mardi 17 mars 2015

Cas du 17/03/2015

Presentation: A patient had this LV M Mode scan.





#1: What is this patients ejection fraction (estimate please)?


#2: Is it accurate?





















Explanation: This scan is a M Mode scan of the left ventricle short axis.  The endocardial walls are easily visible so the ejection fraction (> 50% in this case) is easily calculated.  

The ejection fraction from a M Mode scan of the LV SAX view is very accurate in most cases except where remote wall motion abnormalities are present.  

However, even in the presence of remote wall motion abnormalities, this calculation is fairly accurate because all of the coronary arteries supplied myocardium are present in this view and significant remote wall motion is unlikely.  

About the only serious wall motion abnormality that would make this scan inaccurate would be a distal LAD lesion where the whole apex is akinetic or dyskinetic thereby decreasing the ejection fraction signficantly.



















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