Pediatric Echocardiogram Protocol

Subcostal

  1. Abdominal Situs (Left & Right Sweep)

Subcostal Long Axis

  1. 2D/Color Sweep color compare
  2. 2D/Color Atrial Septum Sweep (Optimize image to focus on septum with narrowing sector width and increase depth/zoom)

Subcostal Short Axis

  1. 2D/Color Sweep color compare (Beginning at IVC/SVC to LV apex)
  2. 2D FXN RV & LV (Optimize image/Zoom, Can be used for Area Measurement)
  3. Descending Aorta color compare/ PW
  4. 2D/Color compare IVC sweep to level of kidney

Apical

  1. 2D/Color Sweep Ventricular Septum color compare (Posterior to Anterior sweep) Clip 1 Clip 2
  2. 2D/Color compare Pulmonary Valve (RVOT)/CW
  3. 2D/Color compare Tricuspid Valve/ CW
  4. 2D/Color compare Mitral Valve/ CW
  5. 2D Left Ventricle (Volume length measurement)
  6. 2D/Color compare Aortic Valve (Apical 5 Chamber)/CW
  7. Tissue Doppler, LA volumes and PW MV E/A wave Doppler must be obtained for patients with Hypertension, Cardiomyopathy or Sickle Cell Anemia

Parasternal Long Axis

  1. 2D/Color sweep color compare (Color box covering membranous septum sweep posteriorly to Tricuspid valve then anteriorly to Pulmonary valve) Clip 1 Clip 2
  2. 2D/Color compare Pulmonary valve/CW
  3. 2D/Color compare MV/Aorta
  4. 2D Aorta Measurements (Aortic annulus, Root, Sino tubular junction and Ascending aorta) *Ascending aorta must be measured at level of Right Pulmonary artery. Can be measured in Ductal view

Parasternal Short Axis

  1. 2D/Color Sweep Ventricular Septum color compare (Starting at the level of the Aortic valve to the LV apex)
  2. 2D/Color compare Pulmonary Arteries, Pulmonary Valve/CW
  3. 2D FXN Left Ventricle (Level of the Papillary muscles for area measurements)
  4. 2D FXN Left ventricle (Level of the LV apex to look for Hypertrabeculations)
  5. M-Mode (FS%)
  6. 2D/Color compare Aortic Valve (Valve leaflet interrogation)
  7. 2D/Color compare Coronary Arteries (Right and Left Coronary arteries)
  8. 2D/Color compare Coronary Artery sweep (Color box placed between the Right and Left aortic leaflet. Superior sweep from Aortic valve to Ascending Aorta)

Suprasternal

  1. 2D/Color compare Ductal sweep (Sweeping from Ascending Aorta to the LPA/Descending Aorta connection. Ascending Aorta measurement can be obtained here. Measure above the level of Right Pulmonary artery)
  2. 2D/Color compare Left Pulmonary Veins
  3. 2D/Color compare Right Pulmonary Veins (Right Upper Pulmonary view can also be obtained in the Subcostal short axis view or High Right Parasternal view)
  4. 2D/Color compare Aortic Arch branching
  5. 2D/Color compare Aortic arch /CW Proximal Descending Aorta

Quantification

  1. Left ventricular size & Function Quantification (M-Mode/Bullet method)
  2. Mitral & Tricuspid valve (Apical 4 view)
  3. Pulmonary Valve (PLAX)
  4. Aortic Annulus, Root, Sino Tubular Junction and Ascending Aorta (PLAX) * Ascending Aorta can be measured in Ductal view above the Right Pulmonary Artery

2D/Color compare Aortic arch /CW Proximal Descending Aorta
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