Focused Cardiac Ultrasonography for Right Ventricular Size and Systolic Function

This multimedia instructional article explains how focused cardiac ultrasonography (FCU) can be used at the bedside to visually and semi-quantitatively evaluate right ventricular (RV) size and systolic function. Indicated for patients with chest pain, shock, dyspnea, or cardiac arrest, FCU helps identify RV dysfunction—often associated with pulmonary embolism, myocardial infarction, and left-sided heart failure. The procedure relies on visual parameters including RV cavity size compared to the left ventricle (LV), septal shape, longitudinal shortening, and change in RV cavity area between systole and diastole. Views include the standard apical four-chamber view, RV-focused apical view, parasternal short-axis view, and subcostal four-chamber view. A curved septum and relatively small RV cavity suggest normal loading; flattening of the septum and RV enlargement suggest pressure overload. Longitudinal shortening ≥2 cm or cavity area decrease ≥1/3 correlates with preserved systolic function. Though not a substitute for comprehensive echocardiography, FCU enables early screening and clinical decision-making. Limitations include operator experience and variable accuracy in identifying abnormalities.

This multimedia instructional article explains how focused cardiac ultrasonography (FCU) can be used at the bedside to visually and semi-quantitatively evaluate right ventricular (RV) size and systolic function. Indicated for patients with chest pain, shock, dyspnea, or cardiac arrest, FCU helps identify RV dysfunction—often associated with pulmonary embolism, myocardial infarction, and left-sided heart failure. The procedure relies on visual parameters including RV cavity size compared to the left ventricle (LV), septal shape, longitudinal shortening, and change in RV cavity area between systole and diastole. Views include the standard apical four-chamber view, RV-focused apical view, parasternal short-axis view, and subcostal four-chamber view. A curved septum and relatively small RV cavity suggest normal loading; flattening of the septum and RV enlargement suggest pressure overload. Longitudinal shortening ≥2 cm or cavity area decrease ≥1/3 correlates with preserved systolic function. Though not a substitute for comprehensive echocardiography, FCU enables early screening and clinical decision-making. Limitations include operator experience and variable accuracy in identifying abnormalities.