1/4 One of our biggest issues in #echofirst is foreshortening. Overcoming by trying to put probe downw ards, respiratory efforts by patient also helpful, than better extension of LV but maybe near fileld artifact-- solution change focus & TGC -- or use #UAE when suspect thrombus
2/4 using #UAE in #echofirst is quick & easily done by changing MI (preset LVO or contrast MI 0,21 or less) giving small amount 1 ml & wait until it gets in the LV, when having artifacts as attenuation or shadowing or swirling wait little more
3/4 and ask patient to make some profound respiratory movements than image will be clearer, in case of very low SV or EF use second bolus of #UEA. ALWAYS REMEMBER HAVING ANTIALLERGIC MED. NEAR BY, as this is a possible problem.
4/4 Not to use if sPAP > 90 mmHg, hemodynamic critical unstable under dobutamine & R-L shunt
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