Page 310 - Cardiac Nursing

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286 P A R T III / Assessment of Heart Disease
■ Figure 13-15 These images are from the subcostal window as evidenced by the liver at the top of images.
Left: Subcostal long axis. Middle: Subcostal short axis in diastole. Right: Subcostal short axis in systole. RA, right
atrium; RV, right ventricle; LA, left atrium; LV, left ventricle. (Echo courtesy of Harborview Medical Center,
Seattle, Washington.)
Contrast Echo and arterial circulation (right and left heart structures). Echo con-
trast agents are composed of bubbles. The size of the bubbles de-
There are several purposes for the use of contrast in echocardiog- termines whether they will cross the pulmonary vasculature mi-
raphy. The diagnostic indication will dictate the specific type of crocirculation. Red blood cells cross the pulmonary capillaries and
contrast. One simple classification system of echo contrast agents are 6 to 8 μm in diameter.
is whether the contrast agent crosses the pulmonary vasculature Saline microbubbles (agitated saline) are commonly used for
microcirculation. Some contrast agents remain in the venous cir- detection of shunts, primarily because the bubbles are too large to
culation (right heart structures) while others will be in the venous cross the pulmonary vasculature microcirculation (Fig. 13-20).

■ Figure 13-16 Left: Suprasternal long axis. Right: Suprasternal short axis. Ao, aorta; RPA, right pulmonary
artery; Des Ao, descending thoracic aorta; LA, left atrium. Four arrows in left atrium identify each pulmonary vein.
(Echo courtesy of University of Washington Medical Center, Seattle, Washington.)