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Focused Cardiac Ultrasound

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  1. Welcome

    Introduction to FoCUS
    2 Topics
  2. Section 1
    Video: Cardiac Anatomy
  3. Cardiac Anatomy
    3 Topics
  4. Section 2
    Key Video: Obtaining the 5 Views
  5. Acquisition & the 4Ps
    4 Topics
    |
    1 Quiz
  6. Acquiring The 5 Views
    5 Topics
    |
    1 Quiz
  7. Clinical Case Scenario
  8. Section 3
    Interpretation
    11 Topics
    |
    2 Quizzes
  9. Interpretation: The RUSH Protocol
    1 Quiz
  10. Section 4
    Medical Management
  11. Foundations of Echocardiography
  12. References
    References & Further Reading

Quizzes

Lesson Progress
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A Clinical Case

Let’s start with a common clinical scenario where point of care cardiac ultrasound could prove useful.

A 65 year old man presents to the emergency department with chest pain and shortness of breath. He also reports mild calf pain over the past few days but puts this down to a muscle strain from playing tennis last week.. The emergency physician is trained in POCUS and performs a scan. What could be causing his symptoms?

What is your differential diagnosis ?

  1. Acute Myocardial Infarction? Has the patient had a cardiac event accounting for his chest pain and shortness of breath?
  2. Pulmonary Embolism? Does he have a Deep Vein Thrombosis and Pulmonary Embolism?
  3. Pericardial Effusion / Tamponade? No history of trauma, but pericardial effusions have many causes.
  4. Sepsis / Distributive Shock? Does he have a pneumonia ?
  5. Pneumothorax or other lung pathology?
Parasternal Short Axis
Answer. Click to open.

The cardiac scan shows a parasternal short axis view of the heart. A few things stand out immediately.

  • The right ventricle is huge !
  • The left ventricular cavity is small in comparison
  • The interventricular septum is flattened for most of the cardiac cycle

These findings, along with the history point strongly to a diagnosis of acute pulmonary embolism.

We will learn why in the following sections.