This is a trial: haemodynamic measurements/ results by echocardiography in comparison with PA-cath-results. about 75 y old patient with cardiogenic shock by occlusion of RCA. Echocardiographic results: 1. contractility by mv-insufficiency: dp/dt about 320 mmHg/s (this shows a distinct impairment of left ventricle). 2. an approach to LVEDP by E/E`: about 12,7 mmHg 3. approach to CVP alternatively RAP: collapsibility of IVC: one can see, that there is no undulation/ collapsibility of IVC, diameter of IVC > 2 cm: RAP about 15-20 mmHg 4. approach to cardiac output: LVOT-VTI about 23,5 cm, LVOT-area 1,53 cm^2 (radius 0,7 cm) > stroke volume about 36 ml; heart rate: 110/min > cardiac aoutout about 3,9 l/min 5. tricupid valve (TV): Vmax: 3,4 m/sec, PAPs 35 mmHg + CVP; ATC of PV-flow 89 msec, PV-VTI 12,3 cm, one can calculates the PVR with two methods: > a. PVR= TV-flow velocity/ VTI of RVOT x 10 + 0,16; in this case you can calculate: PVR= 3,4 m/s / 0,125 m x 10 + 0,16 = 276 dyn*s*cm^-5 > b. PVR= (PAPm-PCWP)/CO x 79,9; in this case I couldn´t measure the PAPm and PAPd because I couldn´t depict a PV-insufficiency-signal by echocardiography. In comparison: the PA-cath-results: PCWP (LVEDP) 13-14 mmHg, CVP 19 mmHg, CO 4,3-4,5 l/min, PVR 285 dyn*s*cm^-5, SVR 890 dyn*s*cm^-5, cardiac power 0,71 W In my opinion is echocardiographic measurements of a few parameters a good option to approach haemodynamic in patient and to make a fast decision of therapeutical treatment in ER or ICU. I´m lookinf forward to any comment, hints, tipps and critic. That could help me to improve my skills in that kind of echocardiographic technique.

Added by: Emmel
Tags: TTE ICU echodynamic haemodynamic PA-cath
Date: 2012-01-29

A man in his 40s presents with an new onset heart failure, severe HTN (SBP ~240) and this mass in his LV. What could it be? Is it thrombus?

Added by: drdavemd
Tags: unknown ventricular mass hyperechoic
Date: 2009-04-28

In this parasternal short axis transthoracic clip, you can see the D shape of the LV common in patients with RV pressure overload. The IV septum also bounces in this particular patient with a history of sternotomy for aortic valve replacement.

Added by: drdavemd
Tags: tte parasternal short RVP post-op
Date: 2011-12-07

In this clip, we can see the right atrium collapsing, but is it indicative of tamponade? When does it seem to occur during the cardiac cycle? Does the amount of effusion affect your assessment?

Added by: drdavemd
Tags: right atrial collapse tamponade
Date: 2009-03-29

This apical TTE clip demonstrates the appearance of a patient with a severe dilated LV cardiomyopathy that has resulted in distortion of the mitral valve, severe prolapse, and regurgitant flow.

Added by: drdavemd
Tags: mitral prolapse apical TTE dilated
Date: 2010-02-05

In this zoom view of the aoritc valve in parasternal short axis TTE, the aortic valve appears bicuspid, but there is a echo artifact crossing the valve. What do you think?

Added by: drdavemd
Tags: aortic valve bicuspid artifact
Date: 2011-03-10

If you look carefully at the posterior leaflet of the mitral valve, on the atrial side, you will see a small vegetation. The patient has no signs or symptoms of infection, does this represent endocarditis?

Added by: drdavemd
Tags: mitral valve vegetation posterior leaflet
Date: 2009-03-23

This parasternal long axis TTE clip shows a bizarre calcification on the atrial/posterior aspect of the mitral valve. Does the central clearing indicate that this is an old abscess or is it just a run-of-the-mill calcification?

Added by: drdavemd
Tags: transthoracic TTE calcification abscess
Date: 2009-05-14

Does this aortic valve look abnormal? This is an incidental finding from a study of a trauma patient with hypotension. There is no known prior history of aortic stenosis or rheumatic disease. Does it help if there is no significant gradient measured across the valve?

Added by: drdavemd
Tags: rheumatic aortic valve stenotic
Date: 2009-10-15

Frequently, the descending aorta can be seen just behind the left atrium in the parasternal long axis view on TTE. In this case, a subtle finding is a serious one that must be detected. The linear echodensity across the aorta is an acute dissection of the aorta.

Added by: drdavemd
Tags: parasternal TTE aorta dissection
Date: 2010-04-01

Rheumatic Mitral stenosis with SEVERELY++ dilated LA and Moderate-Severe Mitral Regurgitation. Peak velocity over MV of 2.3m/s and a mean gradient of 6.6mmHg. LA measured 8.8cm in PLAX and had an A4CH area of 161cm².

Added by: EHaumann
Tags: Dilated LA, Mitral valve stenosis
Date: 2011-12-12

Anyone can you identify this mitral prosthesis?

Added by: DrO
Tags: TEE mitral prosthesis mechanical valve
Date: 2008-11-10

This patient suffers from massive biatrial enlargement, over 5 cm each!

Added by: drdavemd
Tags: TTE enlarged atrium biatrial apical
Date: 2009-03-26

A man in his 40s presents with an new onset heart failure, severe HTN (SBP ~240) and this mass in his LV. What could it be? Is it thrombus?

Added by: drdavemd
Tags: unknown ventricular mass hyperechoic
Date: 2009-04-28

HCM

Added by: sonnet
Tags: HCM
Date: 2009-09-30

Elderly female patient with AF, Pulmonary hypertension, Bilateral pleural efuusion. Echo showed...

Added by: sonnet
Tags: LA mass, AF, Pulmonary hypertension
Date: 2009-11-19

What is the red jet adjacent to and to the right of Ao. Valve?

Added by: sdraza1
Tags: Parasternal short axis Ao Valve
Date: 2010-11-07

excess mitral tissue moving into the left ventricular outflow tract during systole,with color aliasing,without significant subaortic obstruction.

Added by: magehana47
Tags: excess accessory mitral valve tissue lvot echo
Date: 2011-06-07

This patient became suddendly Hypoxiemic and hypotensve . He was hospitalized since 8 days because he suffered from severe necrotizing fascitis and acute liver failure . He passed off quickly . Post mortem autopsy confirmed diagnosis

Added by: diego
Tags: Pulmonary hypertension
Date: 2011-08-16

30 yo guy previously healthy . No history of cardiac desease . Admitted in ER after a sudden and heavy chest pain . Hypotenson and pulmonary edema . He has been quick intubated and mechanically ventilated . He had no chance to survive . This patient passed off after 2 days ICU stay

Added by: diego
Tags: STEMI
Date: 2011-08-17