{"id":455,"date":"2016-09-01T19:14:58","date_gmt":"2016-09-01T19:14:58","guid":{"rendered":"https:\/\/sites.austincc.edu\/sonography-resources\/?page_id=455"},"modified":"2016-09-06T19:02:28","modified_gmt":"2016-09-06T19:02:28","slug":"apical-window","status":"publish","type":"page","link":"https:\/\/sites.austincc.edu\/sonography-resources\/spectral-doppler-measurements\/apical-window\/","title":{"rendered":"Apical Window"},"content":{"rendered":"<h2>LV inflow @ MV tips<\/h2>\n<p>From an apical 4C view, obtain a pulsed Doppler signal of LV inflow. Place the sample volume at the tips of the mitral valve leaflets during diastole. Ensure the cursor is aligned parallel to flow of the valve. Measure the peak E, peak A and A duration.<\/p>\n<p><a href=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.01.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-534\" src=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.01.jpg\" alt=\"6.2.01\" width=\"640\" height=\"467\" srcset=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.01.jpg 773w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.01-300x219.jpg 300w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.01-768x560.jpg 768w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<h2>MV VTI<\/h2>\n<p>From an apical 4C view, obtain a CW Doppler spectrum of the mitral flow. Place the cursor parallel to flow of the valve to ensure the highest velocities are obtained. The spectrum should demonstrate a filled-in \u201cM\u201d shaped spectrum. Trace the VTI.<\/p>\n<p><a href=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.03.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-526\" src=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.03.jpg\" alt=\"6.2.03\" width=\"640\" height=\"447\" srcset=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.03.jpg 790w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.03-300x210.jpg 300w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.03-768x537.jpg 768w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<h2>MV PHT<\/h2>\n<p>From an apical 4C view, obtain a CW Doppler spectrum of the mitral flow. Place the cursor parallel to flow of the valve to ensure the highest velocities are obtained. The spectrum should demonstrate a filled-in \u201cM\u201d shaped spectrum. The spectrum obtained for the mitral VTI can be used. Measure the PHT by tracing the slope of the spectrum from the peak E to baseline.<\/p>\n<p><a href=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.04.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-527 size-large\" src=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.04-1024x716.jpg\" alt=\"6.2.04\" width=\"640\" height=\"448\" srcset=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.04-1024x716.jpg 1024w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.04-300x210.jpg 300w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.04-768x537.jpg 768w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.04.jpg 1202w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<h2>Pulmonary vein measurements<\/h2>\n<p>From an apical 4C view, obtain a pulsed Doppler spectrum of pulmonary venous flow. It maybe helpful to increase the depth and use color Doppler imaging to optimize the flow profile. Once the signal is obtained, measure the S wave, the D wave, and the Ar duration.<\/p>\n<p><a href=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.05.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-528 size-large\" src=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.05-1024x768.jpg\" alt=\"6.2.05\" width=\"640\" height=\"480\" srcset=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.05-1024x768.jpg 1024w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.05-300x225.jpg 300w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.05-768x576.jpg 768w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.05.jpg 1121w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<h2>LVOT VTI<\/h2>\n<p>From an apical 5C view, obtain a pulsed Doppler spectrum of LV out flow. Place the sample volume just proximal to the aortic valve cusps. The spectrum should demonstrate a bright modal band with a filled in window and a closure \u201cclick\u201d. Trace the VTI being careful to avoid the feathers around the spectrum.<\/p>\n<p><a href=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.06.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-529 size-large\" src=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.06-1024x768.jpg\" alt=\"6.2.06\" width=\"640\" height=\"480\" srcset=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.06-1024x768.jpg 1024w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.06-300x225.jpg 300w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.06-768x576.jpg 768w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.06.jpg 1121w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<h2>AV VTI<\/h2>\n<p>From an apical 5C view, obtain a CW Doppler spectrum of LV outflow. Place the cursor parallel to flow of this valve to ensure the highest velocities are obtained. The spectrum should demonstrate a filled-in bullet shaped spectrum. Trace the VTI careful to avoid the feathers around the spectrum.<\/p>\n<p><a href=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.07.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-530 size-large\" src=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.07-1024x768.jpg\" alt=\"6.2.07\" width=\"640\" height=\"480\" srcset=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.07-1024x768.jpg 1024w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.07-300x225.jpg 300w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.07-768x576.jpg 768w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.07.jpg 1121w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<h2>TV VTI<\/h2>\n<p>From an apical modified RV view, obtain a CW Doppler spectrum of RV inflow. Place the cursor parallel to flow of this valve to ensure the highest velocities are obtained. The spectrum should demonstrate a filled-in \u201cM\u201d shaped spectrum. Trace the VTI careful to avoid the feathers around the spectrum.<\/p>\n<p><a href=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.08.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-531\" src=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.08.jpg\" alt=\"6.2.08\" width=\"640\" height=\"483\" srcset=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.08.jpg 802w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.08-300x226.jpg 300w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.08-768x579.jpg 768w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<h2><\/h2>\n<h2>TDI @ septal annulus<\/h2>\n<p>From an apical 4C view, activate the tissue Doppler modality and align the pulsed Doppler sample volume at the septal annulus of the mitral valve. Be sure the sample volume is not on the LV or LA wall. Also, ensure the image is not angled and the LVOT is not seen.<\/p>\n<p><a href=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.9.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-532\" src=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.9.jpg\" alt=\"6.2.9\" width=\"640\" height=\"470\" srcset=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.9.jpg 802w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.9-300x220.jpg 300w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.9-768x564.jpg 768w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<h2>TDI @ lateral annulus<\/h2>\n<p>From an apical 4C view, activate the tissue Doppler modality and align the pulsed Doppler sample volume at the lateral annulus of the mitral valve. You may need to shift the unage ti align the cursor parallel to the motion of the lateral annulus. Be sure the sample volume is not on the LV or LA wall.<\/p>\n<p><a href=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.10.jpg\" target=\"_blank\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-533\" src=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.10.jpg\" alt=\"6.2.10\" width=\"640\" height=\"480\" srcset=\"https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.10.jpg 802w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.10-300x225.jpg 300w, https:\/\/sites.austincc.edu\/sonography-resources\/wp-content\/uploads\/sites\/115\/2016\/09\/6.2.10-768x576.jpg 768w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>LV inflow @ MV tips From an apical 4C view, obtain a pulsed Doppler signal of LV inflow. Place the sample volume at the tips of the mitral valve leaflets during diastole. Ensure the cursor is aligned parallel to flow of the valve. Measure the peak E, peak A and A duration. MV VTI From [&hellip;]<\/p>\n","protected":false},"author":22,"featured_media":0,"parent":268,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-455","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/sites.austincc.edu\/sonography-resources\/wp-json\/wp\/v2\/pages\/455","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sites.austincc.edu\/sonography-resources\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/sites.austincc.edu\/sonography-resources\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/sites.austincc.edu\/sonography-resources\/wp-json\/wp\/v2\/users\/22"}],"replies":[{"embeddable":true,"href":"https:\/\/sites.austincc.edu\/sonography-resources\/wp-json\/wp\/v2\/comments?post=455"}],"version-history":[{"count":0,"href":"https:\/\/sites.austincc.edu\/sonography-resources\/wp-json\/wp\/v2\/pages\/455\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/sites.austincc.edu\/sonography-resources\/wp-json\/wp\/v2\/pages\/268"}],"wp:attachment":[{"href":"https:\/\/sites.austincc.edu\/sonography-resources\/wp-json\/wp\/v2\/media?parent=455"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}