At Heart of the Matter Study

1)     Parasternal Long Axis View :

a. 2D-grayscale at Aorta-Mitral valve level

b. 2D-color at Aorta-Mitral valve level

c. 2D-grayscale of zoom of Aortic Valve (to measure LVOT)

d. 2D-colour on zoom of Aortic Valve

e. M-Mode at Left Atrium / Aorta junction for : LA/Ao ratio

f.  M-Mode at tip of mitral valve

g. 2D-grayscale of tricuspid valve (scan posteriorly)

h. 2D-color of tricuspid valve

                                               i. CW Doppler of tricuspid valve to obtain Tricuspid regurgitant jet if present.

                                              ii. PW Doppler at inflow portion for E/A

i.   2D-grayscale sweep to RVOT

j.   2D-colour at RVOT

k. 2D-Zoom of Pulmonary valve

                                               i. PW-Doppler at RVOT

                                              ii. CW-Doppler through RVOT (especially for pulmonary insufficiency jet)

2) Parasternal short axis (PSAX) view:

a. 2D-grayscale at Pulmonary valve and Aortic valve level

b. 2D-Colour at Pulmonary valve and Aortic valve level

                                               i. PW-Doppler at RVOT

                                              ii. CW-Doppler at RVOT (especially for pulmonary insufficiency jet)

c. M-Mode at left atrium – aorta junction

d. 2D-grayscal Sweep from aortic valve to LV apex

e. 2D-colour sweep from aortic valve to LV apex over interventricular septum

                                               i. CW Doppler of tricuspid valve to obtain Tricuspid regurgitant jet if present.

                                              ii. PW Doppler at inflow portion for E/A

f.  M-Mode at Tip of mitral valve in PSAX

g. 2D-grayscale view (at least 3 beats) at mitral valve level

h. 2D-grayscale view (at least 3 beats) at mid-papillary muscle level

i.   2D-grayscale view (at least 3 beats) at LV apex level

3) Apical View

a. 2D-grayscale Apical 4 chamber view in 2D – LV focused with Left Atrium

b. 2D-colour over Mitral valve

c. 2D-grayscale Apical 4 chamber view in 2D – RV focused with Right Atrium

d. 2D-colour over Tricuspid valve

e. PW below the tricuspid valve for E/A velocities

f.  PW below the mitral valve for E/A velocities

g. CW-Doppler of tricuspid valve to obtain Tricuspid regurgitant jet – even if unavailable, please record so that we can do a systolic-diastolic time ratio.

h. Color on left atrium with low-velocity filter for pulmonary vein

                                               i. PW-Doppler in right upper pulmonary vein

i.   M-Mode in A4C for the Lateral wall of the RV to get TAPSE (line of interrogation should ideally cross the Apex).

j.   Tissue Doppler Imaging (TDI)

                                               i. TDI on RV free wall below the tricuspid valve

                                              ii. TDI on LV free wall below the mitral valve

                                             iii. TDI of septum below the attachment of mitral valve

k. Apical 3 Chamber view of LV in 2D-grayscale

                                               i. Apical 3 chamber view in 2D-Color to see flow from mitral through Aortic Valve

1. PW at LVOT

2. PW in cavity to measure the isovolumetric relaxation time (inside cavity in A3C)

l.   Apical 2 Chamber view of the LV in 2D in 2D grayscale (make sure to have all the LV walls)

m. Colour over Mitral Valve

                                               i. PW below Mitral Valve in A2C

n. 3D LV volume, 3D RV volume

                                               i. Capture using High Volume Capture

                                              ii. Capture using 4 beat acquisition

4) Subcostal (if possible – difficult during pregnancy):

a. Subcostal long axis:

                                               i. 2D-grayscale and 2D color over the inter-atrial septum (for inter-atrial shunt)

b. Subcostal short axis:

                                               i. 2D-grayscale and 2D color over the inter-atrial septum (for inter-atrial shunt)

                                              ii. 2D-colour over the descending aorta

                                             iii. PW of the descending aorta.

                                             iv. 2D + Colour over IVC and subhepatic veins

                                              v. PW of the subhepatic veins

5) Suprasternal notch:

a. Aortic Arch in 2D-grayscale and 2D-color

                                               i. PW in Ascending Aorta

                                              ii. PW in Descending Aorta

b. Branch Pulmonary artery (Moustache view)

                                               i. 2D-grayscale and 2D-Color

1. PW in LPA and in RPA if possible

• RVd (m-mode)

• IVS diastole (m-Mode)

• LVd (m-mode) diastole

• Posterior wall (M-Mode) diastole

• LVd (m-mode) systole

• LV mass-C (m-mode) 

• LA (M-mode) 

• Aorta (M-Mode) 

• Ao Valve opening 

• Ao root diameter - PLAX 

• Sinotubular junction 

• Asc Aorta measurement (PLAX) 

• Tricuspid valve (open) in PLAX

• Pulm Valve opening

• RVOT_VTI PLAX

• Heart Rate (VTI_RVOT) in PLAX

• PAAT in PLAX

• RVET in PLAX

• Peak pulmonary insufficiency (mmHg)

• End pulmonary insufficiency (mmHg)

