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July 2020 A&A Video Summary

Video Author: Jeanette Esau
Published on: 06.16.2020
Associated with: July 2020, Volume 131, Issue 1;

Video summary of featured articles in Anesthesia & Analgesia for July 2020.

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Video 13: Normal apical four chamber (A4).

0:08

Video 6: Systolic anterior motion of the anterior mitral leaflet in the PLAX

0:07

July 2020 A&A Video Summary

2:23

Rapid Central Vein Assessment and brachiocephalic vein visualization

0:15

Video 21: Subcostal four chamber in a patient with pericardial effusion and tamponade.

0:11

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July 2020 A&A Video Summary

Creator: Jeanette Esau

Duration: 2:23

Video summary of featured articles in Anesthesia & Analgesia for July 2020.

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Laryngeal mask airway and cough simulation

Creator:

Duration: 0:06

Video depicting a cough simulation with no leak of black light fluorescent Glo Germ™ around the laryngeal mask airway

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High flow nasal canullae aerosolization simulation

Creator:

Duration: 0:36

Video depicting aerosolization of Glo Germ ™ during various high flow nasal canullae conditions. A simple face mask restricts the dispersion of particules

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Three-layer transparent drape technique

Creator:

Duration: 0:13

Video depicting three-layer transparent drape technique for extubation.

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Creator: Marta Kelava

Duration: 0:39

SAP block can be performed in supine or lateral position. Using a 12-15 MHz linear ultrasound probe, scanning starts from the midclavicular line just below the clavicle. The ribs are counted with caudal and lateral probe movement until the 4th and 5th ribs are identified in the midaxillary line. The in-plane needle approach and injection is usually performed in an anteroposterior or craniocaudal direction in the midaxillary line at the level of the 4-5th ribs with LA deposition above (superficial SAP) or below (deep SAP) the serratus anterior muscle

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Creator: Marta Kelava

Duration: 0:41

The PIF block is performed under ultrasound guidance, with either cranio-caudal or latero-medial needle advancement. The latter has been proposed to avoid inadvertent puncture of the perforating branch of the internal thoracic artery or the anterior perforating veins joining the internal thoracic vein, with the goal to deposit LA between the pectoralis major and intercostal muscles. The craniocaudal in-plane needle approach and injection is usually performed 1 cm lateral to the sternum at the midsternal level with LA deposition between the pectoralis major and intercostal muscles.

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PECS I&II blocks

Creator: Marta Kelava

Duration: 1:16

A 12-15 MHz linear ultrasound probe is placed at a midclavicular line below the clavicle. The probe is moved inferolaterally to the level of the 3rd rib. With a slight medial tilt, the three layers of muscles are identified: pectoralis major, pectoralis minor and serratus anterior. When performing both blocks simultaneously, single puncture site can be used to preserve near-field imaging with deposition of the LA between the layers of the serratus anterior and pectoralis minor (PECS II), followed by needle withdrawal and injection between the pectoralis minor and pectoralis major (PECS I)

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Creator: Marta Kelava

Duration: 0:36

The ESP block is performed in a sitting, prone or lateral decubitus position under ultrasound guidance. A high frequency (12-15 MHz) linear array transducer is placed in a parasagittal plane and moved from a lateral to medial direction until the ribs are no longer visualized and transverse processes of T3-5 are identified. An in-plane needle is inserted in the craniocaudal direction and advanced below the erector spine muscle with the tip contacting the T5 transverse process. LA is injected and lifting of the erector spine muscle off the transverse process with craniocaudal spread of the LA is confirmed.

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June 2020 A&A Video Summary

Creator: Jeanette Esau

Duration: 2:00

Video summary of featured articles in Anesthesia & Analgesia for June 2020.

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Creator: Yu-Ting Lin

Duration: 00:07

Corresponding to Figure 2, it shows the 3D animation of the MGH/MF dataset comprising 10,583 ECG beats, including clinical unstable angina (red), ischemic ECG pattern (green), and healthy control (blue).

