Top 5 Tips: Diastology

ICEM Conference Pearls of Wisdom

POCUS Workshop Instructors Dr Jonathan Henry and Dr Claudiu Radeanu

1. Big left atrium, but both LV systolic function and mitral valve are normal? You need to suspect diastolic dysfunction!

2. Eyeballing doesn't help a lot from this point on - you'll need to take 2 measurements from your apical 4-chamber view ...

3. First, place your PW Doppler gate at the MV leaflet tips, and measure your peak E (passive filling) and A (active filling) wave height.

4. Next, place your tissue Doppler gate at the mitral valve annulus, and measure the e'. Then you can calculate your E/e' ratio - simple!

5. Finally, be a clinician and interpret all this data within the clinical context. Whether giving fluids or diuresing, you now have the power to be more individualised with managing LV filling pressures, and avoiding potential harm.

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