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Evaluating Cardiac Ejection Fraction

A 38-year-old male patient presented to the physician’s office in Haiti with a complaint of palpitations for the past 6 months. There was no history of fever, chest pain, dyspnea, orthopnea or edema. There was no significant past medical history. Patient was not on any medication. Patient denied alcohol and drug abuse. Family history was not significant. An assessment of the patient found the following:

Temp – 98.6 Degrees Fahrenheit

HR – 88 BPM

BP – 114/74 mm Hg

RR – 18 per minute

EKG showed normal sinus rhythm with normal axis. No ST -T changes.

Physical exam was unremarkable.

A POCUS cardiac exam was performed. Below is one of the videos from the patient’s echo.

Question:

From the assessment and exam…

  1. Is there any pathology seen?
  2. Is the Ejection Fraction in the normal range?

(answers below)


Answers

  1. Normal PLAX view findings.
  2. An eyeball method to determine approximate EF is used in POCUS cardiac exams using the PLAX view. In normal cases, the anterior leaflet of the mitral valve comes very close or within 8 mm of the interventricular septum or even touches the IVS. Make sure that the IVS is not thickened or the patient does not have a sigmoid septum.
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