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Creator: Yu-Ting Lin

Duration: 00:07

Corresponding to Figure 3 panel C, it shows the 3D animation of 1-min ECG beats during the intra-operative ST-elevation event.

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Creator: Yu-Ting Lin

Duration: 00:07

Corresponding to Figure 3 panel D, it shows the 3D animation of 4,299 consecutive ECG beats from the ISTE (Intra-operative ST-Elevation) data colored with time sequences, combined with 10 minutes of healthy ECG data as the control (754 beats) in gray color.

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Creator: Yu-Ting Lin

Duration: 00:07

Corresponding to Figure 4 panel D, it shows the 3D animation of the Nicardipine effect on 2,364 ABP pulses from 12 cases that form 12 trajectories moving upward. All cases are labeled with different colors with fading as time evolves.

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Creator: Yu-Ting Lin

Duration: 00:07

Corresponding to Figure 5 panel B, it shows the 3D animation of 223 pulses from the ABP waveform of a single case of endotracheal intubation.

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Creator: Yu-Ting Lin

Duration: 00:07

Corresponding to Figure 5 panel C, it shows the 3D animation of the ABP waveforms (labeled in color) of the case shown in Figure 5 Panel B, as well as another 8 cases (labeled in gray) from the ETI (Endo-Tracheal Intubation) dataset that comprises 2,957 pulses.

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Creator: Yu-Ting Lin

Duration: 00:07

Corresponding to the supplementary material Figure S3 right panel, it shows the 3D animation of the combination of the 66 mins ABP waveform from the ISTE ABP dataset (color) and the Nicardipine dataset (gray).

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Animated Poincare Plot of Progressive Ataxic Breathing Severity

Creator: Sean Ermer

Duration: 00:13

This video demonstrates what the Poincare plot looks like as ataxic breathing severity progresses

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May 2020 A&A Video Summary

Creator: Jeanette Esau

Duration: 1:27

Video summary of featured articles in Anesthesia & Analgesia for May 2020.

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Wearable video glasses provide hands-free mechanism for real-time emergency consultation during airway management

Creator: Nicholas Dalesio

Duration: 00:49

This is a patient encounter whereby video glasses worn by a clinician managing the airway could relay the scene via audio and video imaging to a consulting expert in real-time. Images of the airway via the videolaryngoscope monitor as well as the vital signs and scene dynamics are relayed using a wearable video camera so the on-scene clinician is not restricted by handheld video devices.

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Demonstration of ultrasound use for real-time confirmation of caudal block placement.

Creator: Adam C. Adler, MS, MD, FAAP, FASE

Duration: 1:21

Demonstration of ultrasound use for real-time confirmation of caudal block placement.

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July 2020 A&A Video Summary

Creator: Jeanette Esau

Duration: 2:23

Video summary of featured articles in Anesthesia & Analgesia for July 2020.

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Laryngeal mask airway and cough simulation

Creator:

Duration: 0:06

Video depicting a cough simulation with no leak of black light fluorescent Glo Germ™ around the laryngeal mask airway

Play Video | + Favorites

High flow nasal canullae aerosolization simulation

Creator:

Duration: 0:36

Video depicting aerosolization of Glo Germ ™ during various high flow nasal canullae conditions. A simple face mask restricts the dispersion of particules

Play Video | + Favorites

Creator: Marta Kelava

Duration: 0:39

SAP block can be performed in supine or lateral position. Using a 12-15 MHz linear ultrasound probe, scanning starts from the midclavicular line just below the clavicle. The ribs are counted with caudal and lateral probe movement until the 4th and 5th ribs are identified in the midaxillary line. The in-plane needle approach and injection is usually performed in an anteroposterior or craniocaudal direction in the midaxillary line at the level of the 4-5th ribs with LA deposition above (superficial SAP) or below (deep SAP) the serratus anterior muscle

Play Video | + Favorites

Creator: Marta Kelava

Duration: 0:41

The PIF block is performed under ultrasound guidance, with either cranio-caudal or latero-medial needle advancement. The latter has been proposed to avoid inadvertent puncture of the perforating branch of the internal thoracic artery or the anterior perforating veins joining the internal thoracic vein, with the goal to deposit LA between the pectoralis major and intercostal muscles. The craniocaudal in-plane needle approach and injection is usually performed 1 cm lateral to the sternum at the midsternal level with LA deposition between the pectoralis major and intercostal muscles.

