Place cardiac probe at nipple line near the left side of the sternum. Slide on anterior chest until obtain view of the heart.
Center image on screen, heel if needed.
Rotate = lengthen the LVOT.
Sweep to widen the LV.
Assessment: Normal LV function:
Fractional Shortening > 30% mid LV
EPSS < 1cm (mitral valve leaflet comes within 1cm of interventricular septum)
Mid LV dilation < 5cm at end diastole
LV free wall > 1cm thick, thickens with contractions.
Parasternal Short Assessment
Once a parasternal long image is obtained, heel to center the LV on screen + ensure septum is horizontal.
Rotate 90 degrees with probe marker to left shoulder of patient.
Fan to see papillary muscles.
Assessment: Normal LV function
Fractional shortening > 30%
Mid LV dilation < 5cm at end diastole
LV free wall > 1cm thick, thickens with contractions.
Want concentric squeeze throughout LV.
note: kissing ventricles in systole = hyperdynamic = dry
Apical 4 Assessment
Probe marker in same direction as screen marker, beam towards right shoulder, place cardiac probe at apex (often near the nipple line). Slide until find the heart and center in the middle of screen.
Heel to make septum vertical.
Sweep to easily see all four chambers.
Rotate to widen the ventricles.
Assessment: Normal LV function:
Fractional Shortening > 30% mid LV
Mid LV dilation < 5cm at end diastole
LV free wall > 1cm thick, thickens with contractions.
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