Transducer Position & LV Geometry

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Example of left ventricular long axis foreshortening
Figure 14

Another example: above (Figure 14) incorrect transducer position on the apical anterior wall, foreshortening of the LV long axis (7.8 cm) and overestimation of the LV end-diastolic volume (123 ml). Below (Figure 15), correct positioning of the transducer on the true LV apex: the correct LV long axis= 8.2 cm, and end-diastolic volume= 106 ml.
This is a 43 year old patient with previous AMI and CABG.

Example of correct positioning of the transducer on the true left ventricular apex
Figure 15
Figure 16. 2D apical 2-chamber
Figure 17. 2D apical 2-chamber

In this patient, also the 2-chamber has been acquired incorrectly (Figure 16). Compare to the correct visualization of the apical 2-chamber (Figure 17): the long axis is foreshortened and the RV cavity can be seen inferiorly to the inferior apex (Figure 16), pointing to a misalignment of the view. The plane of the image is not through the midplane of the true 2-chamber view, but is displaced medially. This causes a false normokinesis / hyperkinesis of the LV apical segments.

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