Play Video | + Favorites

PECS I&II blocks

Creator: Marta Kelava

Duration: 1:16

A 12-15 MHz linear ultrasound probe is placed at a midclavicular line below the clavicle. The probe is moved inferolaterally to the level of the 3rd rib. With a slight medial tilt, the three layers of muscles are identified: pectoralis major, pectoralis minor and serratus anterior. When performing both blocks simultaneously, single puncture site can be used to preserve near-field imaging with deposition of the LA between the layers of the serratus anterior and pectoralis minor (PECS II), followed by needle withdrawal and injection between the pectoralis minor and pectoralis major (PECS I)

Play Video | + Favorites

Creator: Marta Kelava

Duration: 0:36

The ESP block is performed in a sitting, prone or lateral decubitus position under ultrasound guidance. A high frequency (12-15 MHz) linear array transducer is placed in a parasagittal plane and moved from a lateral to medial direction until the ribs are no longer visualized and transverse processes of T3-5 are identified. An in-plane needle is inserted in the craniocaudal direction and advanced below the erector spine muscle with the tip contacting the T5 transverse process. LA is injected and lifting of the erector spine muscle off the transverse process with craniocaudal spread of the LA is confirmed.

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June 2020 A&A Video Summary

Creator: Jeanette Esau

Duration: 2:00

Video summary of featured articles in Anesthesia & Analgesia for June 2020.

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Creator: Yu-Ting Lin

Duration: 00:07

Corresponding to Figure 2, it shows the 3D animation of the MGH/MF dataset comprising 10,583 ECG beats, including clinical unstable angina (red), ischemic ECG pattern (green), and healthy control (blue).

Play Video | + Favorites

Creator: Yu-Ting Lin

Duration: 00:07

Corresponding to the supplementary material Figure S3 right panel, it shows the 3D animation of the combination of the 66 mins ABP waveform from the ISTE ABP dataset (color) and the Nicardipine dataset (gray).

Play Video | + Favorites

Animated Poincare Plot of Progressive Ataxic Breathing Severity

Creator: Sean Ermer

Duration: 00:13

This video demonstrates what the Poincare plot looks like as ataxic breathing severity progresses

Play Video | + Favorites

Wearable video glasses provide hands-free mechanism for real-time emergency consultation during airway management

Creator: Nicholas Dalesio

Duration: 00:49

This is a patient encounter whereby video glasses worn by a clinician managing the airway could relay the scene via audio and video imaging to a consulting expert in real-time. Images of the airway via the videolaryngoscope monitor as well as the vital signs and scene dynamics are relayed using a wearable video camera so the on-scene clinician is not restricted by handheld video devices.

Play Video | + Favorites

Demonstration of ultrasound use for real-time confirmation of caudal block placement.

Creator: Adam C. Adler, MS, MD, FAAP, FASE

Duration: 1:21

Demonstration of ultrasound use for real-time confirmation of caudal block placement.

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March 2020 A&A Video Summary

Creator: Jeanette Esau

Duration: 2:09

Video summary of featured articles in Anesthesia & Analgesia for March 2020.

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Supplemental Video 1. The ultrasound-assisted paramedian spinal anesthesia without cephalad angulation.

Creator: Sun-Kyung Park

Duration: 00:27

The performance of spinal anesthesia using preprocedural ultrasound skin marking, via paramedian approach.

