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Assessment of Left Ventricular Function in the Critically Ill Patient

  • Point of Care Thoracic Ultrasound (S Koenig, Section Editor)
  • Published:
Current Pulmonology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

A rapid qualitative assessment of left ventricular (LV) function is one of the cornerstones of point of care ultrasonography. The purpose of this review is to use a case-based approach to demonstrate how point of care echocardiography can be used to perform a qualitative assessment of LV systolic function.

Recent Findings

Various studies have demonstrated that using standard goal-directed echocardiography views, the assessment of myocardial thickening, endocardial excursion and the motion of the anterior leaflet of the mitral valve can be used to classify the LV systolic function into four broad categories: (1) normal, (2) hyperdynamic, (3) reduced, and (4) severely reduced LV function.

Summary

Rapid qualitative assessment of LV systolic function provides valuable information, especially in patients with undifferentiated shock. However, it is important for the sonographer to recognize their limitations, be well versed in the pitfalls of each technique, and request a formal evaluation where appropriate.

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References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Author information

Authors and Affiliations

  1. Division of Pulmonary, Critical Care and Sleep Medicine, Long Island Jewish Medical Center/North Shore University Hospital, Northwell Health System, Hofstra-Northwell School of Medicine, New York, USA

    Gulrukh Zaidi

Authors
  1. Gulrukh Zaidi
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Correspondence to Gulrukh Zaidi.

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Conflict of Interest

Gulrukh Zaidi declares no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Point of Care Thoracic Ultrasound

Electronic supplementary material

Video 1

This PLAX view shows normal myocardial thickening, endocardial excursion and brisk movement of the anterior leaflet of the mitral valve towards the septum. (WMV 1375 kb)

Video 2

PSAX view at the mid-ventricular level showing normal myocardial thickening and normal endocardial excursion . (WMV 1068 kb)

Video 3

A4C view showing normal LV function (WMV 1188 kb)

Video 4

S4C view showing normal LV function (MP4 4075 kb)

Video 5

PLAX view showing a hyperdynamic LV with robust myocardial thickening, endocardial excursion and brisk movement of the anterior leaflet of the mitral valve. (WMV 1560 kb)

Video 6

PSAX view confirms vigorous contraction and thickening of all the myocardial segments of the hyperdynamic LV (WMV 1262 kb)

Video 7

A4C view showing hyperdynamic LV (WMV 1363 kb)

Video 8

S4C view showing hyperdynamic LV (WMV 1456 kb)

Video 9

Virtual IVC (WMV 799 kb)

Video 10

PLAX view showing reduction in endocardial excursion, myocardial thickening and excursion of the anterior leaflet of the mitral valve indicating severely reduced LV function. (MP4 5899 kb)

Video 11

PSAX view showing severely reduced LV function without any segmental wall motion abnormalities. (MP4 6019 kb)

Video 12

A4C view showing severely reduced LV and RV function (MP4 5714 kb)

Video 13

S4C View confirming a severe reduction in biventricular function (MP4 5951 kb)

Video 14

Plethoric IVC (MP4 6010 kb)

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Cite this article

Zaidi, G. Assessment of Left Ventricular Function in the Critically Ill Patient. Curr Pulmonol Rep 6, 164–168 (2017). https://doi.org/10.1007/s13665-017-0190-z

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  • DOI: https://doi.org/10.1007/s13665-017-0190-z

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