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Echo


Yale Atlas:  http://www.yale.edu/imaging/echo_atlas/views/index.html

Stanford Echo:  http://www.stanford.edu/group/ccm_echocardio/cgi-bin/mediawiki/index.php/Main_Page

Pressure gradient (dP) (mmHg) = 4v2 (m/s)

Mean PA pressure = 0.61 × PASP + 2

Stroke volume = VTILVOT x AreaLVOT

LAP = SBP - dPLA/LV (MR jet)

Pulmonary hypertension = High TR max velocity (≥ 2.6 m/s) or low PA acceleration time (<105)

EF ≈ 20 + 44(aortic root displacement [cm])  (Acad EM 2013; 20:367-373)

Reference limits and values and partition values of left ventricular function
  Women Men
Reference range Mildly abnormal Moderately abnormal Severely abnormal Reference range Mildly abnormal Moderately abnormal Severely abnormal
Linear method
Endocardial fractional shrt'ng, % 27–45 22–26 17–21 ≤16 25–43 20–24 15–19 ≤14
Midwall fractional shortening, % 15–23 13–14 11–12 ≤10 14–22 12–13 10–11 ≤10
2D Method
Ejection fraction, % ≥55 45–54 30–44 <30 ≥55 45–54 30–44 <30

Estimation of right atrial pressure from the inferior vena cava (spontaneously breathing)

Inferior vena cava diameter Change with respiration Estimated right atrial pressure mmHg
Small <1.5 cm Collapse 0
Normal 1.5–2.5 cm Decrease by >50% 5
Normal Decrease by <50% 10
Dilated >2.5 cm Decrease by <50% 15
Dilated with dilated hepatic veins No change 20

                                                                                                    Am J. Cardiol. 1990;66: 493-6

Estimation of CVP from the IVC (mechanically ventilated)

Diastology:

Lusitropy = myocardial relaxation
Increased with catecholamines
Decreased with extracellular calcium

Emergency Ultrasound Podcast:

Mitral Valve Inflow (MVI)
Normal: E > A
Impaired Relaxation: E < A
Pseudonormal: E > A
Restrictive: E >> A

Mitral Annulus Tissue Doppler (TDI)
Normal: e' > a'
Normal: e' > 8

Nagueh-Formula: 1.9 + (1.24 x E/E') = PCWP


Echo Curriculum Videos:

Part I - Principles of Ultrasound (4:54)

https://www.dropbox.com/s/am24m57ldgyq97k/Part%20I%20-%20Principles%20of%20Ultasound.wmv

Part II - Basic Views (4:44)

https://www.dropbox.com/s/qrq70qpya6yw8an/Part%20II%20-%20Basic%20Views.wmv

Part III - Doppler and Valves (4:46)

https://www.dropbox.com/s/4jhqdd8f8h2zqgo/Part%20III%20-%20Doppler%20and%20Valves.wmv

Part IV - Functional Assessment (5:18)

https://www.dropbox.com/s/v1v4krioyndtx5j/Part%20IV%20-%20Functional%20Assessment.wmv


Additional resources:

Principles of Ultrasound:

http://folk.ntnu.no/stoylen/strainrate/Ultrasound/#Imaging

Basic Views:

http://www.echopedia.org/wiki/Standard_imaging_Views

Doppler and Valves:

http://www.echopedia.org/wiki/Normal_Values_of_TTE

Stroke Volume and EF:

http://www.criticalecho.com/content/tutorial-5-assessment-lv-systolic-function

Diastolic function:

http://www.echocardiology.org/diastolicfunction.htm

http://www.echobasics.de/diastole-en.html

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