Jona Profile picture
Feb 6, 2023 11 tweets 6 min read Read on X
Super easy explain of physiologic Hepatic Pulsed Wave Doppler waveform.

🧵1/
#doppler #radiology #pocus #vexus #hemodinamics #butterflyiq @ButterflyNetInc @hepocus
2/
After appropriate technique to get PWD of suprahepatic Veins.
Look for the 4 classic waves of the tetraphasic spectrum of the hepatic veins (a,S,v,D).
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Most of the flow in the hepatic veins is hepatofugal (towards heart).
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The spectrum is phasic and predominantly anterograde (towards heart).
5/ Waves Meaning.

a: Atrial contraction. It's retrograde.
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S: Systole causes a suction effect in the right atrium. Most anterograde wave of the cycle.
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v: Peak represents the opening of the tricuspid valve and the transition from systole to diastole.
8/

D: Rapid ventricular filling.
9/

Now we can link it to the EKG trace.
10/
RT:)
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More from @JonahSerranoMD

Feb 18, 2023
♂ 50 y. With pulsatile femoral mass. history of femoral puncture 💉.

1/4
#vasculardoppler #ultrasound #MedEd #FOAMed #POCUS #radiology @ButterflyNetInc
2/4
Dx?
3/4 Ying-yang , or pepsi sign described in both true and false aneurysms.

On Doppler ultrasound, the yin-yang sign indicates bidirectional flow due to the swirling of blood within the true or false aneurysm. twitter.com/i/web/status/1… Image
Read 6 tweets
Feb 9, 2023
A straightforward, hands-on approach to Portal Vein Pulsed Wave Doppler.

Physiologic and pathologic waveforms

🧵0/7

#doppler #PWD #echofirst #POCUS #VexUs @ButterflyNetInc
1/ 7 PHYSIOLOGIC

Physiologic flow should be always antegrade and hepatopetal ( towards trasducer). Could be monophasic or gently ondulating,

In doppler it should be red (get the smallest angle posible).
To Remember:

Fugal: Away

Petal: Toward

Normal velocity: 16-40 cms
Read 12 tweets

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