PLAX Linear Measurements
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Several parasternal linear measurements are made in end diastole to assess wall thickness and dimensions. One should avoid the papillary muscle and the RV portion of the septum if visiible.

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The internal dimension in systole can be used to calculate fractional shortening, which here is 31%. 

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Both systolic and diastolic measurements can also be made using M Mode with care to align the cursor properly so it is perpendicular to the LV walls. Convention here is to measure leading edge to leading edge.

Ejection Fraction

4 Chamber Diastole

To calculate EF you will need to trace the LV in diastole and systole in both the 4 chamber and 2 chamber views making sure not to include papillary muscles or trabeculations.

From there the biplane method of disks is used to create volumes and determine the EF.

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4 Chamber Systole

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2 Chamber DIastole

EF is calculated as 

(Diastolic Volume-Systolic Volume)/Diastolic Volume x 100%

Here it is 65%

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2 Chamber Systole

2c.sys.jpg
LV Mass

Parasternal Short Axis - Mid LV

For LV mass you need to also trace the parasternal short axis 

endocardial and epicardial borders. Try to avoid the papillary muscles and trabeculations.

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LA Volume 

4 Chamber Systole

For the LA volume you trace the LA in both the 4 and 2 chambers in ventricular systole. Be careful not to include the pulmonary veins which is a common error. 

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2 Chamber Systole

LA volume is calculated by taking both the area in the 4 chamber and 2 chamber view, multiplying them and then by 0.85 and dividing by the maximal length from each view (back wall to MV tips)

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