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Table 2 Variables assessed and definitions of abnormality findings in heart POCUS

From: Impact of point-of-care ultrasound on the hospital length of stay for internal medicine inpatients with cardiopulmonary diagnosis at admission: study protocol of a randomized controlled trial—the IMFCU-1 (Internal Medicine Focused Clinical Ultrasound) study

  Variable assessed Definitions
LV volume LVEDD Normal LVEDD 3–5.6 cm
LV dilated > 5.6 cm
Hypovolemia < 3 cm
LV systolic function Overall subjective impression Normal – Reduced – Increased
Difference between diameters in diastole and systole (LVEDD–LVESD) in PLAX view Normal 28–44 mm
Reduced < 28 mm
Increased > 44 mm
Difference between areas in diastole and systole
(LVEDA–LVESA) in PSAX view
Normal 50–65 mm2
Reduced < 50 mm2
Increased > 65 mm2
RV size Compared to LV size Normal < 2/3 of LV size
RVEDD Normal < 4 cm
Increased > 4 cm
RV systolic function Overall subjective impression Normal – Decreased
LA size LA diameter in PLAX or A4C views Normal < 3.5 cm
LA area in A4C view Normal < 20 cm2
Increased > 20 cm2
LA filling pressure Inter-atrium septum movement Normal: systolic reversal of the inter-atrium septum
High filling pressure: fixed curvature of the inter-atrium septum to the right
Low filling pressure: systolic buckling of the inter-atrium septum
Cardiac valves Leaflets appearance and thickness
Opening of the valve
Presence of reverse jet
Significant aortic stenosis:
An opening < 1.5 cm in PLAX or
Heavy calcification with inability to see the valve opening
Significant aortic regurgitation:
A jet that runs on the wall of the LV outflow track
A jet that is wider than 25% of the diameter of LVOT
A jet that extends down to the ventricle > 2.5 cm
Significant mitral stenosis:
Impaired opening of the mitral valve
A hockey stick appearance of one or both of the mitral leaflets
Significant mitral regurgitation:
Regurgitation jet covering > 20% of the LA area in A4C or PLAX
A turbulent jet that runs along the wall of the atrium
Prominent flail mitral valve leaflet or rupture papillary muscle
Significant tricuspid regurgitation:
Any edge-tracking jet
Any central jet > 5 cm2
Pericardial effusion Presence of anechoic space between parietal and visceral pericardium Significant pericardial effusion is defined as > 0.5 cm in any view
Inferior vena cava Diameter of the inferior vena cava in the subcostal view during normal breathing Maximum diameter in cm and percentage of collapsibility during normal inspiration are reported. Estimation of the right atrium pressure is informed as follows:
IVC < 2.1 cm collapsing > 50% ➔ RAP: 3 mmHg
IVC > 2.1 cm collapsing < 50% ➔ RAP: 15 mmHg
Values between the two above ➔ RAP:8 mmHg
  1. A4C apical four chambers, LA left atrium, LV left ventricle, LVEDA left ventricle end-diastole area, LVEDD left ventricle end-diastole diameter, LVESA left ventricle end-systole area, LVESD left ventricle end-systole diameter, PLAX parasternal long axis, POCUS point-of-care ultrasound, PSAX parasternal short axis, RAP right atrium pressure, RVEDD right ventricle end-diastole diameter