How to echo

Question 1

What equipment do we ned for echocardiography? (3)

Answer 1

• Cut out table
• Chair / stool

–correct height so you are comfortable!

•Correct probe choice for your patient

Question 2

What 3 things are involved in the prep?

Answer 2

•Clipping

–Apex beat on both sides

–Midline in the most cranial abdomen

• Spirit
• Gel

Question 3

What probe size do we use for:

1. Cats/small dog
2. Medium dog
3. Large dog

Answer 3

1. 7.5
2. 5
3. 2.5-3.5

Question 4

What view is this?

Answer 4

Right parasternal long axis 4 chamber

Question 5

What view?

Answer 5

Right parasternal long axis views

Question 6

What view?

Answer 6

Right parasternal long axis (RPLA)
4 chamber view

Question 7

Where do we go from the RPLA? Like how do we move to get the next view

Answer 7

• rotate the probe anticlockwise 20 degrees
• lift the wrist so the probe is angled more cranially

Question 8

What view and what does the arrow show?

Answer 8

Right parasternal LA 5 chamber view

(aorta)

Question 9

What is involved in the subjective assessment of the RPLA? (3)

Answer 9

–movement ventricles

–chamber dimensions

–valve morphology and motion

Question 10

What is involved in the quantitative assessment of the RPLA? (2)

Answer 10

–left atrium diameter

–left ventricle

• wall thickness
• diameter / volume

Question 11

What does this show?

Answer 11

LA size

Question 12

What does this show?

Answer 12

LV dimensions

Question 13

How do we get to the RSPA from RPLA?

Answer 13

From RPLA 4 chamber view turn thumb to bum and turn the probe 90o.

Tilt probe +/- slide probe up chest wall as necessary.

Question 14

What view?

Answer 14

Right parasternal short axis views

Question 15

What view is this and at what level?

Answer 15

Right parasternal short axis view
LV @ pap mm level

Question 16

What view is this and at what level?

Answer 16

Right parasternal short axis @ chorda tendinae

Question 17

What view and level is this?

Answer 17

Right parasternal short axis @ chorda tendinae

Question 18

What view and level is this?

Answer 18

Right parasternal short axis @ mitral valve

Question 19

What view and level is this?

Answer 19

Right parasternal short axis @ mitral valve

Question 20

What view of this?

Answer 20

Right parasternal short axis views

Question 21

What view and level is this?

Answer 21

Right parasternal short axis @ aortic valve

Question 22

What view and level is this?

Answer 22

Right parasternal short axis @ aortic valve

Question 23

Right parasternal short axis views

What do we subjectively assess? (3)

Answer 23

–movement ventricles

–chamber dimensions

–valve morphology and motion

Question 24

Right parasternal short axis views

What do we quantitavely assess? (4)

Answer 24

–Left atrium diameter

–Aorta diameter

–Pulmonary artery diameter

–M-mode

• EPSS
• LV

Question 25

What is the issue?

Answer 25

LA is big

Question 26

What does M mode tell us?

Answer 26

What is happening along this line with time!

Question 27

What is this?

Answer 27

M-Mode from RPSA view

Question 28

Which modes can we make measurements in? (3)

Answer 28

•2DE, MM and Doppler studies

Question 29

What should the LV:LA be in the RPLA view?

Answer 29

1:1

Question 30

Which mode do we use in dogs and cats for measuring chamber size? What increases the accuracy?

Answer 30

* Usually use M-mode in dogs * In cats 2DE sometimes better due to asymmetric hypertrophy * If can’t get a good MM then using 2DE imaging is better than poor M-mode * An ECG makes measuring more accurate

Question 31

How do you measure using M mode? Where should the cursor be?

Answer 31

* Always start from a right parasternal long axis view with a horizontal IVS * Turn 90 degrees ‘thumb to bum’ * Ensure the LV is ROUND * Ensure that the cursor is exactly in between the papillary muscles i.e. Transecting the LV into two equal halves

Question 32

What % of dogs lie outside of measurement reference ranges?

Answer 32

5%

Question 33

What can cause artefacts? (4)

Answer 33

* Usually poor contact * Side-lobe artefact * Reverberation artefact = mirror image * Breathing