Major chambers in view
โฃLA
โฃLV
โฃAorta
โฃRV(OT)
4/ Deconstructing the PLAx view:
โข The ๐ฝ๐ฟ๐ผ๐ฏ๐ฒ ๐บ๐ฎ๐ฟ๐ธ๐ฒ๐ฟ ๐ถ๐ ๐ผ๐ป ๐๐ต๐ฒ ๐ฅ๐๐๐๐ง, or oriented toward the Aorta/LA relative to LV apex
โข The top of the screen (๐ฅ๐ฉ) ๐ถ๐ ๐ฐ๐น๐ผ๐๐ฒ๐๐ to the probe and
โข (Aorta and MV in view)
โข LA and LV free wall furthest
5/ With those constraints one can determine general PLAx probe location
โข Probe marker ~10 oโclock
โข ~3rd intercostal space
โข Perpendicular to chest
6/ ๐ง๐๐ฆ๐ง!
The Apical 3 chamber is a similar view
Deconstructing this is a good exercise to solidify the concept
History, utility and how well does it perform ๐๐ถ๐๐ต ๐๐น๐๐ฟ๐ฎ๐๐ผ๐๐ป๐ฑ
a thread
Pasteur (not Louis) first described HJR as a sign of TR in 1885
Rondot in 1898 actually coined the phrase HJR and noted that it didnโt just reflect TR
In 1925 Lian (professor) and Blondel (internโฆ wonder who did most of the work ๐ ) reported that ๐ฝ๐ฟ๐ฒ๐๐๐๐ฟ๐ฒ ๐ฐ๐ผ๐๐น๐ฑ ๐ฏ๐ฒ ๐ฎ๐ฝ๐ฝ๐น๐ถ๐ฒ๐ฑ ๐ฎ๐ป๐๐๐ต๐ฒ๐ฟ๐ฒ ๐ผ๐ป ๐๐ต๐ฒ ๐ฎ๐ฏ๐ฑ๐ผ๐บ๐ฒ๐ป, not just the liver, to get the response
Reminder the
โฃ๐ฅ๐ฉ is the most ๐ฎ๐ป๐๐ฒ๐ฟ๐ถ๐ผ๐ฟ structure
โฃ๐๐ the most ๐ฝ๐ผ๐๐๐ฒ๐ฟ๐ถ๐ผ๐ฟ
3/ Multiple โviewsโ can be obtained with this probe rotation, from the
โข ๐ฎ๐ผ๐ฟ๐๐ถ๐ฐ level
โข through the base (๐บ๐ถ๐๐ฟ๐ฎ๐น level) of the heart
โข past the ๐ฝ๐ฎ๐ฝ๐ถ๐น๐น๐ฎ๐ฟ๐ level
โข to the ๐ฎ๐ฝ๐ฒ๐
โข The ๐ฝ๐ฟ๐ผ๐ฏ๐ฒ ๐บ๐ฎ๐ฟ๐ธ๐ฒ๐ฟ ๐ถ๐ ๐ผ๐ป ๐๐ต๐ฒ ๐ฅ๐๐๐๐ง, or oriented toward the LA/LV relative to RA/RVx
โข The top of the screen (๐๐ฝ๐ฒ๐ ) ๐ถ๐ ๐ฐ๐น๐ผ๐๐ฒ๐๐ to the probe and
โข Atria are furthest
3/ With those constraints one can determine general ๐๐ฐ๐ probe location
โข Probe marker ~3 oโclock (๐ถ๐ด๐ถ๐ข๐ญ๐ญ๐บ 2:30)
โข ~5rd IC space
โข ~Midclavicular line (๐ข๐ญ๐ต๐ฉ๐ฐ๐ถ๐จ๐ฉ ๐๐๐ ๐ข๐ฏ๐ฅ ๐ข๐ฑ๐ฆ๐น ๐ข๐ณ๐ฆ๐ฏ'๐ต ๐ข๐ญ๐ธ๐ข๐บ๐ด 1:1)
โข Probe tilted to head