Rebellion21: Demystifying Right Heart Ultrasound via Melissa Myers, MD

In this 15-minute video from day 2 of the Rebellion in EM 2021 conference, Dr. Melissa Myers, MD helps you take your echo to the next level by demystifying right heart ultrasound. In this lecture she teaches how to evaluate right heart strain using Tricuspid Annular Plane Systolic Excursion (TAPSE) as well as tips and tricks to differentiate acute and chronic right heart strain.

Melissa Myers, MD
Program Director Emergency Medicine Ultrasound Fellowship
Department of Emergency Medicine
San Antonio Military Medical Center (SAMMC)
San Antonio, TX
Twitter: @MelissaMyersMD

Objectives

1. Participants will be able to perform TAPSE to evaluate for right heart strain
2. Participants will be able to use measurements of the RV to differentiate acute vs chronic right heart strain

Outline

1. Introduction
   1. Brief review of RV dilation
2. TAPSE
   1. Review apical 4 chamber (A4C) view needed to obtain TAPSE (Tricuspid Annular Plane Systolic Excursion)
      1. TAPSE <16mm linked to higher 30d mortality
      2. Acute vs Chronic: During End Diastole, if RV free wall ≥5mm most likely chronic and if <5mm most likely acute
   2. Review evidence behind TAPSE
   3. Review pathology videos

Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)