Complete Study
How much time should a complete TTE take, which includes the acquisition of all images?
45-60 minutes
What imaging views can we obtain from the parasternal window?
PSLAX - RVOT, RVIT
PSSAX - Aorta Level, Mitral Level, Paps Level, Apex
What imaging views can we obtain from the apical window?
What is the best position for the patient to be in when imaging the subcostal window?
Supine with knees bent
What are the 3 main assessments of the heart that echo is used for?
Structure, Function, Hemodynamics
What are the modalities that we can use in the PSLAX view?
What is the best view for measuring LA and LV volumes?
4ch and 2ch
LV-focused view for LV volumes
What are the 3 views in the Subcostal window?
Subcostal 4ch, Subcostal SAX-IVC, and Subcostal SAX-Ab Aorta
What does PACS stand for?
Picture Archiving and Communication System
To calculate the RVSP, which parasternal view would be the best, and what would we measure?
RVIT in PSLAX or Tricuspid Valve in PSSAX at the Aorta level, measure the TR jet
What would M-Mode be used for in the Apical Window?
TAPSE - Tricuspid Annular Plane Systolic Excursion
from RV focused view
To assess RV systolic function
What can 2D imaging of the SSN view uncover?
Dilation and/or Dissection of the aorta
Coarctation
Name at least 5 basic pieces of information that should be entered before starting the study.
- Name and/or identifier of the laboratory, location, contact information
- Study date
- Patient identification and demographics, date of birth +/- age, gender
- Patient location (inpatient vs. outpatient), study location (echocardiography lab, portable – intensive care unit (ICU), Emergency Room (ER), etc.)
- Height, weight, body surface area
- Blood pressure
- Study indication.
- Referring physician identification
- Interpreting physician identification
- Sonographer identification
- Type of study (e.g., adult TTE, neonatal TTE, TEE, stress echocardiographic etc.)
LV for wall motion abnormalities (WMA)
Structure and Function of anatomy seen
Presence of fluid in the pericardial space
Which modality can assess regional systolic and diastolic ventricular function?
TDI
What is the subcostal 4-chamber view best used to assess? (name at least 2)
- Determine the presence of fluid in the pericardial space
– Abnormalities of the atrial septum
– Masses
- Ascites (fluid in abdominal cavity)
- VSDs
What are the 3 modalities that are used for hemodynamic assessments?
– Colour flow Doppler imaging
– Pulsed wave Doppler tracings
– Continuous wave Doppler tracings
How can we determine the Ejection Fraction in the PSLAX view?
Using M-Mode or 2D measurements. Measure the LVIDd and LVIDs.
The LVEF will be calculated using the Teichholz method.
What abnormal flow patterns can be seen in the apical window? And what are the best apical views to see these flows?
AI/AS - 5 ch, 3ch
MR/MS, TR/TS - 4 ch
What view and method can be used to determine right atrial pressures?
Subcostal SAX - IVC, Sniff Test