GUH-ICU&Anaesthesia
GUH-ICU&Anaesthesia

@GUH_ICU_Anaesth

10 Tweets 8 reads Jul 27, 2021
3rd of 3 retweets today
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GUH Echo tweetorial
1/1
The Apical 4-Chamber
2/9
As always we will first look at the hand movements:
1.Slide laterally – following the rib space
2.Rock probe tail laterally
3/ 9
As I was taught – forget about palpating the apex beat – big movements until you see the heart and then small movements to get the best on axis image
Remember on axis is:
1. Apex of LV forming apex of image
2. Septum is vertical and central
3. Both Valves opening
4/9
What are we looking at?
5/9 Once on axis prior to acquiring your image :
1.Depth
2.Width
3.Gain
4.Focus
6/9
Correcting off axis mistakes
Lateral slide + Rock tail laterally
7/9
LV assessment
Look at the diagram in the bottom Left corner:
8/9 RV assessment (isolated RV view for teaching purposes):
RV size should be no more than 2/3 size of LV Function requires looking at both:
1.TAPSE
2.RV Free wall motion
9/9.
TAPSE
1. Get best view of RV
2. Cursor placed through TV lateral annulus
3. Press M- Mode ->measure distance of systolic annular RV excursion along this line (See below)

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