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Download Echo/12. Rv en PE
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Rechtzijdige problematiek Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen RV funktie • Infarct in Rv komt procentueel minder voor • Beoordeling – visueel zoals bekend van LV funktie – meting d.m.v Tricuspid Annular Plane Systolic Excursion = TAPSE • Soms gedilateerde RV Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen TAPSE • Meting vanuit apicale 4- kamerscan • Meet de verkorting van de RV doormiddel van m-mode Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen Meetwaarden TAPSE • • • • < 10 mm 10 -15 mm 15 - 20 mm > 20 mm = = = = slechte RV funktie matige RV funktie normale RV funktie goede RV funktie Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen RVVO • • • • Right Ventricul Volume Overlaod Dilated RV dimension Paradoxil ventricular septal motion sever Tricuspid regurgitation Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen Causal • ASD = atrium septum defect with right ventricul hypertrofic • pulmonal embolien, without right ventricul hypertrofic • Secundair, leftside volume overlaod Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen RVVO Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen Pericardium Pericardial Effussion Pericardial thickening Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen Pericardial Effusion • Small effusion always posterior • moderate and large surrounding the heart but is not found behind the left atrium • subcostale 4 chamberview first place to see • large pericardial effusion result into cardiac tamponade Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen Pericardeffusion Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen Cardiac Tamponade • Large effusion surrounding the heart • diastolic collaps of RA en RV • Paradoxil ventriculair septal motion • Pulsed doppler – Tricuspid valve flow increased – Mitral valve flow decrease by at least 30 - 40 % Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen Causal • Pericarditis • Rupture of the free wall after infarction LV or RV • After bypass Ok Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen Pericardial contriction • Echorich pericardium and thickening • systolic retractation apex, looking outside of the body • asynchronic ventrical septum motion • Deceleratie time < 150 msec. Rapid E to F slope • dilated ivc Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen Restrictif pericardium Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen Causal • Chronic pericarditis • irradiation mediastium (Hodgkin) Fontys Paramedische Hogeschool Eindhoven, Mariette Raadsen
