Comprehensive TTE Measurements

Parasternal Measurements

PLAX 2D MeasurementsDescriptionECGEcho
LV Wall (septum, inferior wall) Thickness and LV End-Diastolic DimensionLevel just below the MV leaflet tips. Perpendicular to LV long axis. Inner edge to inner edge. Peak of R WaveEnd-diastole: first frame after mitral valve closure or the frame with the largest LV dimensions/volume.
 LV End-Systolic DimensionLevel just below the MV leaflet tips. Perpendicular to LV long axis. Inner edge to inner edge.  End-systole: frame after aortic valve closure or the smallest LV dimension/volume.
LVOT Diameter3-10mm from aortic valve plane. Parallel to Aortic Valve plane. Inner edge to inner edge. Mid-systole: maximal separation of leaflets
Aortic Root DiameterSinus of Valsalva: just outside of AV leaflets. Parallel to Aortic Valve plane. Outer edge to Outer edge.Peak of R WaveEnd-diastole: just before aortic valve opens
Ascending Aorta DiameterLargest area. Parallel to Aortic Valve plane. Outer edge to Outer edge.Peak of R WaveEnd-diastole: just before aortic valve opens
PLAX/PSAX Doppler MeasurementDescription
RV Inflow TV CW: TR Peak VelocityIf full TR jet present, measure velocity at peak (choose highest)
RV Outflow PV CW: 
PSAX TV CW: TR Peak VelocityIf full TR jet present, measure velocity at peak (choose highest)

Apical Measurements

Apical 2D MeasurementsDescriptionECGEcho
LA VolumeDraw LA in both 2 and 4 chambers End-systole: before mitral valve opens, largest area
LV Volume Draw LV in both 2 and 4 chambers End-diastole 
RV Basal Diameter  End-diastole 
Apical M-Mode/Doppler MeasurementsDescription
Mitral Inflow PW: E and A WavesMeasure velocity at E wave (wave before p wave) and A wave (wave after p wave)
Medial MV TDIMeasure velocity at peak E’ (below baseline wave before p wave)
Lateral MV TDIMeasure velocity at peak E’ (below baseline wave before p wave)
RV Inflow CW: TR Peak VelocityIf full TR jet present, place velocity at peak (choose highest)
TAPSE Draw from base to peak
Lateral TV TDI: S wave Measure velocity at systolic peak
 A5C/A3C LVOT PW Measure V1 velocity at peak
 A5C/A3C AV CW Measure V2 velocity at peak

Subcostal Measurements

MeasurementDescription
RAP Pressure: IVC with SniffMeasure IVC just distal to hepatic vein at rest and with sniff
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