now we're ready to get started in
performing our Echo exam so our patient
has been prepared well positioned and
now we're ready to get started my thumb
is on the thumb Notch and we've applied
a little bit extra gel just to ensure we
have good contact and what I will now do
is feel for the apex beat
and I'll place the probe in the
intercostal space just over the apex
beat now what we're looking for in this
right peristal long AIS view this is
going to be the four chamber view so
we'll be looking at the right atrium the
right ventricle the left atrium and the
left ventricle so what we're wanting to
do is get it so that the
vent the left ventricle is horizontal as
horizontal as possible so that we know
that it's truly in a long AIS view by
convention the base of the heart is
towards the right of the ultrasound
image and the Apex is more towards the
left so we'll just have a look at our
ultrasound image and see what we need to
do to change it to really optimize our
our right peristernal long axis for
chamber
View and it's looking pretty
good however we don't have a really good
C view of the left ventricle so we'll
just need to make a few small
adjustments what I'll now do is rotate
my probe anticlockwise just ever so
slightly always keeping an eye on the
image to see exactly how it's
looking and that's much better
if you're losing a bit of the left
ventricle off of the left side of the
screen what you can actually do is
either move an intercostal space
cranially or you can also Slide the
probe down towards the sternum a little
bit more
ventrally that's a much better
view we can evaluate various structures
on here including the left atrium
the left ventricle the mital
valves the right atrium the right
ventricle to some
degree but really we're wanting to look
at the at the left side particularly on
this
view so we're looking to see the
contractility how much the heart is
actually doing its
job we can also evaluate the mitro valve
leaflets
and we can evaluate chamber
size I've just Frozen the image and what
we can now do is actually look at the
ratio of the diameter of the left atrium
compared to the left ventricular
internal diameter during diast this will
give us an idea of whether or not the
left atum is enlarged When comparing it
to the left
ventricle we can scroll backwards and
forwards through our Frozen an image
Bank from this particular scan and just
have a look and see if we can catch it
in
diast we don't have the ECG leads
attached at this time because most
people not everybody has this available
in general practice and so what we'll
try and do is estimate diast
and that will give us a fair
approximation so what we'll now do is
perform some measurements looking at
again the diameter of the left atum
compared to the diameter of the left
ventricular internal diameter during
diast I've put on my calipers
and we've made a measurement of the left
atrium we'll now look at the left
ventricular internal
diameter and as you can see the
measurement of both of these is around
about 3 and 1/2 cm
the ratio should be 1: one of the
diameter of each left atrium and the the
left ventricle the the internal diameter
and that's what we have in this case so
this is a normal dog