TTE FOCUS Views 3.0.0

This resource aims to enhance the training and assessment capabilities of practitioners involved in anesthesia, critical care, and emergency medicine through a focused approach to cardiac evaluation. Focused Cardiac Ultrasound (FOCUS) is a rapid, qualitative technique used for quick bedside assessment of cardiac function, requiring familiarity with the 3D anatomical structures seen in 2D transthoracic echocardiography (TTE).

To facilitate this process, an interactive application has been developed to support the instruction and understanding of normal and pathological cardiac states using FOCUS. The tool emphasizes a subset of five key TTE views, selected from the standard twenty:

• Parasternal long axis
• Parasternal short axis
• Apical four chamber
• Subcostal four chamber
• Subcostal inferior vena cava

Users have access to TTE recordings for each view, accompanied by a corresponding 3D model that displays the probe position, ultrasound plane, cardiac structures, and rib cage. Views can be selected via a menu or navigated sequentially using arrow controls. The 3D representations are rotatable in both horizontal and vertical planes, allowing examination from multiple perspectives.

The model components—including the probe, ultrasound plane, heart, and rib cage—can be manipulated independently; the rib cage can be temporarily removed, and sections of the heart above the echocardiographic plane can be excluded to facilitate better visualization. Additionally, the orientation of the heart model can be adjusted to ensure accurate correlation with the TTE images.

This module specifically reviews the application of FOCUS in detecting pericardial abnormalities such as localized effusions and tamponade physiology and their subsequent impact on cardiac function.

*Note: This application has yet to incorporate assessments of the right ventricle, left ventricle, and hypovolemic conditions as detailed on the associated website: http://pie.med.utoronto.ca/TTE/TTE_content/focus.html