1.The Focused Echocardiographic Examination Sharon Kay PhD MSc (Perfusion) MSc (echocardiography) BSc

2. The Heart revealed 5 different tools / modalities are used in every day cardiac echo 3. 3D echo Spectral Doppler Colour Doppler 2D echo Strain / speckle track 4. The Heart revealed 5 different tools / modalities are used in every day cardiac echo It will take years of training > 5, multiple scans > 4000 to become an expert and be able to exclude things THIS IS NOT WHAT BCC / EFOCUS / Rapid cardiac assessment IS! 5. The Heart revealed - EFOCUS Arm to your clinical medicine BE A DR Helping strengthen your impressions Not a diagnostic tool or fishing expedition 6. The Heart revealed - EFOCUS EFOCUS FEEL LIMITED ECHOWINFOCUS FATE RACE EFAST BEDSIDE SONO 7. FATE CARD - Android / IPhone 8. FATE 9. Subcostal long axis 10. Subxiphoid long axis 11. Subxiphoid Short 12. Subxiphoid IVC 13. Parasternal long axis 14. Parasternal short axis - LV 15. Parasternal short axis - Valves 16. Apical 4 chamber 17. The Heart revealed S Size M Movement A Artefacts C Comparison C Consistency 18. Normal Dilated 19. RV Dilated LV Dilated 20. Subcostal Aorta 21. LVEF Mildly reduced 22. Moderate global dysfunction 23. Severely reduced 24. AMI - segmental Inferolateral MI 25. CHAMBERS Size Compare chambers LV to RV Ventricles to atria All 4 chambers remodel in size depending on pathology present eg: PHT / Aortic incompetence / pressure 26. CHAMBERS Size Wall thickness (or thinness) Hypertrophy hypertension systemic or pulmonary Deposits sarcoid / amyloid / HOCM 27. CHAMBERS Movement Function Compare Fractional shortening the squeeze of the Ventricle Global Cardiomyopathy ETOH / myocarditis Athletes Segmental AMI / IHD / Tako Tsubo (not without and Cath) 28. CHAMBERS The atria Size ( LA dilated ? why) Diastolic dysfunction / regurgitation / stenosis / PVR? IAS hypermobile / aneurysmal / PFO / Not just filling pressure Movement Masses Thrombus / SEC / myxoma / Artifact 29. Apical 5 chamber 30. Apical 2 chamber 31. Apical long axis 32. DIASTOLOGY - FILLING PRESSURES Diastology Normal Normal for age, without LA dilatation Impaired relaxation with normal filling pressures Impaired relaxation with elevated filling pressures Decrease in LV compliance Pseudo normalization - Moderate Reversible restrictive - Marked Irreversible restrictive Severe Constrictive 33. Pericardial effusion 34. Pulmonary hypertension 35. Haematoma 36. Masses LA myxoma 37. VALVES Stenosis - Movement Artifact Are the leaflets mobile Comparison moving similar to same Lunar valves and AV valve 38. Aortic stenosis 39. Mitral stenosis 40. CASE STUDY 41. CASE STUDY 42. The heart revealed S Size M - Movement A - Artefacts C - Comparison C - Consistency