Loops to store
The purpose of storing loops is to back up your written comment and to compare with scans in the future. As a rule of thumb, this should be a 2D and colour Doppler of every view, colour Doppler of everything you then use PW or CW on, and every PW or CW measurement. Do use the simultaneous view.
These do not have to be stored in the order below.
Use the gain so that the blood is black and the tissue grey, and the sliders to make this uniform down the image.
Adjust depth so the heart is about ¾ of the window.
1 transverse SC view, 2D only. Must have IVC and Ao in.
2 longditudinal SC with Ao, 2D + colour, showing pulsatile flow in Ao.
3 longditudinal SC with IVC, 2D + colour, showing flow in IVC and liver veins.
4 SC 4 chamber view 2D + colour – Atria (with PFO if there)
5 SC 4 chamber view 2D + colour – Ventricles
6 SC 4 chamber view 2D + colour – Outflow tracts
7 Apical 4 chamber view 2D + colour – Show both inlet valves at the same time, focusing colour window on MV
7a If regurgitation, then Doppler using CW and store this.
8 Apical 4 chamber view 2D + colour – Show both inlet valves at the same time, focusing colour window on TV
8a If regurgitation, then Doppler using CW and store this.
9 Apical 4 chamber view 2D + colour, focusing colour window on septum, looking for VSD. Window needs to extend from apex to outlet valves.
9a if VSD – Doppler with CW
10 Apical 5 chamber view 2D and Doppler, colour window on AV
11 PW just above AV for flow
12 Apical 5 chamber view 2D and Doppler, colour window on PV
13 PW just above PV for flow
14 LA – 2D only, showing full LV to apex, and both MV and AV
15a LA – 2D + colour, recording colour at MV
15b LA – 2D + colour, recording colour at AV
15C LA – 2D + colour, recording colour along ventricular septum (change the size and shape of the colour window)
16 SA – 2D + colour – LA, PVs (drop the scale on the colour so that you can see flow in the PVs
17 SA – 2D – AV, showing coronaries and 3 leaflet valve (if Kawasaki suspected, measure coronaries and look for flow in them too)
18 SA – 2D + colour – PA, branch PA, PDA
18a If ductal flow seen, duct cut (2D and colour)
19 Arch view – 2D and colour.
19a Doppler of distal arch