Pulmonary embolism (PE) is a critical condition where one or more of the arteries within the lungs become occluded by a blood clot. Quick diagnosis and treatment is crucial to keep mortality rates low. It is common for PE’s to originate from lower limb deep venous thrombosis (DVT). In other words:
In Hepatic Veins 101, we discussed the structure, function and waveforms of the hepatic veins, in regards to the cardiac cycle. This blog will cover how the hepatic veins play a role with the right heart. We tend to forget about the importance and useful information the hepatic veins provide us. Lets review, how the hepatic veins play a role in:
Over that past two months, we have discussed various methods for evaluating the right heart. Guided from the updated ASE chamber quantification guidelines, we have been able to elaborate on quantifying methods for:
Before jumping into assessing the RV with the Fractional Area Change method, lets recap the past couple weeks. Last week, we talked about two methods for quantifying the function of the RV (TAPSE & S’ Wave). We selected these methods to explain first due to ease, reproducibility and established prognostic value. As some of our readers pointed out and as we discussed the TAPSE and S’ Wave methods do have limitations though. The 3 main limitations are:
We have been teaching on correct techniques for right heart assessment (including TAPSE and RVSP) for a while now and we still seem to face a little resistance sometimes in regards to the clinical significance of right heart assessment. In order for us to learn and retain information we often have to understand the relevance and make a connection between what we are learning and how it relates to things we know.
We dedicated the month of April to learning about ways to implement right heart quantification into our routine exams. This month, we are going to continue that journey and discuss ways to evaluate the function of the right heart!
We recently reviewed basic right heart anatomy and outlined the ASE updated recommendations for quantifying right heart size and function. For the 2nd part of our Right Heart blog series, we are going to discuss proper measurements for size evaluation of the right ventricle (RV).
CardioServ is dedicating the month of April to right heart quantification awareness! This month we will present a series of blogs to review the proper methods to quantify right ventricular size and function.
An 85 year old patient presents to the ER with worsening shortness of breath and a history of known pulmonary hypertension. Her chest x-ray reveals massive cardiomegaly. An echo is ordered to assess the status of her pulmonary hypertension. We will present this echo to illustrate the correct techniques when performing an echocardiogram with the indication of pulmonary hypertension. Learn about the LV Eccentricity index and the latest recommendations for calculating correct RA pressure through evaluation of the IVC.
Pulmonary embolism continues to cause at least 60,000 deaths per year in the United States according to CDC statistics. Ten percent of symptomatic pulmonary emboli are fatal within one hour of symptoms onset. However, diagnosis can often be difficult because the presenting signs and symptoms are nonspecific and often mimic other cardiac and pulmonary diseases. Interventional strategies to remove or dissolve thrombi continue to improve. With these improvements, our ability to understand and diagnose also needs to improve. Echocardiography can aid in the diagnosis of pulmonary embolism and provides important functional information about the right and left ventricle that cannot be ascertained from other tests.
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