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Aug 24 • 3 tweets • 3 min read
Illustration of the Effects of Changes in Intrathoracic and Intracardiac Pressures During Respiration in Normal Versus Constrictive Heart.
#echofirst #MedEd #POCUS #IMPOCUS
🔗 sciencedirect.com/science/articl…
Typical changes during respiration in the interventricular septum movement (white arrows) and blood flow velocities (black arrows). Insets depict typical Doppler velocity (y-axis) versus time (x-axis) tracings across
MV, TV, PV & HV.
🔗nature.com/articles/nrcar…
#POCUS #echofirst
Another easy-to-understand representation of variation on transmitral and tricuspid flow in constrictive pericarditis.

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More from @NephroP

NephroPOCUS Profile picture
Aug 22
Time to update the #VExUS resources pinned thread 🧵📌
1/ Tweetorial on image acquisition.
#POCUS #MedEd
2/ The original #VExUS paper
theultrasoundjournal.springeropen.com/articles/10.11… Image
3/ Review article on #VExUS by @nephrothaniel and me in @KidneyMed
🔗kidneymedicinejournal.org/article/S2590-… Image
Read 22 tweets
NephroPOCUS Profile picture
Aug 22
#POCUS quiz for #VExUS enthusiasts.
Image obtained from a patient with heart failure with preserved EF. IVC 1.9 cm with 30% inspiratory collapse.
Here is the intra-renal image. Interpretation of the venous waveform?
POLL in thread 👇
#MedEd #Nephrology Image
👆#POCUS
S = systolic venous wave
D = diastolic venous wave
@khaycock2 @ArgaizR @msenussiMD You'll like it (I know u know the answer 🤫)
Read 4 tweets
NephroPOCUS Profile picture
Aug 20
CVP waveform - a variant of #VExUS #POCUS
Tracings obtained from a 38-year-old female with severe aortic stenosis and mild pulmonary hypertension who underwent aortic valve replacement. What's the difference from pre to post-op?
Se thread for answer and source.
#MedEd
ncbi.nlm.nih.gov/pmc/articles/P…
Read 4 tweets
NephroPOCUS Profile picture
Aug 9
Cardiac tamponade on #POCUS #echofirst
Click on 'ALT' for description
#MedEd #IMPOCUS #Nephrology
From 🔗pubmed.ncbi.nlm.nih.gov/32572594/ Two-dimensional (2D) and M-mode echocardiographic signs of p
Mitral inflow Doppler and LVOT VTI in tamponade.
'ALT' for description
#POCUS #echofirst #MedEd Respiratory variations in flow velocities by spectral Dopple
Pulsus paradoxus: during inspiration, right heart filling occurs at the expense of the left, so that its transmural pressure transiently improves & then reverts during expiration (Ventricular interdependence). Seen as 👆on #POCUS
Read 5 tweets
NephroPOCUS Profile picture
Jun 8
#POCUS #MedTwitter #Nephpearls
Many #VExUS enthusiasts asked for a #tweetorial on image acquisition pearls. Did one b4 but time for an updated one 🧵

#1 Let's start with basics
Color Doppler identifies the flow + tells the direction (blue is away & red towards the probe [BART])
#2 👆BART holds good unless u invert the scale.
👇Pulsed wave Doppler (PWD) depicts blood flow at a certain point (sample volume) - we analyze the pattern of flow + velocity using this mode.
Above-the-baseline = flow towards the probe (like red on color)
Below = away (like blue)
#3
While performing any Doppler study, it's important to keep in mind that the angle between US beam & blood flow determines the accuracy of velocity displayed. Parallel = best, perpendicular = worst
As #VExUS does not rely on absolute velocities, its OK not to have perfect angle
Read 28 tweets
NephroPOCUS Profile picture
May 27
#POCUS #VExUS consult for #hyponatremia. Elderly pt with h/o mitral valve replacement. On Bumetanide, UNa ~70 mmol/L, Uosm ~250🧵
Trace edema, JVD +, feels OK
Calling hemodynamic friends @khaycock2 @ThinkingCC @ArgaizR @msiuba @IM_Crit_ @MDBeni @siddharth_dugar Educate us!
1/ IVC
2/ 👆Consistent with elevated right atrial pressure.
👇Hepatic vein #VExUS
D-only pattern (rhythm: ventricular paced)
3/ Portal vein #VExUS
Doesn't look bad
Read 12 tweets

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