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Computerized Surgical Safety Checklist Training Video

Creator: Srdjan Jelacic

Duration: 10:52

This is a training video demonstrating the use of computerized surgical safety checklist. All operating room team members were required to view the training video.

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January 2020 A&A Video Summary

Creator: Jeanette Esau

Duration: 1:43

Video summary of featured articles in Anesthesia & Analgesia for January 2020.

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Prebypass Mid Esophageal TEE views of a Bullet In the Aortic Root

Creator: Lee Goeddel

Duration: 0:14

In prebypass imaging the midesophageal 5 chamber view with color Doppler demonstrated a bullet in the aortic root and absence of aortic valve regurgitation. With simultaneous orthogonal imaging the bullet was localized to the non-coronary sinus of Valsalva within the aortic valve. An eccentric mitral regurgitation jet was found in the anterior leaflet of the mitral valve in the midesophageal long axis view. RCC= Right coronary cusp of the aortic valve. LCC= Left coronary cusp of the aortic valve. NCC= Non-coronary cusp of the aortic valve.

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Post Bypass Mid Esophageal TEE views after Bullet Removal and Mitral Valve Repair

Creator: Lee Goeddel

Duration: 0:08

Post-bypass images of the ME 4C view showed no gross abnormality. The midesophageal long axis view demonstrated trace central mitral regurgitation after repair, no residual aortic regurgitation, and an intact aortic root. A2= Middle scallop of the anterior leaflet of the mitral valve. P2= Middle scallop of the posterior leaflet of the mitral valve. AV= Aortic Valve.

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Creator: Brianne Aiken

Duration: 3:06

IPACK block performed for Total Knee Arthroplasty

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Combined Glidescope + Fiberscope as dynamic guide tracheal intubation demonstration

Creator: L. Rovira

Duration: 00:32

This video show our usual technique of tracheal intubation using a combined technique involving the use of a Glidescope and using a flexible guide (in this case a disposable fiberscope) to pass the tube through the vocal cords. The video contains in synch outer and inner (Glidescope camera) view.

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February 2019 A&A Video Summary

Creator: Jeanette Esau

Duration: 1:48

Video summary of featured articles in Anesthesia & Analgesia for February 2019.

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December 2018 A&A Video Summary

Creator: Jeanette Esau

Duration: 1:54

Video summary of featured articles in Anesthesia & Analgesia for December 2018.

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September 2018 A&A Video Summary

Creator: Jeanette Esau

Duration: 1:58

Video summary of featured articles in Anesthesia & Analgesia for September 2018.

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Rapid Central Vein Assessment and brachiocephalic vein visualization

Creator: Paolo Beccaria

Duration: 0:15

The video represents RaCeVA method, RaCeVA is the acronyms for Rapid Central Vein Assessment. It is the ultrasound method to identify the adequate site and side to central venous access placement.

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Creator: Diana Zakarkaite

Duration: 0:21

Mitral valve P2 segment prolapse (Live 3D zoom MV “surgeon’s” view). The jaws of the device are opened in the left atrium, and the prolapsing P2 segment is captured.

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March 2018 A&A Video Summary

Creator: Jeanette Esau

Duration: 1:47

Video summary of featured articles in Anesthesia & Analgesia for March 2018.

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Video Supplement

Creator: Roy Kiberenge

Duration: 0:55

Video of ultrasound-guided dynamic needle tip positioning technique with synchronized live ultrasound view. The arterial puncture and the sequential advancement of the catheter and needle is shown with the corresponding ultrasound image.

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December 2017 A&A Video Summary

Creator: Jeanette Esau

Duration: 1:56

Video summary of featured articles in Anesthesia & Analgesia for December 2017.

