1/n #POCUS findings of effusive constrictive pericarditis. Patient presented with 2 months progressive pedal edema and ascites. Pericardial effusion, funny bounce of IVS
2/n A4C septal bounce
3/n Plethoric IVC
4/n High JVP (pt standing up!)
5/n prominent x and y descents in IJV flow
6/n Pleural effusion
7/n Ascites
8/8 Mitral and tricuspid flow respiratory variation

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More from @DrShukla14

26 Oct
1/n #POCUS as a part of ED evaluation for first episode of atrial fibrillation (this demographic has significant prevalence of rheumatic heart disease) - appears grossly normal - moving on to other views...
2/n Apical 4C also grossly normal....
2/n but as probe swept caudally from A4C .. what’s that in RA?
Read 6 tweets
5 Oct
1/n #POCUS M/68, vomiting since 6 hours, back pain since 1 h. Says no to chest pain /abd pain / dyspnea. Diaphoretic, vomiting, HR 90, RR 24, BP 128/70, SpO2 91% (air). Reduced BS left side, Abd distended, nontender. ECG normal. Is it acute aortic? Tried to get PLAX heart -
2/n - scanning right parasternal area - found the heart - hyperdynamic, but nothing grossly wrong there.
3/n #POCUS Another look at left hemithorax anteriorly (parasaggital plane, mid-clavicular line, 4th. ICS)
Read 9 tweets
30 Sep
Thread 1/4 - #POCUS Case - MPA+bilateral PE. HR 110, BP 94/68, Sats 98% room air. Subjectively, patient feels well, no dyspnea/pain. Warm skin. Shifted to EM Resus. Lytic or not? Young pt, no known co-morbids / provocation.
2/4 #POCUS - RV does not seem dilated
3/4 #POCUS - IVC seems collapsed
Read 5 tweets
4 Jul
#POCUS case - F/80. Known mesenteric stenosis (celiac origin, and SMA). Has upper abdominal pain off and on - ? mesenteric angina. Now presents with severe upper abdominal pain. Tender+++ epigastrium, no peritonism. Normal GB ultrasound and lipase. Lactate 0.4. Previous CT:
Epigastric tenderness and normal lactate argue against acute mesenteric occlusion. #POCUS - SMA origin
#POCUS Color doppler SMA
Read 6 tweets
27 Jun
Thread 1/n. #POCUS findings in a M/31, leg swelling and abdomen distention progressive since 1/12. Starting with right IJV (high gain setting)
Abdomen RUQ Image
Abdomen LUQ
Read 8 tweets
22 Sep 19
Thread - (1/n) #POCUS findings in Left Main coronary occlusion.. this is not a STEMI - its WORSE ! M/50, 12 h intermittent chest pain. 2 hours of constant chest pain. Normal BP, no rales... but.. ECG horrible.
Thread - (2/n) #POCUS findings in Left Main coronary occlusion
Thread - (3/n) #POCUS findings in Left Main coronary occlusion: Cardiology fellow seeing patients .. they (and I) can't appreciate any rales.. but this is how lungs appear all over anteriorly
Read 6 tweets

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