ABSTRACT
The first step when evaluating ventricular function is to determine if the cardiac cavity dimensions are within the normal range. Guidelines for the quantification of LV and RV size and function have been published.5-7Pocket cards (Figure 5.1) and web-based applications (asecho.org) can be helpful reminders during the evaluation of these measurements. Ideally, measurements should be indexed to body surface area (BSA) (Figure 5.2). The key TEE measurements are summarized in Figure 5.3. Important measurements are LV dimension, which can be obtained in mid-esophageal (ME) two-and four-chamber views or transgastric (TG) two-chamber view at 90° (Figure 5.3A), LV wall thickness (Figure 5.3B), RV dimensions (Figure 5.3C), RV outflow tract dimensions (Figure 5.3D), and atrial dimensions (Figure 5.3E). Measurement of LV dimension and thickness allows calculation of LV mass, which more precisely determines the presence of LV hypertrophy (Figure 5.4). Details for other measurements can be found in recent guidelines by Lang et al.5 and specialized textbooks.8 Volume measurements are much more precise than 2D measurements, but these require either specialized equipment such as 3D echocardiography or mathematical estimations that are beyond the basic TEE evaluation.
