

Episode 78: Echoing the RV with Matt Siuba
13 snips Aug 21, 2024
Matt Siuba, an intensivist at the Cleveland Clinic and a master of zentensivism, dives deep into the critical assessment of the right heart using echocardiography. He discusses the dynamics of the right ventricle and its interplay with the left ventricle, especially during patient shock. Listeners will learn about innovative non-invasive techniques to evaluate right heart function and the significance of pulmonary artery dynamics in cases of pulmonary hypertension. Siuba emphasizes the need for systematic assessments to enhance patient management in critical care.
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Three-Domain RV Framework
- Assess the RV using three simple domains: size, squeeze, and septal kinetics.
- These three findings integrate to show whether the RV contributes to shock.
Dilation Often Precedes Septal Failure
- RV dilation often precedes septal dyskinesia and can be an early compensatory response.
- Persistent dilation suggests abnormality and possible progression to LV impairment.
Use TAPSE And Trend Consistently
- Use TAPSE as a practical bedside surrogate for RV ejection performance and trend it consistently.
- Measure TAPSE the same way each time to validly compare serial changes.