Abstract
This chapter provides an introductory overview of basic body surface ultrasonography, focused transthoracic echocardiographic examination (TTE), and focused assessment with sonography in trauma (FAST). The overall goal is to provide the reader with the tools to utilize ultrasonography to facilitate clinical decision-making and impact patient management and outcome. The goal of this chapter is to aid the reader in learning how to perform a basic exam and recognize normal anatomy. We will concentrate on two-dimensional (2D) imaging, targeted color flow Doppler (CFD) valve assessment, and continuous wave Doppler (CWD).
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Bibliography
Jensen MB, Sloth E, Larsen KM, Schidt MB. Transthoracic Echocardiography for cardiopulmonary monitoring in the intensive care unit. Eur J Anaesthesiol. 2004;21:700–7.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Electronic Supplementary Material
Parasternal long axis view of the left heart. Video/few initial seconds are still images. (a): Anterior chest wall; (b): right ventricular outflow tract; (c): long axis left ventricle, with anteroseptal wall on top and inferolateral wall on bottom; (d): aortic root, with AV between “c” and “d”; (e): left atrium, with mitral valve between “c” and “e”; (f): with line delineating left pleura; (g): descending thoracic aorta in short axis. This video is part of the book titled “Cardiac Anesthesia -The Basic Evaluation and Management,” Springer Publisher, Inc., 2019, edited by Dr. Ahmed Awad, and complement the chapter “The Fundamentals of TTE, and FAST Examination” by Dr. Enrique Pantin & Dr. Denes Papp. (MP4 6213 kb)
Parasternal long axis view of the right heart. Video/few initial seconds are still images. (a): Right ventricle; (b): right atrium. Area between “a” and “b” sits the tricuspid valve; top arrow depicts the opening of the coronary sinus, and bottom arrow indicates the inferior vena cava as they join the right atrium. This video is part of the book titled “Cardiac Anesthesia-The Basic Evaluation and Management,” Springer Publisher, Inc., 2019, edited by Dr. Ahmed Awad, and complement the chapter “The Fundamentals of TTE, and FAST Examination” by Dr. Enrique Pantin & Dr. Denes Papp (MP4 5439 kb)
Parasternal short axis view of the heart. Video/few initial seconds are still images. Short axis view of the base of the right (a) and left ventricle (b). The area between “a” and “b” is the interventricular septum. The white dot represents a rib cartilage that only allows some ultrasound waves to go through it and thus the area imaged distal to is very blurred. Note the quarter moon shape inside the left ventricle; this is the mitral valve with its anterior leaflet on top and posterior leaflet below. This video is part of the book titled “Cardiac Anesthesia-The Basic Evaluation and Management,” Springer Publisher, Inc., 2019, edited by Dr. Ahmed Awad, and complement the chapter “The Fundamentals of TTE, and FAST Examination” by Dr. Enrique Pantin & Dr. Denes Papp (MP4 6046 kb)
Parasternal short axis view at the level of the aortic valve. Video/few initial seconds are still images. Probe tilted caudally from left ventricular short axis view making the ultrasound plane scan cephalad. (a): Right atrium; (b): right ventricle; (c): pulmonary artery and its bifurcation; (d): left atrium; (e): descending thoracic aorta in short axis. The tricuspid valve is located between “a” and “b.” The pulmonic valve is located between “b” and “c.” The interatrial septum is located between “a” and “d.” The aortic valve in short axis is located in the middle of the figure. The three cusps are noted. The cusp closest to the interatrial septum is the non-coronary cusp, the cusp near the pulmonary artery is the left coronary cusp, and the cusp near the right ventricle – usually anterior in the image – is the right coronary cusp. Note the two white dots at top of the image; they represent two ribs, and the black area beyond is the shadowing generated due to the ultrasound beam impossibility of going through the ribs. This video is part of the book titled “Cardiac Anesthesia-The Basic Evaluation and Management,” Springer Publisher, Inc., 2019, edited by Dr. Ahmed Awad, and complement the chapter “The Fundamentals of TTE, and FAST Examination” by Dr. Enrique Pantin & Dr. Denes Papp (MP4 4971 kb)
Apical four chamber view. Video/few initial seconds are still images. This image is between a “4-chamber view” and a “5-chamber view” and was obtained tilting the probe slightly caudad to have the ultrasound beam aim more anteriorly and showing the left ventricular outflow track. (a): Right atrium; (b): right ventricle; (c): left ventricle; white arrow: left ventricular outflow tract; (d): left atrium. Tricuspid valve between “a” and “b,” mitral valve between “d” and “c,” interatrial septum between “a” and “d,” and interventricular septum between “b” and “c.” This video is part of the book titled “Cardiac Anesthesia-The Basic Evaluation and Management,” Springer Publisher, Inc., 2019, edited by Dr. Ahmed Awad, and complement the chapter “The Fundamentals of TTE, and FAST Examination” by Dr. Enrique Pantin & Dr. Denes Papp. (MP4 5101 kb)
Subxiphoid view of the heart. Video/few initial seconds are still images. With the probe placed just below the xiphoid appendage, the abdominal wall is seen, and then the liver “(a),” and through it the right heart on top and then the left heart bellow. (b): Left atrium, above it the right atrium; (c): left ventricle, and above it the right ventricle. This video is part of the book titled “Cardiac Anesthesia-The Basic Evaluation and Management,” Springer Publisher, Inc., 2019, edited by Dr. Ahmed Awad, and complement the chapter “The Fundamentals of TTE, and FAST Examination” by Dr. Enrique Pantin & Dr. Denes Papp. (MP4 5321 kb)
Left and right anterior chest view. Video/few initial seconds are still images. With the probe placed in a sagittal plane in the mid-axillary line, the chest wall (a) is scanned. Each space scanned should allow view of a full intercostal area with the rib above (b) and below (b) in short axis. Note the shadowing generated below the ribs, and it is thus impossible to see beyond them. The pleural line (c) seen sliding under the chest wall demonstrating there is lung present bellow the chest wall, and no pneumothorax or pleural effusion in the area examined. This video is part of the book titled “Cardiac Anesthesia-The Basic Evaluation and Management,” Springer Publisher, Inc., 2019, edited by Dr. Ahmed Awad, and complement the chapter “The Fundamentals of TTE, and FAST Examination” by Dr. Enrique Pantin & Dr. Denes Papp. (MP4 1140 kb)
Internet Resources
-
History of ultrasound:
Siddharth Singh and Abha Goyal. The Origin of Echocardiography A Tribute to Inge Edler. Tex Heart Inst J. 2007; 34(4): 431–438. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2170493/pdf/20071200s00010p431.pdf
A short History of the development of Ultrasound in Obstetrics and Gynecology.
Dr. Joseph Woo.
http://www.ob-ultrasound.net/site_index.html
-
Educational videos:
YouTube, use generic and specific search terms such as: TTE, transthoracic echocardiography, FAST, lung ultrasound, pneumothorax on ultrasound, etc.
Resources and Tutorials on Emergency Medicine Ultrasound.
Rights and permissions
Copyright information
© 2021 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Pantin, E.J., Papp, D. (2021). The Fundamentals of Transthoracic Echocardiography (TTE) and the Focused Assessment with Sonography in Trauma (FAST) Examination. In: Awad, MD, MBA, A.S. (eds) Cardiac Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-030-51755-7_10
Download citation
DOI: https://doi.org/10.1007/978-3-030-51755-7_10
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-51754-0
Online ISBN: 978-3-030-51755-7
eBook Packages: MedicineMedicine (R0)