Basic Transthoracic Echocardiography (Cardiac Ultrasound) - TTE Made Simple

POCUS 1012 minutes read

Basic trans thoracic echocardiography includes various imaging windows and pathologies, with probe positioning and mode selection being crucial for accurate assessment. Differentiating between pericardial and pleural effusions, estimating ejection fraction, and evaluating IVC measurements are essential in guiding fluid management and making critical patient care decisions.

Insights

  • Proper probe positioning and mode selection are crucial in trans thoracic echocardiography, with standard mode indicating the patient's right hip and cardiac mode pointing to the right shoulder, ensuring accurate imaging and diagnosis.
  • Utilizing echocardiography for fluid management involves assessing IVC measurements, including diameter changes and the collapsibility index, to guide appropriate fluid administration based on CVP levels, ultimately aiding in patient care decisions and optimizing preload reserve.

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Recent questions

  • What is the probe of choice for basic trans thoracic echocardiography?

    The cardiac probe, also known as the phased array probe, is the preferred probe for basic trans thoracic echocardiography.

  • How is the indicator positioned in standard mode for echocardiography?

    In standard mode, the indicator is on the left of the screen, with the probe marker pointing to the patient's right hip in a long AIS view.

  • What is the first step in obtaining cardiac views during echocardiography?

    The first step in obtaining cardiac views is the parasal long axis view, followed by rotating the probe for short axis and apical four chamber views.

  • How can ejection fraction be estimated during echocardiography?

    Ejection fraction can be estimated visually or quantitatively using E Point Septal Separation (EPSS) during echocardiography.

  • How can pericardial effusion and pleural effusion be differentiated during echocardiography?

    Pericardial effusion and pleural effusion can be differentiated by specific ultrasound markers indicating each condition, with the presence of RV collapse and symptoms of hypoperfusion indicating pericardial effusion.

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Summary

00:00

Essential Techniques in Echocardiography Imaging

  • Basic trans thoracic echocardiography includes Imaging windows and various pathologies.
  • The probe of choice is the cardiac probe, also known as the phased array probe.
  • Probe positioning is crucial, with standard mode having the indicator on the left of the screen.
  • In standard mode, the probe marker points to the patient's right hip in a long AIS view.
  • In cardiac mode, the indicator is on the right of the screen, with the probe marker pointing to the patient's right shoulder.
  • Troubleshooting image issues involves checking the indicator position and ensuring the LV is on the left of the screen.
  • Obtaining cardiac views starts with the parasal long axis view, followed by rotating the probe for short axis and apical four chamber views.
  • The parasal long AIS view is essential for estimating ejection fraction and identifying various heart structures.
  • Ejection fraction can be estimated visually or quantitatively using E Point Septal Separation (EPSS).
  • Differentiating between pericardial and pleural effusions is crucial, with specific ultrasound markers indicating each condition.

13:42

"IVC Measurements for Fluid Management in Tamponade"

  • Pericardial effusion and tamponade are distinguished by the presence of RV collapse and symptoms of hypoperfusion, with ultrasound aiding in identifying cardiac standstill in patients without a pulse, indicating a lack of pumping rather than an arrhythmia.
  • IVC measurements, including diameter changes during respiratory cycles and the collapsibility index, are crucial for fluid management, with a high cable index suggesting low CVP and vice versa, guiding appropriate fluid administration.
  • Obtaining correct IVC images involves a subcostal approach, measuring diameter changes throughout the respiratory cycle, and calculating the cable index to predict preload reserve and determine optimal fluid levels, aiding in patient care decisions.
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