Cardiac - Assessment of LV Function

Parasternal Long Assessment

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/rock if needed.
Rotate = lengthen the LVOT.
Sweep/fan to widen the LV.
Assessment: Normal LV function features:
- Fractional Shortening > 30% mid LV
- EPSS < 1cm (mitral valve leaflet comes within 1cm of interventricular septum)
  - Ideally < 0.7cm
- Mid LV dilation < 5cm at end diastole

Parasternal Short Assessment

Once a parasternal long image is obtained, heel/rock to center the LV on screen + ensure septum is horizontal.
Rotate 90 degrees with probe marker to left shoulder of patient.
Fan/sweep to see papillary muscles.
Assessment: Normal LV function
- Fractional shortening > 30%
- Mid LV dilation < 5cm at end diastole
- 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/rock to make septum vertical.
Sweep/fan 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