EagleView Ultrasound in ICU Cardiac Cases
- written by Dr. Mustafa Taha
Shared by Dr. Mustafa Taha(@مصطفى محمود السيد from Facebook)
Case I
This 50 year male pt come with SOB and cough with lower limbs swelling, pt admitted to ICU and mechanically ventilated, on examination pt was in respiratory distress, Bp 90/50 , JVP elevated.
The shape of chest wall showed pectus excavatum with thoracic scoliosis with coarse crepitations on auscultation, bedside echo was done by EagleView US and show hugely dilated right atrium together with right ventricle with evidence of Dshape interventricular septum provide severe pulmonary hypertension with sever tricuspid regurge, inferior vena cava was congested and poorly collapsed which give hint about elevated pressure in right atrium.
Case diagnosed later as core pulmonale due to chest wall deformity complicated by chest infection.
Case II
This 40-year-old male patient presented to ER with acute confusion rapidly admitted to ICU.
On ICU ,the patient was in deep coma Glasgow coma scale was 5 and blood pressure was 80/50, JVP was raised and radial pulse was rapid and irregularly irregular, cardiac auscultation showed pan systolic murmur, spleen hugely enlarged and there are peripheral signs of infective endocarditis(Janeway lesion Osler nodules splinter hemorrhages and finger ulcerations), investigations are done and CT of brain show ischemic CVA.
I provide rapid bedside echo by EagleView, and the result was big mitral valve vegetations with rapid heart rate due to atrial fibrillation.
The case was diagnosed as Infective endocarditis with splenic and brain ischemic infarction due to vegetation emboli.