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Assessment of Left Ventricular Systolic Function Using Echocardiography

Dr Jim Moore Miss Samantha King. Assessment of Left Ventricular Systolic Function Using Echocardiography. Cardiac Ultrasound.

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Assessment of Left Ventricular Systolic Function Using Echocardiography

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  1. Dr Jim Moore Miss Samantha King Assessment of Left Ventricular Systolic Function Using Echocardiography

  2. Cardiac Ultrasound • The use of Echocardiography in the suspected Heart Failure patient is said to be: the ‘gold standard’ test to confirm the diagnosis of heart failure and establish it’s cause. • 2D echo

  3. Transducers • Phased array • Small footprint • Frequency used is in MHz range • 2 – 3.5MHz • Resolution versus penetration • Harmonics

  4. Transducer Orientation

  5. Imaging Planes • Long axis • Short axis • Apical four and five chamber

  6. Imaging Views • Preparing the patient • Parasternal long axis • Parasternal short axis • Apical four and five chamber • Apical two chamber • Subcostal • Suprasternal

  7. Parasternal Long Axis • Septum • Posterior wall • LV Dimensions • Mitral valve • LVOT • Ascending aorta

  8. Parasternal Short Axis – Papillary Muscle Level • Regional wall motion assessment at mid – level

  9. Apical Four Chamber • Septum • Lateral wall • Apex • Mitral Valve • Right Heart Chambers

  10. Subcostal View • Assess right heart • IVC • IAS

  11. Assessment of Left Ventricular Systolic Function • M-mode • - advantages • - disadvantages

  12. LV Systolic Function – Regional Wall Motion • ASE recommends 16 segments • Divided into basal, mid and apical sections • Further described as anterior, posterior, inferior, septal and lateral

  13. Regional Wall Segments

  14. Coronary Artery Supply • Regional wall analysis correlates well with coronary artery supply • LAD – anterior, septum • RCA – inferior, basal septum • Circumflex – lateral, posterior

  15. Regional Wall Motion Abnormality • Normal - >30% wall thickening in systole • Hypokinetic - < 30% wall thickening in systole • Akinetic – no inward movement • Dyskinetic – out of phase 180degrees • Aneurysmal – thinned and bulging outwards

  16. LV Systolic Function – ‘Eyeball’ Assessment • Experienced operator • Quick and easy • Subjective • Subtle findings overlooked

  17. Doppler • Doppler helps to quantify global LV dysfunction • 30% of patients with normal LV systolic function have underlying diastolic dysfunction

  18. Other Echocardiographic Findings • LA • Mitral valve apparatus • LVOT • Interventricular septum • Myocardium/pericardium • Aortic valve • Tricuspid valve • Pulmonary valve and artery • Right heart chambers

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