BELAJAR ECHO a practical guide for reporting and interpretation.pptx

tentang bagaimana melakukan pemeriksaan echo

1. BASIC ECHOCARDIOGRAPHY

2. STANDARD/BASIC VIEW

3. STANDARD/BASIC VIEW

4. Parasternal Long Axis View STANDARD/BASIC VIEW Aortic valve level Mitral valve level Papilary muscle level Apical View Subcostal View Parasternal Short Axis View 4C 3 C 2C

5. PARASTERNAL LONG AXIS VIEW (PLAX) RVOT RVOT LA LV Ao DA IVS IVS AML P ML

6. PARASTERNAL SHORT AXIS VIEW (AORTIC VALVE LEVEL) Aortic valve Tricuspid valve

7. PARASTERNAL SHORT AXIS VIEW (MITRAL VALVE LEVEL)

8. PARASTERNAL SHORT AXIS VIEW (PAPILARY MUSCLE LEVEL)

9. APICAL 4 CHAMBER VIEW

10. APICAL 2 CHAMBER VIEW

11. SUBCOSTAL 4 CHAMBER VIEW

12. SUPRASTERNAL NORTH VIEW A. Brachiocephalica A. Komunis karotis kiri A. Subclavia kiri

13. AORTIC VALVE & LEFT ATRIAL M-MODE

14. M-MODE

15. MITRAL VALVE M-MODE EPSS PMVL

16. COLOUR DOPPLER RED TOWARD BLUE AWAY

17. RESUME ECHO EXAM (TTE)

18. RESUME ECHO EXAM (TTE)

19. SYSTEMATIC ASSESSMENT LV size and function RV size and function Valves Thrombus intracardiac Pericardial fluid

20. LV DIMENSION AND FUNCTION LV Linear cavity dimensions LV wall thickness LV mass LV volumes LV function

21. LV DIMENSION AND FUNCTION LV linear cavity dimensions

22. LV DIMENSION AND FUNCTION LV linear cavity dimensions

23. LV DIMENSION AND FUNCTION LV linear cavity dimensions

24. LV DIMENSION AND FUNCTION LV wall thickness

25. LV DIMENSION AND FUNCTION LV mass

26. LV DIMENSION AND FUNCTION LV volume

27. LV DIMENSION AND FUNCTION LV systolic function Kualitatif ( melalui M-Mode) E-point septal separation (0-5 mm) Derajat pergerakan anteroposterior dari aortic root Kuantitatif

28. LV DIMENSION AND FUNCTION Regional LV Wall motion

29. LV DIMENSION AND FUNCTION Regional LV Wall motion

30. STANDARD RV VIEW AND MEASUREMENT VIEW Parasternal long axis Parasternal short axis RV inflow Apical 4 C Subcostal 4 C MEASUREMENT Size Wall thickness Systolic unction

31. RV DIMENSION AND FUNCTION RV Size LV Systolic Function Qualitatively : Normal, mildly reduced, moderate reduced, severely reduced LV volumes LV function

32. RV DIMENSION AND FUNCTION RVOT Proximal RVOT Distal RV Mid (RVD2)& Basal (RVD1)

33. RV DIMENSION AND FUNCTION

34. RV DIMENSION AND FUNCTION

35. RV DIMENSION AND FUNCTION

36. RV DIMENSION AND FUNCTION

37. RV DIMENSION AND FUNCTION (RESUME)

38. VENTRICULAR DIASTOLIC FILLING AND FUNCTION Diastolic dysfunction = merupakan tanda awal dari penyakit jantung Evaluasi = Pola pengisian LV dan RV Pola pengisian RA dan LA Velocity of myocardial motion

39. FASE DIASTOLIK NORMAL Fase diastolic normal Isovolumic relaxation Early rapid diastolic filling Diastasis Late diastolic filling (Atrial contraction) Fase diastolic RV analog dg LV ( namun durasi lebih pendek )

40. FUNGSI DIASTOLIK Parameter fungsi diastolik Relaksasi ventrikuler Myocardial/chamber compliance Tekanan pengisian

41. LV relaxation Terjadi selama isovolumic relaxation Merupakan proses AKTIF membutuhkan energi Faktor yang mempengaruhi Internal loading forces (cardiac fiber length) External loading condition ( wall stress, arterial impedances) Inactivation of myocardial conctraction (metabolic, neurohumoral , pharmacogical ) FUNGSI DIASTOLIK Abnormal relaxation IVRT memanjang Penurunan tekanan ventrikel melambat (reduced – dP / dt ) Penurunan puncak early peak filling rate (reduced E)

42. FUNGSI DIASTOLIK V entricular compliance Compliance = rasio perubahan volume dibagi perubahan tekanan ( dV / dP ) Stiffness = kebalikan compliance = rasio perubahan tekanan dibagi perubahan volume ( dP / dV ) Dipengaruhi oleh Fx intrinsic = myocard dan chamber ( Bentuk dan ukuran ventrikel) Fx ekstrinsik = pericardium, volume RV, tekanan pleural Penurunan diastolic compliance IVRT memendek Steep deceleration slope ( curam ) Penurunan puncak late peak filling rate (reduced A)

43. FUNGSI DIASTOLIK Early diastolic filling rate (E) dipengaruhi oleh Perubahan preload Perubahan transmitral volume flow rate (ex MR) Perubahan tekanan atrial (ex peningkatan LV EDP ok MR) L ate diastolic filling (A) dipengaruhi oleh Irama jantung Fungsi kontraksi atrium Ventrikel EDP Heart rate PR interval (timing of atrial contraction) Ventricular diastiolic function

44. PENGHITUNGAN FUNGSI DIASTOLIK Standard clinical measurement of LV inflow

45. FUNGSI DIASTOLIK

46. KLASIFIKASI DISFUNGSI DIASTOLIK

47. KLASIFIKASI DISFUNGSI DIASTOLIK

48. DISFUNGSI DIASTOLIK PADA KASUS KLINIS