Table 4.8 A protocol for 2DE and M-mode echocardiography


Preparation

Consider suitable restraint of the horse and protection of equipment

Clip hair from the axillae except in very fine-haired animals

Clean dirt and grease away with soap/spirit

Apply acoustic gel

Attach the ECG clips

Alter the gain settings and post-processing as appropriate

Examination

Start with right parasternal long-axis view

Assess: image quality, must be adequate for thorough examination overall size and shape of left ventricle

overall size and shape of right ventricle overall size and shape of right atrium relative size of aorta, LV and left atrium

IVS especially just below the aortic root (site of most VS Ds)

tricuspid valve structure

mitral valve structure

aortic valve and aortic root structure

LV, IVS, mitral valve and aortic valve motion

Rotate transducer to obtain a right short-axis view

Assess: aortic valve structure IVS structure LV and IVS motion

Position the M-mode cursor across the middle of the LV (bisecting the chordae) and switch

to M-mode

Measure LVD at end-diastole and end-systole

Calculate FS%

Assess: high frequency motion, velocity and pattern of IVS, mitral valve and aortic valve motion (can measure systolic time intervals)

Rotate and angle the transducer to image the pulmonary valve (RV inflow-outflow view)

Assess: tricuspid valve structure tricuspid valve motion pulmonary valve structure pulmonary valve motion

Measure the size of pulmonary artery using 2DE

Switch to left parasternal position, examine in long-axis

Assess: overall size and shape of left ventricle structure of mitral valve motion of LV, VS, mitral valve and aortic valve

Measure the LA diameter using 2DE (maximise diameter and measure at the base of the annulus)

Rotate transducer to obtain a short-axis view

Assess the motion of LV and IVS

Position M-mode cursor across LV

Measure LVD at end-diastole and end-systole

Calculate FS%

Adjust the plane of the beam to identify specific lesions as necessary during the examination