Advertisement

Transthoracic Echocardiography: The Basic Views

  • Sonia NhieuEmail author
Chapter
  • 1.9k Downloads

Abstract

Bedside transthoracic echocardiography (TTE) is a valuable, noninvasive, point-of-care diagnostic tool that can be used for cardiac evaluation of symptomatic or hemodynamically unstable patients. Use of TTE in the perioperative setting, emergency medicine or critical care patient population can provide new objective data and guide clinical management. The increasing availability of TTE and minimal training required to become competent makes the bedside TTE examination complementary to TEE.

Keywords

Transthoracic echocardiography Cardiac ultrasound Basic views Bedside transthoracic echocardiography (TTE) Noninvasive 

Abbreviations

TTE

Transthoracic echocardiography

TEE

Transesophageal echocardiography

LV

Left ventricle

FOCUS

Focused cardiac ultrasound

ASE

American Society of Echocardiography

ACEP

American College of Emergency Physicians

PEA

Pulseless electrical activity

LAX

Long axis

LA

Left atrium

LVOT

Left ventricular outflow tract

RV

Right ventricle

SAX

Short axis

IVC

Inferior vena cava

Supplementary material

Video 14.1

Parasternal LAX view (AVI 58,276 kb)

Video 14.2

Parasternal SAX view of the AV (AVI 440,322 KB)

Video 14.3

Parasternal SAX basal view of the mitral valve (AVI 22,444 KB)

Video 14.4

Parasternal SAX mid-papillary view of the LV (AVI 41,569 KB)

Video 14.5

Apical four-chamber view (AVI 38,502 KB)

Video 14.6

Lack of respiratory variation in the IVC suggests that the patient is not fluid responsive (AVI 154,693 KB)

Video 14.7

Parasternal SAX view showing an obliterated LV cavity during systole, suggestive of hypovolemia (AVI 113,911 KB)

Video 14.8

Parasternal SAX view of a hemodynamically significant pericardial effusion (AVI 5,711 KB)

Video 14.9

Apical four-chamber view demonstrating the McConnell’s sign, an echocardiographic finding in which the apical RV is spared. This patient had an acute pulmonary embolus (AVI 34,376 KB)

References

  1. 1.
    Melamed R, Sprenkle MD, Ulstad VK, Herzog CA, Leatherman JW. Assessment of left ventricular function by intensivists using hand-held echocardiography. Chest. 2009;135(6):1416–20.CrossRefPubMedGoogle Scholar
  2. 2.
    Labovitz AJ, Noble VE, Bierig M, Goldstein SA, Jones R, Kort S, et al. Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J Am Soc Echocardiogr Off Publ Am Soc Echocardiogr. 2010;23(12):1225–30.CrossRefGoogle Scholar
  3. 3.
    Oren-Grinberg A, Gulati G, Fuchs L, Pinto DS. Hand-held echocardiography in the management of cardiac arrest. Anesth Analg. 2012;115(5):1038–41.CrossRefPubMedGoogle Scholar
  4. 4.
    Breitkreutz R, Price S, Steiger HV, Seeger FH, Ilper H, Ackermann H, et al. Focused echocardiographic evaluation in life support and peri-resuscitation of emergency patients: a prospective trial. Resuscitation. 2010;81(11):1527–33.CrossRefPubMedGoogle Scholar
  5. 5.
    Boyd JH, Forbes J, Nakada T, Walley KR, Russell JA. Fluid resuscitation in septic shock: a positive fluid balance and elevated central venous pressure are associated with increased mortality. Crit Care Med. 2011;39(2):259–65.CrossRefPubMedGoogle Scholar
  6. 6.
    Muller L, Bobbia X, Toumi M, Louart G, Molinari N, Ragonnet B, et al. Respiratory variations of inferior vena cava diameter to predict fluid responsiveness in spontaneously breathing patients with acute circulatory failure: need for a cautious use. Crit Care Lond Engl. 2012;16(5):R188.CrossRefGoogle Scholar
  7. 7.
    McConnell MV, Solomon SD, Rayan ME, Come PC, Goldhaber SZ, Lee RT. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol. 1996;78(4):469–73.CrossRefPubMedGoogle Scholar
  8. 8.
    Price S. Hemodynamic monitoring using echocardiography in the critically ill—Chapter 2 Transthoracic echocardiography: normal two-dimensional and doppler imaging. 2011. p. 13–29.Google Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Division of Cardiovascular Anesthesiology and Critical CareTexas Heart Institute at Baylor St. Luke’s Medical CenterHoustonUSA

Personalised recommendations