Advanced Functional Echocardiographic Views Including PDA Assessment and Hemodynamic Evaluation

Abstract

A bedside point-of-care echocardiography can provide real-time anatomical, physiological, and hemodynamic information which helps in making physiology-based timely and accurate clinical decisions. Application of advanced echocardiography techniques can be applied to assess cardiac function, preload and afterload, and evaluate cardiac contractility/functions. They can be applied to estimate cardiac output and in diagnosis and hemodynamic evaluation of pulmonary hypertension and patent ductus arteriosus. It is indispensable in the management of patients with shock, pulmonary hypertension, and patent ductus arteriosus. While most of these conditions have been described in the other chapters of this book, this chapter focuses on (1) diagnosis and hemodynamic evaluation of patent ductus arteriosus, and (2) Estimation of left ventricle output, right ventricle output, and superior vena cava flow. Ductal patency cases can be assessed on point-of-care ultrasound (POCUS), however a detailed hemodynamic evaluation is out of the scope of POCUS assessment, and it should be performed by a pediatric cardiologist or neonatologist trained in echocardiography. Although hemodynamic evaluation of the patent ductus arteriosus, estimation of left and right cardiac outputs, and superior vena cava flow are out of the scope of cardiac POCUS, a brief description of these echocardiographic techniques have been provided in this chapter to enhance the understanding of cardiovascular physiology for the readers who are interested in learning advanced echocardiography.