• Eccentricity D1 LV systole

• Eccentricity D2 LV (perp) systole

• Eccentricity D2 RV systole

• Eccentricity D1 LV diastole

• Eccentricity D2 LV diastole

• Eccentricity D2 RV diastole

• EDA (LV - 5/6) - PSAX view at mid papillary level

• ESA (LV - 5/6) - PSAX view at mid papillary level

• LV-Mass (AL)

• LV-Mass (TE)

• RVOT diameter in PSAX

• RVOT VTI in PSAX

• HR VTI in PSAX

• PAAT VTI in PSAX

• RVET VTI in PSAX

• MV-Measure (valve open) - A4C

• Mitral regurgitation

• MR severity

• Mitral stenosis

• MS severity

• Tricuspid regurgitation

• TR severity

• Tricuspid stenosis

• Tric Stenosis severity

• Aortic insufficiency

• Ao Ins severity

• Aortic stenosis mom

• Aortic Stenosis Mom severity

• Pulmonary insufficiency

• Pulm Insu severity

• Pulmonary stenosis mom

• Pulm stenosis severity

• TR (mmHg) - RV-RA gradient

• Systolic duration (TR)

• Diastolic duration (TR)

• E MV

• A MV

• Deceleration time of E wave

• A4C - EDV LV

• A4C - EDA LV

• A4C - Length Diastole LV

• A4C - ESV LV

• A4C - ESA LV

• A4C - Length Systole LV

• A2C - EDA LV

• A2C - EDV LV

• A2C - length diastole LV

• A2C - ESV LV

• A2C - ESA LV

• A2C - length systole LV

• EF Byplane

• LA volume in A4C

• LA volume in A2C

• VTI_LVOT

• HR_LVOT

• E of Tricuspid

• A of Tricuspid

• E deceleration of Tricuspid Valve

• TAPSE M-Mode

• TAPSE by FAC

• RA planimetry

• EDA RV

• ESA RV

• Mitral valve (A4C) measurement

• TV measurement (A4C)

• RV base diameter

• RV mid-cavity diameter diastole (A4C)

• RV Length diastole (A4C)

• RV length systole

• TDI S RV

• TDI E RV

• TDI A RV

• TDI Ejection Time RV

• TDI ET-IVCT-IVRT of RV

• TDI S Septum

• TDI E Septum

• TDI A Septum

• TDI ET-IVCT-IVRT of septum

• TDI Ejection Time septum

• TDI S lateral LV

• TDI E lateral LV

• TDI A lateral LV

• TDI Ejection time lateral LV

• TDI ET_IVCT_IVRT lateral LV:

• Inter-atrial shunt if present 

• MPA measurement

• Peak S wave velocity of pulmonary vein 

• Peak D wave velocity of pulmonary vein

• Atrial reversal duration of pulmonary venous vein

• A2C_pLS

• A2C_PLSR

• A2C_EDSR

• A4C_PLS

• A4C_PLSR

• A4C_EDSR

• A4C_TTP_PLS_Average

• A3C_PLS

• A3C_PLSR

• A3C_EDSR

• Apical_MyoGLS

• Apical_EndoGLS

• Apical_EF

• Apical_EDV

• Apical_ESV

• Apical_GRS

• Apical_ESL

• Apical_ESDbas

• Apical_EDL

• Apical_EDDbas

• Apical_SD_TS_Peak

• Apical_SD_LS_Peak

• RV_MyoGLS

• RV_EndoGLS

• RV_EDA

• RV_ESA

• RV_FAC

• RV_GRS

• RV_FreeWallSt

• RV_ESL

• RV_ESDbas

• RV_EDL

• RV_EDDbas

• RV_PLSR

• RV_EDSR

• RV_Freewall_displacement

• RV_PLS_Septum

• RV_PLS_Freewall

• RV_PLSR_Septum

• RV_PLSR_Freewall

• LA_EndoGLS

• LA_EF

• LA_EDV

• LA_ESV

• LA_FAC

• LA_Leftwall_PLS

• LA_Roof_PLS

• LA_Rightwall_PLS

• PSAX_Midpap_PCR

• PSAX_Midpap_PCSR

• PSAX_Midpap_EDSR

• PSAX_Midpap_RS

• PSAX_Midpap_RSR

• PSAX_Apex_CS

• PSAX_Apex_CSR

• PSAX_Apex_rotation

• PSAX_Apex_rot_velocity

• PSAX_Base_CS

• PSAX_Base_CSR

• PSAX_Base_rotation

• PSAX_Base_velocity

• PSAX_MyoGCS

• PSAX_EndoGCS

• PSAX_EDA

• PSAX_ESA

• PSAX_FAC

• PSAX_GRS

• PSAX_Delta_ROT

• PSAX_SD_RS_Syst

• PSAX_SD_CS_Syst

• 3DLV_EDV

• 3DLV_ESV

• 3DLV_SV

• 3DLV_EF

• 3DLV_Mass

• 3DLV_SDI

• 3DLV_GLS

• 3DLV_GCS

• 3DLV_Twist

• 3DLV_Torsion

• 3DLV_Length

• 3DLV_Apical_rotation

• 3DLV_Basal_rotation

• 3DRV_EDV

• 3DRV_ESV

• 3DRV_SV

• 3DRV_EF

• 3DRV_RVDd_base

• 3DRV_RVDd_mid

• 3DRV_RVLd

• 3DRV_TAPSE

• 3DRV_FAC

• 3DRV_RVLS_Septum

• 3DRV_RVLS_Freewall