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Video 2: RV strain measurement using the Vivid E9 System (GE, Chicago, IL, USA)

Creator: Massimiliano Meineri, MD

Duration: 1:15

The ME four chamber view is analyzed using the Automated Function Imaging (AFI) software package. The LV long axis strain model is applied to the RV to allow correct labeling of septal segments. Tracking quality is automatically assessed for each segment (green: good or red: poor). Parametric display provides measurements for each of the six RV and global strain. The latter is normal at – 22.3% with regional peak variability with basal segments below normal limits. RV myocardial region of interest is redefined and the septum de-selected to obtain RV free wall strain that is measured at approximately -22%

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Absent PV on 2D TEE

Creator: Dr Neelam Aggarwal

Duration: 00:24

A thin rim of valve tissue is seen at pulmonic annulus in modified ME RV inflow-outflow view (sector angle at 800) and modified ME aortic valve long-axis view (sector angle at 1150)

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Supplemental Digital Content 2

Creator: Dr Lachlan F. Miles

Duration: 1:08

Two- and three-dimensional imaging of the aortic valve in the long axis in both mid-esophageal five chamber and the mid-esophageal long axis and modified mid-esophageal aortic valve short axis views. The full course of the fistula tract is difficult to appreciate without color flow Doppler. The change in perspective to long axis allows the viewer to distinguish between flow through the VSD (in systole) and the aorto-right ventricular fistula (in diastole).

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Supplemental Digital Content 3

Creator: Dr Lachlan F. Miles

Duration: 1:01

Two- and three-dimensional imaging of the left and right ventricular outflow tract using the transgastric left ventricular long axis view. The distance of the area of interest from the transducer decreases spatial resolution. Furthermore, the path of the fistula relative to the probe in this position precludes satisfactory Doppler alignment.

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Real-time ultrasound-guided left supraclavicular approach to the central vein

Creator:

Duration: 0:15

Real-time ultrasound-guided left supraclavicular approach to the central vein

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Real-time ultrasound-guided right supraclavicular approach to the central vein

Creator:

Duration: 0:15

Identify the right jugular vein and carotid artery at the level of the thyroid cartilage on the short-axis view. Then, the probe is moved caudally following the internal jugular vein in the center of the monitor. Once the probe has reached the clavicle, it is inclined following the internal jugular vein to identify where it merges with the right subclavian vein and the underlying pleura on the long-axis view. The puncture needle is inserted using the long-axis view and advanced while identifying the needle point in real-time, until it reaches the right brachiocephalic vein.

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Video 3: Post cardiopulmonary bypass (CPB) comprehensive TEE examination.

Creator: Dr. Saikat Bandyopadhyay

Duration: 1:04

No tumor fragments or residual tumor were found during this examination however significant RV dilation and hypokinesis is noted. No inter-atrialcommunication was seen with color flow Doppler.

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Video clip 2. 2D-TEE analysis of the right coronary artery and tricuspid valve

Creator:

Duration: 0:24

First part: The ME view, obtained by slightly withdrawing the probe from the modified ME 5-chamber view in video clip 1, demonstrates two cardiac masses (“proximal” and “distal”), with the RCA penetrating the left side of the distal mass. Second part: Color flow Doppler reveals laminar blood flow in the RCA. Third part: Simultaneous orthogonal planes to the RCA based on the ME aortic valve short axis view. Fourth part: Simultaneous orthogonal planes to the tricuspid valve based on the modified trans-gastric RV inflow-outflow view.

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Video clip 3. 3D-TEE analysis of two primary cardiac lymphomas

Creator:

Duration: 0:15

First part: Superior view. 3D data was acquired with a 4-beat gated full volume mode, based on a modified ME 5ch view. The superior wall of the RA is partially cropped. Second part: The RA view was obtained after rotating the data set of the first part with a 90º up-down rotation to locate the SVC at the 12 o’clock position and a 90º rotation around the vertical axis on the screen. The echogenicity of the distal mass is lower than that of the proximal mass. ‘#’ indicates intra-tumor calcification in the distal mass.

