What are the views in a standard handheld ECHO dataset for patients with COVID-19?

7th Jan 2021

It is important to remember that handheld systems do not have the full functionality of conventional echocardiography machines and are typically limited to two-dimensional (2D) and color Doppler modalities. As well, healthcare professionals using these devices may have varying levels of experience. 

Using a standard study protocol ensures that key clinical questions are addressed, and relevant information is obtained from every patient, in order to avoid unnecessary repeat studies.  

Keep in mind that there will be scenarios where a standard dataset cannot be achieved. These scenarios include limited echocardiography windows when a patient’s COVID-19 clinical syndrome is rapidly deteriorating and requires an urgent intervention. In this case, the most important echocardiogram views will be dictated by the clinical circumstances. 

In a stable patient, the standard protocol includes the use of 2D imaging, and where applicable, color Doppler to assess valve function and flow. 

So, what images will you need to acquire for a focused study using handheld echocardiography (HHE)? 

 

The standard echocardiography dataset 

The standard dataset should include 12 key images (two using the parasternal long-axis (PLAX) view, four using the parasternal short-axis (PSAX) view, four in the apical view, and two using the subcostal view) and two additional focused views of the right ventricle (RV) and inferior vena cava (IVC). 

PLAX view

Start by taking two parasternal long-axis (PLAX) images, one with increased depth and the other with normal depth. The increased-depth image identifies pleural and pericardial effusions. 

Multi-component video of echocardiograms from the parasternal long-axis view at increased depth and normal depth.

Figure 1. The standard echocardiography dataset includes two parasternal long-axis (PLAX) images, one with increased depth and one with normal depth. 

Check out this short video clip from our COVID Mini: Handheld ECHO Course to see an expert explain the two standard PLAX views:

 

PSAX view

Four parasternal short-axis (PSAX) view images should be acquired: one at the aortic valve level, the mitral valve level, the level of the papillary muscle, and the ventricular apex. 

Multi-component video of echocardiograms from the parasternal short-axis (PSAX) view taken at the aortic valve, mitral valve, papillary muscle, and left ventricular (LV) apex.

Figure 2. The standard echocardiography dataset includes four parasternal short-axis (PSAX) view images: one at each of the aortic valve, the mitral valve, the papillary muscle, and the left ventricular (LV) apex. 

Check out this short video clip from our COVID Mini: Handheld ECHO Course to see an expert explain the four standard PSAX views:

 

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Apical view

Next, take four apical view images, one from each of the apical four-, two-, and three-chamber views as standard images, and an RV-focused view. 

Normal four-chamber, two-chamber, three-chamber, and right-ventricle (RV) focused views apical ECHO images.

Figure 3. The standard echocardiography dataset includes four apical view images, one from each of the four-, two-, and three-chamber views, and an RV-focused view. 

Check out this short video clip from our COVID Mini: Handheld ECHO Course to see an expert explain the four standard apical views:

 

Subcostal view

Finally, take two subcostal view images: one from the subcostal four-chamber and the other from the IVC view. 

Subcostal view echocardiograms: the subcostal four-chamber view and the inferior vena cava (IVC) views. Video.

Figure 4. The standard echocardiography dataset includes two subcostal view images: the subcostal four-chamber view and the inferior vena cava (IVC) view. 

Check out this short video clip from our COVID Mini: Handheld ECHO Course to see an expert explain the two standard subcostal views:

 

Using a standard, focused dataset for handheld echocardiography ensures key clinical questions are answered for your patients with COVID-19, while reducing the risk of exposure for the operator. Medmastery note.

 

That’s it for now. If you want to improve your understanding of key concepts in medicine, and improve your clinical skills, make sure to register for a free trial account, which will give you access to free videos and downloads. We’ll help you make the right decisions for yourself and your patients.

Recommended reading

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