Learn how to assess LV Ejection Fraction Qualitatively and Quantitatively

Qualitative Assessment
EPSS
Fractional Shortening
Fractional Area Change
Simpson Method

New #POCUS Blog Post!
https://www.pocus101.com/EF 

#medtweetorial (1/n)

Personally, I use the Qualitative assessment of LVEF the most using the PSLA and PSSA views.

The two main things you can look for:
1)LV muscle contraction (how close are walls coming in)
2)How close is anterior MV getting to the septum

https://www.pocus101.com/EF 

Here is an example of Normal EF.
1. Notice how the septum and posterior wall of LV are contracting nicely and coming together.
2. Notice the anterior mitral valve leaflet moves well and comes close to the septum during early diastole.

https://www.pocus101.com/EF 

Here is an example of severely reduced EF with the LV septum and posterior wall barely moving.

Also, notice how far the anterior mitral valve leaflet is from the septum during diastole.

https://www.pocus101.com/EF 

Easiest Quantitative way to look at EF is E-point septal separation. This is a quantitative way of seeing how close the anterior MV gets to the septum.

https://www.pocus101.com/EF 

Here is a short video we made on how to get EPSS with M-Mode

Fractional shortening is another easy way to assess EF Quantitatively.

https://www.pocus101.com/EF 

Remember, since you are measuring a distance the values don't equal EF. Look at the conversion table below:

Here is a video we made showing you how to measure Fractional Shortening.

Another quantitative technique you can use is Fractional Area Change (FAC) which looks at the actual LV end-diastolic and systolic areas.

https://www.pocus101.com/EF 

Lastly, the most time consuming and operator dependent method is the Simpson (Biplane) method. Here is a great video by @The_echo_lady on how to do this!

There are many pitfalls to doing the Simpson Method. One of them is tracing the endocardial borders correctly. Watch this view if you want to learn how to avoid these errors that can significantly hinder your values.