Transthoracic echocardiographic evaluation of the heart and great vessels

Denault, André; Langevin, Stéphane; Lessard, Martin; Courval, Jean Francois; Desjardins, Georges

doi:10.1007/s12630-018-1068-4

Cited by 14 publications

(11 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A detailed technical description of the ultrasound technique is beyond the scope of this paper and is well-described elsewhere. 19 Suffice it to say that placing a phased-array transducer just beneath the patient's xiphoid process with the orientation marker directed cranially easily yields a view of the IVC in most patients. From here the operator can freeze the screen and measure the diameter of the IVC at end-expiration, where the intrathoracic pressure is closest to atmospheric pressure.…”

Section: Inferior Vena Cava Analysis: the Basicsmentioning

confidence: 99%

Ultrasound assessment of the inferior vena cava for fluid responsiveness: easy, fun, but unlikely to be helpful

Millington

2019

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Section: Inferior Vena Cava Analysis: the Basicsmentioning

confidence: 99%

Ultrasound assessment of the inferior vena cava for fluid responsiveness: easy, fun, but unlikely to be helpful

Millington

2019

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

“…In conclusion, our data provides valuable information regarding the echocardiographic utility of the subcostal approach aside from its wellrecognized uses. 3,12,31 Even though the subcostal window is one of the standard acoustic views recommended by the American Society of Echocardiography for assessment of inferior vena cava, abdominal aorta, pericardial effusion, right atrium, inter-atrial septum, and RV wall thickness. 12 However, there is no documentation of how often this acoustic view is in fact acquired in a routine basis.…”

Section: Discussionmentioning

confidence: 99%

Right ventricular free wall contractility in subcostal views: A proof‐of‐concept study to assess right ventricular systolic function

López‐Candales

Vallurupalli

2021

Echocardiography

View full text Add to dashboard Cite

Background: Normal right ventricular (RV) function has been traditionally assessed from the apical window. However, in several patients the subcostal window is the only available acoustic. Methods:Given the intricate functional and mechanical inter-dependence between longitudinal tricuspid annular (TA) displacement and RV free wall contractility (RVFW), we studied the utility of RVFW inward motion using both M-mode and velocity with tissue Doppler imaging (TDI) from the subcostal transthoracic view.Results: If a TAPSE value ≥ 2 cm is used to identify normal RV function, an RVFW Mmode value > .8 cm, TA TDI s' velocity > .06 cm/s and TA TDI e' velocity value > .05 cm/s identify normal RV systolic function. Furthermore, ROC curve analysis for the RVFW M-mode showed an area under the curve (AUC) of .753 (95% CI: .604-.868) with a cutoff value > .8, sensitivity 75% and specificity 73%; for TA TDI s' AUC at .822 (95% CI:.681-.919) with a cut-off value > .06, sensitivity 75% and specificity 77% and for TA TDI e' the AUC was .771 (95% CI: .624-.882) with a cut-off value > .05, sensitivity 90% and specificity 46%. Reproducibility of repeat RVFW M-mode, TDI s' and e' measurements was good with strong inter-rater agreement (Kappa > .8). Conclusions:The subcostal window appears useful for assessing RV systolic function.

show abstract

“…In addition, presence or absence of pericardial effusion, gross valvular dysfunction, and chamber enlargement can be evaluated. Volume overload and acute pressure overload are associated with right ventricular (RV) enlargement and interventricular septal flattening in diastole (leading to a D-shaped LV assessed in the parasternal short axis cardiac view), whereas chronic pressure overload causes flattening in both systole and diastole [78,79]. RV enlargement is often associated with functional tricuspid regurgitation, which further exacerbates RV overload at end-diastole as well as causes increased right atrial pressure (RAP) and central venous congestion [80].…”

Section: Focused Cardiac Ultrasoundmentioning

confidence: 99%

Diagnosis of Fluid Overload: From Conventional to Contemporary Concepts

Koratala¹,

Ronco²,

Kazory³

2022

Cardiorenal Med

View full text Add to dashboard Cite

Fluid overload has been associated with morbidity and mortality in various clinical scenarios including heart failure and critical illness. It exerts pathologic sequelae in almost all the organ systems. Proper management of patients with fluid overload requires knowledge of the underlying pathophysiology, objective evaluation of volume status, selection of appropriate therapeutic options, and maintenance and modulation of tissue perfusion. There are several methods to appraise volume status but none without limitations. In this review, we discuss the diagnostic utility, prognostic significance, and shortcomings of various bedside tools in the detection of fluid overload and evaluation of hemodynamic status. These include clinical examination, biomarkers, blood volume assessment, bioimpedance analysis, point-of-care ultrasound, and remote pulmonary pressure monitoring. In our opinion, clinicians must adopt a multiparametric approach offsetting the limitations of individual methods to formulate a management plan tailored to patients’ needs.

show abstract

Transthoracic echocardiographic evaluation of the heart and great vessels

Abstract: The integration of the echocardiographic information particularly from the heart and great vessels with the case story, physical examination, laboratory data, and other relevant clinical information should become the way of the future, and this will benefit the patients under our care.

Cited by 14 publications

References 38 publications

Ultrasound assessment of the inferior vena cava for fluid responsiveness: easy, fun, but unlikely to be helpful

Ultrasound assessment of the inferior vena cava for fluid responsiveness: easy, fun, but unlikely to be helpful

Right ventricular free wall contractility in subcostal views: A proof‐of‐concept study to assess right ventricular systolic function

Diagnosis of Fluid Overload: From Conventional to Contemporary Concepts

Contact Info

Product

Resources

About