Cardiac 4

A 69 year old lady is post op day 1 clipping of ACOM cerebral artery aneurysm. She has a history of chronic poorly controlled hypertension. The nurses report pink frothy secretions from her ETT on suctioning. What view is this? What does the echo show? What could be the cause of pulmonary edema?

Answer

This is a parasternal long axis view. The LV walls are significantly hypertrophied. LVEF looks > 55% and there is no evidence of LV systolic dysfunction. Although there could be multiple causes for pulmonary oedema in this critically unwell patient, we should consider diastolic dysfunction and diastolic heart failure as a potential cause. Diastolic heart failure is common in elderly patients, especially in elderly women and is associated with left ventricular hypertrophy.