Thread by @GUH_ICU_Anaesth

GUH - images in Anaesthesia and ICU:
In anticipation of our Level 2 echo tweetorial series

This is a zoomed image of a valve during a level 2 scan

1. Name the valve

Name the valve:

For bonus points -

Name the transthoracic echo view:

@drjimday @pnolan99 @NixLimerick @AnaesTrainees @ICSIreland @BSEcho @iceman_ex @POCUSClub @AndyNeill @cianmcdermott @ICUltrasonica @icmteaching #echofirst

Answers:
1. Tricuspid Valve
2. Right Parasternal View

While the right parasternal view is essential for accurate quantification of aortic stenosis - subtle hand movements can give an an-face view of the tricuspid valve

To obtain the right parasternal view:

1. Lie the patient in the RIGHT lateral position with right hand under the head

2. Obtain the standard PLAX view in this position

3. Follow the path of the ascending aorta across the sternum

4. Rock medially + tail up

The probe now faces down the ascending aorta through the AV

Color doppler shows direction of flow toward the probe

The associated CW doppler signal is therefore above the baseline

Once the angle is identified with 2D and color doppler, the pedoff probe is then used to accurately assess gradients.

It is tricky to learn but worth the effort!

@GoughCJ @drjimday @AnaesTrainees @ICSIreland @pnolan99 @PetermoranPeter @cmc47802929 @cianmcdermott