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 = length the LV/open the LVOT.
Sweep/fan to widen the LV.
Assessment: Features of RV strain
RV > LV size
Rule of thirds: LA, LVOT, RV no longer equal in diameter.
Poor RV free wall contractility
Septum moving towards LV in diastole.
Note: The video shown has no features of RV strain (see how much larger the LV is compared to the RV).
Parasternal Short Assessment
Once a parasternal long image is obtained, heel/rock to center the LV on screen + flatten the septum
Rotate 90 degrees with probe marker to right hip of patient
Fan/sweep to see papillary muscles.
Assessment: Features of RV strain
RV > LV size
Flat inter-ventricular septum
D sign of left ventricle
Septum moving towards LV in diastole.
Note: The video shown has no features of RV strain.
Apical 4 Assessment
Probe marker to right hip, 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 verticle.
Sweep/fan to easily see all four chambers.
Rotate to widen the ventricles.
Assessment: Features of RV strain
RV > LV size
TAPSE of RV free wall < 2cm
Septum moving towards LV in diastole.
Note: The video shown has no features of RV strain.
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