Sharon Kay puts SMACC front and centre while polishing up your echo skills.

1. The Focused
Echocardiographic
Examination
Sharon Kay PhD
MSc (Perfusion)
MSc (echocardiography)
BSc (Med)

2. Echocardiography
echocardiography describes the use of
ultrasound in to assess the heart
v
v
due to diagnostic potential, echo is
widely used as common cardiac investigation
safe, non-invasive, cost effective, most
frequently used imaging procedure in the
diagnosis of heart disease
v

3. v
2D echo
v
Spectral Doppler
v
Colour Doppler

4. 5 things to look for
v
S - Size
v
M - Movement
v
A - Artefacts
v
C - Consistency
v
C - Conclusion

8. v
Subcostal long axis

9. v
Subcostal long axis

10. v
RV Dilated
v
LV Dilated

11. v
Subcostal Short

12. v
Subcostal IVC

13. •
Normal
•
Dilated

14. Subcostal Aorta

15. v
Parasternal long axis

16. v
Parasternal short axis - LV

17. Parasternal short axis - Valves

18. Apical 4 chamber

19. Apical 5 chamber

20. Apical 2 chamber

21. Apical long axis

22. Suprasternal – aortic arch

23. Diastology - What does it all Mean??
•
•
Diastology
• Normal
• Normal for age, without LA dilatation
• Impaired relaxation with normal filling pressures
• Impaired relaxation with elevated filling pressures
Decrease in LV compliance
• Pseudo normalization - Moderate
• Reversible restrictive - Marked
• Irreversible restrictive – Severe
• Constrictive
E>A
PV a reversal
Inflow swing

24. Chambers
•
Size
• All 4 chambers remodel in size depending
on pathology present
• eg: PHT / Aortic incompetence

25. Chambers
•
Movement - Function
• Fractional shortening – the squeeze of
the Ventricle
• Global – Cardiomyopathy –
•
•
•
ETOH
Athletes –
Segmental – AMI / IHD / Tako Tsubo

26. Wall thickness
•
•
Size
(or thinness)
• Hypertrophy – hypertension systemic or
pulmonary
• Deposits – sarcoid / amyloid / HOCM

27. v
•
Mildly reduced
LVEF

28. v
AMI
Inferolateral MI

29. Pericardial effusion

30. v
Haematoma

31. Pulmonary hypertension

32. Cardiomyopathy

33. •
Hypertensive
•
HOCM

34. Chambers
•
•
•
The atria
• Size ( LA – dilated ? why)
•
Diastolic dysfunction ?
IAS – hypermobile / aneurysmal / PFO /
Not just filling pressure …… Movement
Masses
• Thrombus / SEC / myxoma / Artifact

35. Masses
LA myxoma

36. Valves
v
Regurgitation
v
SIZE of chamber and jet

37. v
Mitral regurgitation

38. Valves
v
v
v
Stenosis - Movement
Artifact
Are the leaflets mobile –
Consistently mobile to the other
similar valve
vLunar valves and AV valve

39. Aortic stenosis

40. Mitral stenosis

41. CASE study

49. AV

50. Extra systolic

53. 5 things SMACC
v
S - Size
v
M - Movement
v
A - Artefacts
v
C - Consistency
v
C - Conclusion