Congenital malformations and unusual anatomy can complicate pediatric cardiology. It can be hard to see. An echocardiogram for children may not be as thorough as one for adults. To assess various structural and congenital abnormalities, segmental methods are needed. A Segmental Approach focus only on the structures and the segments connecting them to the heart. To accurately identify and determine the cardiac structures in pediatric echocardiograms, Doppler confirmation is used. This segmental approach can be extended to image acquisition protocols. These protocols should be easy to use for patients and allow reproducible and rapid acquisition of all information. It is not important to focus on the order of the images. It should be the primary goal to collect all data from every window. This article will discuss the procedures used by three institutions to analyze and assess cardiac anatomy and structure.
Parasternal
The child should be in the left-lateral orientation for comfort. This position will allow you to achieve the best imaging. It is located just above or below the fourth intercostal space and is directly next to Sternum. It can appear inverted on the chest or inverted-apical. The transducer indicator can be used to determine the long-axis plane at eleven o’clock. It follows the line of a normal-placed heart.
Apical 4 chambers, Apical 2 Chamber
The transducer at the cardiac apical beat or the indicator at three o’clock can show the apical view. The child can be placed in either a supine or left-lateral position. The left arm should be lifted. These segments will be analyzed again in sequence, usually starting from the posterior and moving towards the anterior. The coronary sinus can be seen posteriorly in the left atrioventricular groove.
Subcostal coronal, sagittal
The key factors that affect the structure and location of the heart are found in the abdominal viscera. These structures can be used for predicting the anatomy of your heart.
Suprasternal long axis
The fourth standard imaging plane is the suprasternal view. Children younger than 5 years may not find this view suitable. To get the best image, it is important to lie on your back. To achieve this, the neck should be fully extended. To achieve hyper extension, you may need to roll under the shoulder or place a pillow. The probe should be placed in child’s supraclavicular and suprasternal areas. The transducer indicator can be used to view the long-axis at approximately 1–2 o’clock.
Right parasternal, high parasternal
If there is no visualization of the septum, superior vena cava or septum, then the right parasternal view can be used. This view is useful for diagnosing sinus venosus defects or unusual partial pulmonary vein draining. You will find the transducer on the right side. The indicator at 12 o’clock shows the systemic vein drainage. This technique is used for imaging the short axis right parasternal.
Ductal view
You can see the juxtaductal region in the context of an Aortic Confrontation with the ductal view. The view is a parasagittal sweep with the transducer positioned in the high left parasternal/infraclavicular area with the indicator at 12 o’clock. Your transducer should be tilted towards the middle to profile the main and left pulmonary vessels.
High left parasternal/infraclavicular
Orthogonal views are orthogonal views. They show high left paternalists and high left short-axis. This view is useful for visualizing branch veins and arteries.
Reporting
Segmental cardiac evaluations must be reported on the final form. The American Society of Echocardiography developed this format and the Inter societal Accreditation Commission added to it. Each lab should follow a consistent reporting format. These reports should include pertinent findings, demographic information, as well as clinical information. These reports should be available to both cardiac and non-cardiac doctors.
Conclusion
This segmental protocol is useful for improving pediatric cardiac assessment. You can modify it to fit your clinical needs. Sometimes, children may not cooperate. It is crucial to get the most important information. It is important to not be focused only on the protocol’s order, but rather the ability and willingness to receive all information.
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