POCUS Learning Modules

MODULE 7:  Cardiac Ultrasound

Curriculum Location: Cardiology / Total Time: 2 hours

For this and all other modules, you are welcome and encouraged to take notes as helpful to you in your Ultrasound/POCUS for Family MedicineEvernote Notebook, found here. 

Learning Module Objectives:

  1. Obtain 4 views of the heart: PLAX, PSA, Apical, and Subcostal

  2. Evaluate the heart for global LV systolic contractility and function

  3. Evaluate the heart for LVH using IVS diameter measurement from PLAX view

  4. Assess the heart for pericardial effusion using the subcostal view

Cardiac US (Time: 30 minutes)

  1. Background Case: Dyspnea and atypical chest pain

    1. Introduction: Read this Case Summary and accompanying Case Questions for a brief example of how POCUS applies to family medicine regarding cardiac ultrasound.

    2. Case description: A 60 year old male with a PMH of Asthma, HTN, HLD, and CAD with normal EF on previous Echocardiogram is admitted with atypical chest pain and mild dyspnea to rule out an MI. Initial troponins are normal. On physical exam, his vitals are normal, he has slight expiratory wheezing but no crackles, and he has trace LE edema. The exam is otherwise unremarkable. EKG shows old inferior Q waves, borderline LVH, and no acute changes. You decide to augment your physical exam with POCUS to evaluate his volume status and heart function. In your evaluation of the IVC, you estimate that his CVP is normal.

    3. Case Question: How is POCUS used to evaluate the heart for LV function, LV hypertrophy, and for pericardial effusion?

  2. Assignments:

    1. First, watch the following SUSME videos – follow along with or take notes in your Evernote as helpful:

      1. Introduction to Cardiac Ultrasound (8 min)

      2. LVH Screening in Patients with Systemic Hypertension (17 min) - Pay attention to slides 6-8 and 24-41; advance through the rest based on interest – there is some repetition with previous SUSME video but repetition can be helpful!

      3. Parasternal Short Axis Views (5:30 min) – Pay particular attention to the Parasternal Short Axis View at the mid-ventricular (papillary mm) level (slide 14), which is the level used in POCUS to help assess global LV systolic function

      4. Apical View (2m): https://www.youtube.com/watch?v=h9xE8yl3_Lg

    2. Next, read the Evernote on Cardiac Ultrasound and review the reference images

    3. Finally, review the following two references:

      1. Pericardial effusion (MGH): https://www.youtube.com/watch?v=dGwV8-0tF-Q– Pay attention to the first 2:50 minutes and how to differentiate pericardial effusion from pulmonary effusion; the last 1:10 is optional (on Tamponade) and may be helpful in a low resource setting emergency

      2. Measurement of LV walls (Stanford ICU): Please review just the first section on LV wall thickness measurement - https://web.stanford.edu/group/ccm_echocardio/cgi-bin/mediawiki/index.php/Left_ventricle_wall_thickness.

Module QUIZ (My favorite part!) (Time: 10 minutes)

  • Congratulations on completing the module. Please click HERE to take your Module Quiz and provide Module feedback.