Table 2.
Variables assessed and definitions of abnormality findings in heart POCUS
| Variable assessed | Definitions | |
|---|---|---|
| LV volume | LVEDD |
Normal LVEDD 3–5.6 cm LV dilated > 5.6 cm Hypovolemia < 3 cm |
| LV systolic function | Overall subjective impression | Normal – Reduced – Increased |
| Difference between diameters in diastole and systole (LVEDD–LVESD) in PLAX view |
Normal 28–44 mm Reduced < 28 mm Increased > 44 mm |
|
|
Difference between areas in diastole and systole (LVEDA–LVESA) in PSAX view |
Normal 50–65 mm2 Reduced < 50 mm2 Increased > 65 mm2 |
|
| RV size | Compared to LV size | Normal < 2/3 of LV size |
| RVEDD |
Normal < 4 cm Increased > 4 cm |
|
| RV systolic function | Overall subjective impression | Normal – Decreased |
| LA size | LA diameter in PLAX or A4C views | Normal < 3.5 cm |
| LA area in A4C view |
Normal < 20 cm2 Increased > 20 cm2 |
|
| LA filling pressure | Inter-atrium septum movement |
Normal: systolic reversal of the inter-atrium septum High filling pressure: fixed curvature of the inter-atrium septum to the right Low filling pressure: systolic buckling of the inter-atrium septum |
| Cardiac valves |
Leaflets appearance and thickness Opening of the valve Presence of reverse jet |
Significant aortic stenosis: An opening < 1.5 cm in PLAX or Heavy calcification with inability to see the valve opening |
|
Significant aortic regurgitation: A jet that runs on the wall of the LV outflow track A jet that is wider than 25% of the diameter of LVOT A jet that extends down to the ventricle > 2.5 cm | ||
|
Significant mitral stenosis: Impaired opening of the mitral valve A hockey stick appearance of one or both of the mitral leaflets | ||
|
Significant mitral regurgitation: Regurgitation jet covering > 20% of the LA area in A4C or PLAX A turbulent jet that runs along the wall of the atrium Prominent flail mitral valve leaflet or rupture papillary muscle | ||
|
Significant tricuspid regurgitation: Any edge-tracking jet Any central jet > 5 cm2 | ||
| Pericardial effusion | Presence of anechoic space between parietal and visceral pericardium | Significant pericardial effusion is defined as > 0.5 cm in any view |
| Inferior vena cava | Diameter of the inferior vena cava in the subcostal view during normal breathing |
Maximum diameter in cm and percentage of collapsibility during normal inspiration are reported. Estimation of the right atrium pressure is informed as follows: IVC < 2.1 cm collapsing > 50% ➔ RAP: 3 mmHg IVC > 2.1 cm collapsing < 50% ➔ RAP: 15 mmHg Values between the two above ➔ RAP:8 mmHg |
A4C apical four chambers, LA left atrium, LV left ventricle, LVEDA left ventricle end-diastole area, LVEDD left ventricle end-diastole diameter, LVESA left ventricle end-systole area, LVESD left ventricle end-systole diameter, PLAX parasternal long axis, POCUS point-of-care ultrasound, PSAX parasternal short axis, RAP right atrium pressure, RVEDD right ventricle end-diastole diameter