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Assessment of Left Ventricular Systolic Function Using Echocardiography

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

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Presentation Transcript
cardiac ultrasound
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
transducers
Transducers
  • Phased array
  • Small footprint
  • Frequency used is in MHz range
  • 2 – 3.5MHz
  • Resolution versus penetration
  • Harmonics
imaging planes
Imaging Planes
  • Long axis
  • Short axis
  • Apical four and five chamber
imaging views
Imaging Views
  • Preparing the patient
  • Parasternal long axis
  • Parasternal short axis
  • Apical four and five chamber
  • Apical two chamber
  • Subcostal
  • Suprasternal
parasternal long axis
Parasternal Long Axis
  • Septum
  • Posterior wall
  • LV Dimensions
  • Mitral valve
  • LVOT
  • Ascending aorta
parasternal short axis papillary muscle level
Parasternal Short Axis – Papillary Muscle Level
  • Regional wall motion assessment at mid – level
apical four chamber
Apical Four Chamber
  • Septum
  • Lateral wall
  • Apex
  • Mitral Valve
  • Right Heart Chambers
subcostal view
Subcostal View
  • Assess right heart
  • IVC
  • IAS
assessment of left ventricular systolic function
Assessment of Left Ventricular Systolic Function
  • M-mode
  • - advantages
  • - disadvantages
lv systolic function regional wall motion
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
coronary artery supply
Coronary Artery Supply
  • Regional wall analysis correlates well with coronary artery supply
  • LAD – anterior, septum
  • RCA – inferior, basal septum
  • Circumflex – lateral, posterior
regional wall motion abnormality
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
lv systolic function eyeball assessment
LV Systolic Function – ‘Eyeball’ Assessment
  • Experienced operator
  • Quick and easy
  • Subjective
  • Subtle findings overlooked
doppler
Doppler
  • Doppler helps to quantify global LV dysfunction
  • 30% of patients with normal LV systolic function have underlying diastolic dysfunction
other echocardiographic findings
Other Echocardiographic Findings
  • LA
  • Mitral valve apparatus
  • LVOT
  • Interventricular septum
  • Myocardium/pericardium
  • Aortic valve
  • Tricuspid valve
  • Pulmonary valve and artery
  • Right heart chambers