Focused cardiac ultrasound by unselected residents—the challenges

BMC Medical Imaging

Table 1 Cardiac parameters and their evaluation by focus cardiac ultrasound (FoCUS) and Standard Echocardiogram (SE)

	FoCUS	Standard Echocardiogram
LV EF (<40%^a)	Visually (no/yes), A4C, LAX	Volume calculations using the biplane method of disks (modified Simpson’s rule) [17, 21, 22]
LV dilated	Visually (no/yes), A4C, LAX
LV WMA	Visually (no/yes), A4C, LAX, A2C
Pericardial effusion	Calliper > 5 mm in end-diastole in any view. (no/yes)
Aortic regurgitation^b	Visual assessment of the jet area (no/yes) [22].	Predominantly by vena contracta measurements. Additionally, the pressure half time method was incorporated when grading AR. [18–20]
Mitral regurgitation^b	Visual assessment of the jet area (no/yes) [22].
RV FAC (<30%)	Visually (no/yes), A4C	FAC in A4C [17]
RV dilated ^c		Single plane area measurements in A4C [17]
RV WMA		Visually (no/yes), A4C
Aortic dilation	Calliper ≥ 4.0 cm, (no/yes)
LA dilated^c	Visually (no/yes), A4C	Biplane area-length method from A4C and LAX [17, 23]

LV left ventricle; EF ejection fraction, WMA wall motion abnormalities, RV right ventricle, FAC fractional area change, LA left atrium, FoCUS focus cardiac ultrasound, SE standard echocardiogram, A4C apical 4-chamber view, LAX apical long axis view, A4C apical 2-chamber view, CW continuous wave Doppler, ASE American Society of Cardiology, AR aortic regurgitation
^aVisual estimate of LV systolic function on basis of EF being over or below 40% This arbitrarily chosen level was in accordance with current heart failure guidelines [13]
^bModerate or severe
^cDilated if more than half the area as compared to that of the LV

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