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Creator: i-movie

Duration: 0:24

Prebypass comprehensive TEE showed severely depressed left ventricular function with spontaneous echo contrast (SEC), basal to mid-ventricular inferior and inferolateral wall akinesis, dilated apex with dyskinesis and no evidence of left ventricular thrombus. A prominent false tendon (FT) was visualized at the mid-esophageal long-axis view both before and after thrombus evacuation. AK: akinesis, DK: dyskinesis.

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Cardiac Venous System – Retrograde Blood Cardioplegia.

Creator: Luiz F Maracaja MD

Duration: 0:15

1. Starting with ME 2-chamber view, activate the orthogonal imaging by aiming the cursor into the atrioventricular groove underneath the left atrial appendage lateral to the CX. 2. Activate CFD with a low-velocity scale (15–30 cm/s). Then, by moving the CFD sector over the atrioventricular groove lateral to the CX, one can display an image of the great cardiac vein (GCV) 3. The orthogonal plane displays retrograde blood cardioplegia flowing anteriorly from the coronary sinus (CS) to GCV and tributaries. The GCV wraps around the left side of the heart and posteriorly merges with the CS.

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Creator: J. Kirk Edwards, MD

Duration: 0:07

2D transesophageal echo (TEE) view of the mid-esophageal (ME) color Doppler x-plane of the short axis (SAX) and long axis (LAX). Color Doppler displays moderate to severe eccentric aortic insufficiency (AI) directed away from the noncoronary leaflet.

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Creator: J. Kirk Edwards, MD

Duration: 0:07

3D transesophageal echo (TEE) en-face view of the aortic root and valve from the aortic perspective. The false lumen is seen overriding the noncoronary leaflet, with extension over the right coronary leaflet.

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How to Perform Focused Cardiovascular Ultrasound

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 23:23

A brief, screen-in-screen review of the techniques required to perform bedside cardiac ultrasound at the parasternal, apical, and subcostal windows.

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Video 2: Significant aortic stenosis seen in the PLAX

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:06

The aortic valve is heavily calcified and does not open well. The degree of stenosis cannot be quantified from this view, but with excursion this limited the assumption should be that the patient has severe stenosis until it is proven otherwise. In addition to aortic valve calcification, the mitral annulus is heavily calcified, there is left ventricular hypertrophy, and the left atrium is enlarged.

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Video 3: Mitral valve prolapse seen in the PLAX

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:06

In systole, the body of both mitral leaflets is above the level of the mitral annulus.

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Video 4: Dilated cardiomyopathy seen in the PLAX

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:08

The RVOT, LA, and LV are all dilated and appear proportionally large compared to the aortic annulus and root. Compare the relative sizes with Video 1 (normal PLAX.) There is evidence of decreased LV systolic function, with decreased motion of the aortic root, decreased excursion of the anterior mitral leaflet, decreased mitral annular excursion, and decreased thickening of the left ventricular segments. There is also a left pleural effusion.

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Video 5: Rheumatic mitral disease seen in the PLAX

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:05

Left ventricular and aortic valve function appear normal. There is thickening of the tips of the mitral leaflets, with diastolic bowing seen particularly in the anterior mitral leaflet (the “hockey stick” appearance). The left atrium appears enlarged as well, consistent with elevated left atrial pressure from mitral stenosis.

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Video 6: Systolic anterior motion of the anterior mitral leaflet in the PLAX

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:07

Multiple beats are shown in this clip and the image does not remain still because the patient was severely dyspneic. The patient has significant hypertrophy of the anterioseptal wall of the left ventricle. In multiple cardiac cycles the anterior mitral leaflet can be seen to impinge on the left ventricular outflow tract.

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Video 7: Both pleural and pericardial effusions seen in the PLAX

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:05

The descending thoracic aorta is outside the pericardium, and a pericardial effusion will be seen extending between the heart and the aorta in this view while a pleural effusion will be seen deep and lateral to the aorta.

