Ao – Aorta (ascending) • PA– Pulmonary Artery • LPA – left pulmonary artery • RPA – right pulmonary artery • CaVC – Caudal Vena Cava

  23. 7. Long Axis – 4 Chamber Technique • Get short axis “mushroom” view • Rotate 90 degrees counterclockwise

  24. 7. Long Axis – 4 Chamber Structures • RV – Right Ventricle • RA – Right Atrium – difficult to view completely • TV – Tricuspid Valve • LV – Left Ventricle • LA – Left Atrium • MV – Mitral Valve, PM – papillary muscle

  25. 7. Long Axis – 4 Chamber Video

  26. 8. Long Axis – LVOT Technique • Find 4 Chamber view • Angle the “dot” toward the shoulders • Elevate the cord end of the probe

  27. 8. Long Axis – LVOT Structures • RV, TV, RA • LV, PM, MV • Very edge of the LA • LVOT – AV (LC, SC), ascending Ao • RPA – Right Pulmonary Artery

  28. 8. Long Axis – LVOT Video Normal Dog Video

  29. Dog RV Measurement Values • RVWd – less than LVWd • RVIDd – 1/3 or less of LVIDd (handout)

  30. Cat Echo Normal Values • IVSTd – 3-6 mm • LVIDd – 10-21 mm • LVPWd – 3-6 mm • IVSTs - 4-9 • LVIDs – 4-11 mm • LVPWs – 4-10 mm • Aos – 6-12 mm • LAd – 7-15 mm • FS - >40% • EPSS - 0-3 mm • EF ->70% • LA:Ao – 0.8-1.4 • RVIDd - 3-7 mm • RVWd - <3 mm • (form)

  31. Ferret Echo Normal Values (Mean) • LVIDD – 11.0 mm • LVIDS - 6.4 mm • LVPW - 3.3 mm • FS - 42% • EPSS - 0

More Related