A 75 year old female patient presented to the ER with anasarca edema. She had a history of permanent atrial fibrillation and hypertension.

On clinical examination increased jugular venous pressure and a holosystolic murmur was noted. Bedside examination with KOSMOS revealed significantly dilated right heart chambers and massive tricuspid regurgitation due to lack of coaptation of the tricuspid valve leaflets.

Parasternal short axis Dilated Right Ventricle
PLAX view showing dilated right ventricle.

Parasternal short axis Lack of coaptation of Tricuspid Valve at Mitral Valve level
PSAX at the level of papillary muscles demonstrating severely dilated right ventricle. D-shape interventricular septum due to pressure and volume overload from right heart chambers is seen. There is also mild pericardial effusion.

Parasternal short axis Tricuspid Valve with color Doppler at Mitral Valve level
PSAX at the level of the mitral valve shows dilated tricuspid valve annulus and apical displacement of the tricuspid valve leaflets due to remodeling of the right ventricle. These changes result in lack of coaptation of the tricuspid valve leaflets and massive tricuspid regurgitation (4).

5 Chamber view of severely dilated right heart chambers
Apical 4 chamber view demonstrating severely dilated right heart chambers and massive tricuspid regurgitation due to lack of coaptation of the tricuspid valve leaflets.

Apical 4 chamber view Tricuspid Valve Regurgitation
Dilated inferior vena cava with minimal respiratory variation is noted.

Apical 4 chamber view Tricuspid Valve Regurgitation
Dilated inferior vena cava with minimal respiratory variation is noted.

  • The Evolution of Ultrasound in Emergency Medicine Practice

    The Evolution of Ultrasound in Emergency Medicine Practice

    The Evolution of Ultrasound in Emergency Medicine Practice Over the past decade, ultrasound has revolutionized emergency medicine, providing real-time bedside diagnostics to guide clinical decisions in time-sensitive scenarios. With this direct access, ultrasound provides the…

    Read More

  • One System for Your Nursing Ultrasound Needs

    One System for Your Nursing Ultrasound Needs

    The Benefits of a Dual-Purpose Ultrasound System for Vascular Access and Bladder Scanning Efficiency and accuracy are central to modern nursing practice, and fundamental bedside procedures such as vascular access and bladder assessment can have…

    Read More

  • What’s Under the Hood of Your Ultrasound Device?

    What’s Under the Hood of Your Ultrasound Device?

    What’s Under the Hood of Your Ultrasound Device? Point-of-care ultrasound (POCUS) has revolutionized bedside diagnostics, allowing clinicians to visualize structures and perform interventions with precision. Portable ultrasound equipment combines advanced technologies, including harmonic imaging and…

    Read More

  • Lung Ultrasound in Acute and Chronic Heart Failure

    Lung Ultrasound in Acute and Chronic Heart Failure

    Lung Ultrasound in Heart Failure Management: Enhancing Diagnosis, Monitoring, and Patient Outcomes in Critical Care Heart failure (HF) represents a significant clinical problem affecting an estimated 60 million people worldwide who require care. It is…

    Read More