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Video 8: Normal parasternal short axis (PSAX.)

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:07

The right ventricle is seen to the left of the screen, with the anterior portion of the left ventricle closest to the probe. The papillary muscles are seen, identifying this as the mid-portion of the left ventricle. Six segments of the left ventricle are seen, representing all three main coronary artery territories.

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Video 9: Parasternal short axis (PSAX) with akinesis of the inferior segment

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:06

The thinning of this segment suggests a scar consistent with previous myocardial infarction.

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Video 10: Parasternal short axis (PSAX) showing a pericardial effusion

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:07

A pericardial effusion around the heart, hyperdynamic left ventricular systolic function, and decreased LV filling in diastole.

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Video 11: Parasternal short axis (PSAX) in a patient with septic shock.

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:07

Septic shock, decreased left ventricular (LV) afterload, and increased cardiac output. The LV is full in diastole and empty in systole, consistent with the patient’s low-afterload state.

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Video 12: Parasternal short axis (PSAX) showing RV pressure overload

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:08

The interventricular septum (IVS) is normally convex with respect to the left left ventricle throughout the cardiac cycle. In this case the IVS is flat in both systole and diastole, suggesting that the right and left ventricular pressures are similar (near systemic pulmonary artery pressures.)

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Video 13: Normal apical four chamber (A4).

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:08

The apex of the left ventricle is directly under the ultrasound transducer. All four chambers can be visualized. There is normal global and regional biventricular systolic function, normal excursion and coaptation of the mitral and tricuspid valves, and normal chamber sizes.

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Video 14: Apical four chamber showing ischemia in the LAD territory

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:11

A large portion of the myocardium at the LV apex is not thickening. There is decreased global LV systolic function and left atrial enlargement as well.

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Video 15: Apical four chamber showing prolapse

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:09

Prolapse of both anterior and posterior mitral leaflets with left atrial enlargement.

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Video 17: Apical four chamber showing an enlarged right ventricle with decreased RV systolic function

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:09

Enlarged right ventricle with decreased RV systolic function in a patient with a history of chronic severe pulmonary hypertension.

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Video 18: Apical four chamber zoomed in on the tricuspid valve

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:11

Apical four chamber zoomed in on the tricuspid valve. This valve does not coapt well in systole, suggesting the presence of significant tricuspid regurgitation.

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Video 19: Normal subcostal four chamber (SC4)

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:10

At the top of the image is the liver. The right atrium and right ventricle are seen well, as is the left ventricle. There is normal global biventricular systolic function. It is important to remember that, while this view often shows all four cardiac chambers, the cross section is not exactly the same as the apical four chamber.

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Video 20: Subcostal four chamber with right ventricular dilation and hypertrophy

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:10

Subcostal four chamber with right ventricular dilation and hypertrophy. The free wall of the RV appears as thick as the left ventricle. The RV appears larger than the LV, suggesting significant enlargement.

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Video 21: Subcostal four chamber in a patient with pericardial effusion and tamponade.

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:11

Subcostal four chamber in a patient with pericardial effusion and tamponade. The effusion is seen as a large echolucent space around the heart. The right atrium appears collapsed in ventricular systole and the right ventricle appears compressed in ventricular diastole. These findings are both consistent with tamponade physiology.

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Video 22: Normal subcostal IVC view (SC IVC)

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:19

The liver is at the top of the screen, with the thin-walled IVC seen entering the right atrium. There is more than 50% collapse of the IVC when the patient sniffs.

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Video 23: Subcostal IVC in a patient with cardiac tamponade

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:10

Subcostal IVC in a patient with cardiac tamponade. The IVC appears dilated and does not collapse as the patient sniffs.

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Video 24: Subcostal IVC in a patient with hypovolemia

Creator: Dr. Josh Zimmerman, MD, FASE

Duration: 0:14

Subcostal IVC in a patient with hypovolemia. The IVC is small and collapses completely as the patient breathes.

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