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Echocardiogram in Congestive Heart Failure
Aka: Echocardiogram in Congestive Heart Failure, Echocardiogram in CHF, Echocardiogram in Systolic Dysfunction, Echocardiogram in Diastolic Dysfunction, E-A Wave Ratio, Measurement of Tau
- See Also
- Echocardiogram
- Bedside Lung Ultrasound in Emergency (Blue Protocol)
- Rapid Ultrasound in Shock (RUSH Exam)
- Inferior Vena Cava Ultrasound for Volume Status
- Congestive Heart Failure
- Systolic Dysfunction
- Diastolic Dysfunction
- Parasternal Long-Axis Echocardiogram View ( PLAX View)
- Parasternal Short-Axis Echocardiogram View (PSAX View)
- Subcostal Echocardiogram View (Subxiphoid Echocardiogram View)
- Apical Four Chamber Echocardiogram View
- Suprasternal Echocardiogram View
- Echocardiogram in Congestive Heart Failure
- Inferior Vena Cava Ultrasound for Volume Status
- Emergency Pericardiocentesis
- Pericardial Effusion
- Stress Echocardiogram
- Transesophageal Echocardiogram
- FAST Exam
- Indication
- Every patient with Congestive Heart Failure!
- Distinguishes
- Systolic Dysfunction
- Diastolic Dysfunction
- Identify underlying valve disease
- Identify underlying ischemic heart damage
- Quantify Congestive Heart Failure severity
- Assessment
- Chamber size (diastolic and end-systolic dimensions)
- Left Ventricular Hypertrophy
- Left Atrial Enlargement
- Ejection Fraction (EF)
- Systolic Dysfunction: EF < 45%
- Diastolic Dysfunction (isolated): EF > 50%
- Echocardiogram accuracy is +/- 5% at best
- Heart Valve Function and dysfunction
- Wall thickness and wall motion abnormalities
- Parasternal long axis view
- Mitral valve leaflet at maximal opening >13 mm distance from septum suggests Ejection Fraction <30%
- Ejection fraction can be estimated visually (tilt probe to include cardiac apex)
- Parasternal short axis view below mitral valve
- Ejection fraction can be estimated visually
- Findings: Diastolic Dysfunction
- Ejection Fraction >50% (see above)
- Abnormal pulmonary venous flow pattern
- Measurement of Tau (LV pressure decay)
- Assesses left ventricular stiffness
- Prolonged isovolemic relaxation time
- Prolonged deceleration time
- E-A Wave Ratio (Trans-mitral valve Blood Flow)
- Components
- E-Wave (LV filling) Peak Flow velocity
- A-Wave (atrial contraction) Peak Flow velocity
- Interpretation
- Normal: 1.5
- Early Diastolic Dysfunction: <1.0
- Late Diastolic Dysfunction: >2.0
- Approach: Obesity
- Body habitus too large for adequate exam
- Nuclear Ventriculogram (MUGA Scan)
- Resources
- Echocardiographer.org
- http://echocardiographer.org/index.html