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Critical Care Echocardiography: Acute Left Ventricular and Valvular Dysfunction

  • Chapter
Ultrasound in the Intensive Care Unit

Part of the book series: Respiratory Medicine ((RM))

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Abstract

A rapid bedside critical care echocardiography (CCE) exam performed by an intensivist can provide an accurate dynamic assessment of left ventricular (LV) and valvular function and accordingly help direct resuscitative efforts. Basic CCE is goal oriented and uses five basic views (parasternal long and short axis, apical four-chamber, subxiphoid, and inferior vena cava views). The focus with basic CCE is to identify major, catastrophic causes of left ventricular failure or valve dysfunction that would affect the hemodynamic status of the critically ill patient. Advanced CCE, on the other hand, requires a comprehensive evaluation of hemodynamic parameters, mastery over image acquisition, and complete understanding of Doppler evaluation. The global visual assessment is the most common method used to estimate LV systolic function. LV systolic function can be categorized as normal, hyperdynamic, moderate dysfunction, or severe dysfunction. The estimation of stroke volume (SV) and cardiac output (CO) by echocardiography can also be a useful method for the assessment of LV systolic function in the critically ill patient. Valve function can be assessed using 2D echocardiography and color Doppler. Although goal-directed echocardiography can be invaluable in the care of critically ill patients, it is also paramount to recognize common pitfalls of CCE that can lead to flawed interpretations. With proper training and competence, intensivists can incorporate the findings from CCE into bedside clinical management strategies.

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Author information

Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, Winthrop-University Hospital, 222 Station Plaza, Suite 400, Mineola, NY, 11501, USA

    Girish B. Nair M.D., FCCP

  2. Division of Pulmonary, Critical Care and Sleep Medicine, Mount Sinai Beth Israel Medical Center, First Avenue & 16th Street, Dazian Building, 7th floor, New York, NY, 10004, USA

    Pierre Kory M.D., MPA, FCCP

  3. Department of Medicine, Division of Pulmonary and Critical Care Medicine, Winthrop-University Hospital, 222 Station Plaza North, Suite 400, Mineola, NY, 11501, USA

    Joseph P. Mathew M.D., FCCP

Authors
  1. Girish B. Nair M.D., FCCP
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  3. Joseph P. Mathew M.D., FCCP
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Correspondence to Joseph P. Mathew M.D., FCCP .

Editor information

Editors and Affiliations

  1. Providence VA Medical Center, Warren Alpert Medical School Brown University, Providence, Rhode Island, USA

    Matthew Jankowich

  2. Memorial Hospital of Rhode Island, Warren Alpert Medical School Brown University, Pawtucket, Rhode Island, USA

    Eric Gartman

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Nair, G.B., Kory, P., Mathew, J.P. (2015). Critical Care Echocardiography: Acute Left Ventricular and Valvular Dysfunction. In: Jankowich, M., Gartman, E. (eds) Ultrasound in the Intensive Care Unit. Respiratory Medicine. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-1723-5_5

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  • DOI: https://doi.org/10.1007/978-1-4939-1723-5_5

  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-1722-8

  • Online ISBN: 978-1-4939-1723-5

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