Ultrasound for critical care physicians: unchain my heart

Abstract

A 46-year-old man presented after a motor vehicle collision. He suffered abdominal injuries (liver laceration, avulsed gall bladder) which were successfully managed nonoperatively. The patient remained intubated on mechanical ventilation and remained hypotensive after the injuries resolved. The patient required norepinephrine at low doses to maintain a normal blood pressure. It was noted the patient had a history of remote tricuspid valve replacement. A bedside echocardiogram was then performed to determine the etiology of the patient's persistent hypotension after hypovolemia had been excluded. Video 1. Apical four chamber view centered on the right heart. Video 2. Apical four chamber view centered on the right heart, with color Doppler over the right atrium and ventricle.