A difficult topic, and clearly not for the basic echocardiogropher. But it’s definitely one of the things that may lead your practice towards more advanced areas, and provide explanations for clinical cardiovascular syndromes encountered…
- Diastolic dysfunction may be more important in its effects when there’s respiratory failure too.
- Good guidance on how to measure it in the world literature: Journal of the American Society of Cardiology.
There’s no doubt that TDI can help give you the answer as to why you have clinical dysfunction in the face of preserved systolic function.
- Deciding if there’s diastolic dysfunction is difficult.
- One measurement alone simply is not enough (although has been used in some research papers!)
- Searching for LV dysfunction must be taken in context of other findings (see here)
Paul Mayo (Pericardial disease)
- Diagnosing pericardial effusion needs to be careful when there’s ascites too
- Pericardiocentesis should only ever be done under ultrasound guidance (look at this)
- The apical view may be better for aspiration of fluid, but has it’s own pitfalls of course
- Inject air bubbles to know where your needle tip really is
It’s hard to encompass everything taught here. So much can be learnt from the descriptions of moving images by international experts. Oh, and Paul Mayo is hilarious.