Queen's POCUS Consult Template

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What to Comment On: 

• LV systolic function 
  • Is the function grossly normal or reduced? 
• RV Assessment
  • RV size Appears normal (2/3 size of LV or less)? 
  • TAPSE ____ cm.
  • Septal flattening present? 
• Mitral valve
  • Is there mitral regurgitation? 
• Tricuspid valve
  • Is there tricuspid regurgitation?
    • If present: What is TR Vmax _____ m/s? 
    • TR pressure gradient _____ mmHg?
• Aortic valve: 
  • Is there aortic regurgitation? 
  • Aortic valve appears tri-leaflet? bicuspid? 
  • Aortic valve VMax_____ m/s.
• IVC Size and Collapsibility
  • IVC diameter _____, Collapsibility _____ 
    • I.e. IVC >2.1 cm, <50% collapsible with inspiration. 
    • I.e. IVC >2.1 cm, > 50% collapsible with inspiration.
    • I.e. IVC ≤ 2.1cm, > 50% collapsible with inspiration. 
  • Estimated right atrial pressure ____ mmHg.
    • i.e. 3mmhg, 8mmhg, 15mmhg
    • Limitations to assessment: 
  • Estimated RVSP ____ mmHg.
    • 4*(TR Vmax²) + estimated RAP
• Cardiac Output 
  • LVOT VTI ____cm. 
  • LVOT diameter ___ cm
  • HR ___ bpm. 
  • Cardiac output ______ L/min. 
• Is there a pericardial effusion? 
• JVP  ____cm above sternal angle.