BloodFlowAcrossIntracardiacShunts:AtrialSeptalDefects
Atrialseptaldefect(ASD)flowjetsvisualizeinthesubcostalandtherightparasternalviews,andsometimesfromtheapicalfour-chamberview.ASDsareusuallyassociatedwithlowvelocitybloodflowthatiscontinuousthroughoutthecardiaccycle,butismostprominentduringlatesystoleandearlydiastole.BloodflowthroughanASDtypicallymovesfromlefttoright,butcanmovefromrighttoleft...[
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BloodFlowPatternsintheHeart:BloodFlowAcrossIntracardiacShunts
Bloodflowthroughashuntissmallanddifficulttodetect.Inaddition,theshuntsiteitselfmaynotbevisibleintheimage,ormultipleshuntsitesmaybepresent.Thedirectionandvelocitiesofbloodflow,thetiming,andthedegreeofturbulencevarysignificantlyamongshuntsites.Colorreversalproducedbyfrequencyaliasingmaymakeitimpossibletodetermineshuntflowdirectionbyre...[
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BloodFlowAcrossStenoticSites:TricuspidStenosis
Youcanseeatricuspidstenosis(TS)flowjetfromtheparasternalRVinflow,theapical,andthesubcostalviews.ATSflowjetappearsindiastole,asbloodmovesthroughthetricuspidvalveintotheRV.TSflowjetsexhibitthesamecharacteristicsasdomildtomoderateMSflowjets.TSoccurslessfrequentlythanMS.BloodFlowAcrossStenoticSites:PulmonicStenosis
Tovisualizethepulmonicstenosis(P...[
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BloodFlowAcrossStenoticSites:AorticStenosis
Althoughdifficulttodetect,youcansometimesseeaorticstenosis(AS)flowjetsfromtheparasternal,apical,andsuprasternalviews.TheASflowjetoccursinsystole,asbloodmovesthroughtheaorticvalveintotheaorta.TheabnormallyhighvelocityASbloodflowjetsoftenexhibitaliasingandcontainhighdegreesofturbulence.TheASflowjetisdifficulttovisualizefromanyviewbecauseoftheeccentrici...[
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BloodFlowPatternsintheHeart:BloodFlowAcrossStenoticSites
Bloodflowacrossstenoticsitesisoftenhighvelocity,andgenerallyaliases.Asthevelocityincreases,thelikelihoodofturbulencealsoincreases.Tovisualizebloodflowacrossastenoticsite,useanyviewthatshowsboththeobstructionandthechamberdistaltoit.Toestimatetheseverityofastenoticlesioncalculatethepressuregradientacrosstheobstruction.CFIidentifiesbloodflo...[
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RegurgitantBloodFlow:PulmonicInsufficiency
Youcanbestseepulmonicinsufficiency(PI)fromtheparasternalshort-axis,theparasternalRVoutflow,andthesubcostalviews.PIappearsindiastole,asbloodflowenteringtheRVOTfromthepulmonicvalve.
Thisparasternalshort-axisviewshowsatrivialjetofPIintheRVOTindiastole.Anenhancedvelocitymapisused.Redandorangeindicatelaminarbloodflowmovingtowardthetransducer.
Alarg...[
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RegurgitantBloodFlow:TricuspidRegurgitation
TheparasternalRVinflow,theparasternalshort-axis,theapicalfour-chamber,andthesubcostalviewsarehelpfulindetectingtricuspidregurgitation(TR).TRappearsinsystole,asbloodflowenteringtheRAthroughtheclosedTV.
Thisparasternalshort-axisviewshowstricuspidregurgitationintheRAinsystole.TheTRjetisturbulent,asindicatedbythemosaicofblue,white,andorange.Theredadj...[
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RegurgitantBloodFlow:AorticInsufficiency
Aorticinsufficiency(AI)isvisiblefromtheapicalparasternalviews.AIappearsindiastole,asbloodflowmovesfromtheaortatotheLVOT.
Thisparasternallong-axisviewshowsaorticinsufficiencyintheLVOTindiastoleusinganenhancedvelocitymap.TheAIjetisprimarilycoloredbluebecauseitmovesawayfromthetransducer.Themosaicofblueandyellowindicatesturbulentbloodflow.
Thediasto...[
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BloodFlowPatternsintheHeart:RegurgitantBloodFlow
Regurgitantbloodflowcanbe:LoworhighvelocityLaminarorturbulentYoumayormaynotseealiasinginregurgitantflowjet.Anyviewthatshowsboththevalveandthechamberproximaltoitcanhelpyoudetectregurgitation.AlthoughCFIcanhelpyoudetectvalvularregurgitation,itsaccuracyinestimatingtheseverityofregurgitationisstillanareaofdiscussion.WhilemanysourcesapplythePWDoppler...[
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NormalBloodFlow:NormalBloodFlowThroughthePulmonicValve
Theparasternalshort-axis,theparasternalRVoutflow,andthesubcostalviewsshowbloodflowthroughthepulmonicvalve.NormalRVOT,insystoleandthebifurcationofthemainpulmonaryarteryimageinthisview.Anenhancedvelocitymapmakesthebloodflowmovingawayfromthetransducerprimarilyblue.Thesmoothprogressionfromlightbluetoyellowindicateshighvelocitysignalsthathaveal...[
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