Echo-of-the-Day

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Echo-of-the-Day Information

The Echo-of-the-Day is a presentation of 1 or more video loops to present an important topic in echocardiography. Please reveiw the image or video loops and then answer the questions below. After you have answered the questions you can view the explanation and obtain CME credit (if available).

You can change the size and the format of the image or video loops by using the links below the image or video loop.

= MP4 Video	= Ogg Video
= WebM Video	= GIF Image
Image/Video Sizes	= JPG Image
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Loop Text Key
Preop	Preop TEE or TTE
Intraop	An Intraop TEE
IntraopPreOp	Intraop TEE or TTE before Operation
IntraopPostOp	Intraop TEE or TTE after Operation
IntraopEnd	Intraop TEE or TTE at End of Anesthesia
Post Op	Postop TEE or TTE

Echo of the Day Information Table

IntraopEnd is usually a TEE after the Operation and after some event occured to show a change in the TEE

Septal Shift

Case#: 145

AMA CME Units: 0.25 Units
Estimated Time: 15 minutes.

Presentation:
A patient present with the following echo loop.

Loop(s):

Case Discussion

The abnormality is an interventricular septal (IVS) shift that occurs at the end of diastole. For the IVS to shift during diastole, the RVEDP must exceed the LVEDP. Since the RV and LV, in this loop, appear to have normal ejection fractions, the volume entering the RV during diastole must exceed the volume of blood entering the LV during diastole. RV volume overload from fluid overload or a shunt (ASD) that is increasing the amount of blood in the RV at the end of diastole must be present. Other causes include constrictive pericarditis (from Still's disease), mechanical dyssynchrony from abberent conduction, pulmonary hypertension, left ventricular unloading (IABP), total absence of the pericardium, Valsalva maneuver, and an LVAD,

CME Section

Please answer the following questions correctly to obtain your CME.

Web Links/References

A rare case of reversible constrictive pericarditis with severe pericardial thickening in a patient with adult onset Still's disease.
E-Echocardiography RV Dilation
Role of radial strain and displacement imaging to quantify wall motion dyssynchrony in patients with left ventricular mechanical dyssynchrony and chronic right ventricular pressure overload.
[Atrial septal defect associated with mitral valve prolapse--prevalence and clinical significance]
Analysis of ventricular septal motion by doppler tissue imaging in atrial septal defect and normal heart.
Ventricular interdependence during Valsalva maneuver as seen by two-dimensional echocardiography: new insights about an old method.
Does septal position affect right ventricular function during left ventricular assist in an experimental porcine model?

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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of University of Nebraska Medical Center, Center for Continuing Education and JLS Interactive, LLC.

The University of Nebraska Medical Center, Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

This activity is approved by the American Society of Radiologic Technologists (ASRT) as sonography-related continuing education (CE). Credit(s) issued for successful completion of ASRT-approved CE activities are accepted by the American Registry of Diagnostic Medical Sonography, American Registry of Radiological Technologists, Cardiovascular Credentialing International and Canadian Association of Registered Diagnostic Ultrasound Professionals. Contact the applicable registry for additional information / restrictions on their acceptance of ASRT CE credit.