Focused Cardiac Ultrasound for Rapid Hemodynamic Assessment: A Primer for Vascular and Interventional Radiologists

Interventional Radiology has evolved to encompass periprocedural and inpatient care of critically ill patients. Acute hypotension and shock can occur in IR patients due to various causes including hemorrhage, sepsis, myocardial infarction, and pulmonary embolism; therefore, the ability to accurately evaluate acutely deteriorating patients must become a part of the IR skillset. Goal-directed sonographic examination of the heart and inferior vena cava provides rapid bedside assessment of anatomic and functional parameters that can be used to determine the etiology underlying a patient's shock. Targets of evaluation include ventricular systolic function/size/thickness, presence of pericardial effusion and tamponade physiology, intravascular volume status, and existence of other structural pathology such as valvular disease and intracardiac masses. Presented is a primer on performing a systematic focused cardiac ultrasound examination for patients experiencing acute hypotension.