Core Studies
ECHO
Four standard echocardiographic windows and haemodynamic assessment
Useful measurements
- 2.1 cm → Normal IVC
- 1.2 cm -> Low volume IVC
- 4 m/s -> severe tricuspid regurgitation
- 4 m/sec -> severe aortic stenosis peak velocity of AV
- 21 mmHg -> normal RVSP
- 44 mmHg -> moderate RVSP
- 70 mmHg → severe RVSP
- 10cm -> poor LVOT VTI
- <3cm -> normal ascending aorta (if dilated ?type A dissection)
- EPSS (end point septal separation of mitral valve) <7 mm normal
Standard windows
There are four standard windows that should be used in every comprehensive or diagnostic level examination:
- Parasternal (short axis and long axis)
- Apical
- Subcostal
PLAX
The parasternal long axis view (of the left ventricle) can be found by making sure that the index marker of the probe is pointed towards the right shoulder.
PSAX
- From the parasternal long-axis view, rotate the transducer 90 degrees clockwise.
- Transducer orientation marker is pointing toward the patient's left shoulder (-2 o'clock).
- Tilt the transducer face slightly upward toward the patient's right shoulder.
| Structure | Assessment |
|---|---|
| Aortic Valve | cusp opening and calcification |
| Tricuspid Valve | motion and regurgitation |
| Pulmonic valve | motion and regurgitation |
| Right atrium | Better assessed in A4C |
| Left atrium | Better assessed in A4C |