123sonography

A patient presented with a severely calcified left internal carotid artery (ICA). Initial qualitative assessment via B-mode, color B-flow, and color Doppler ultrasound suggested critical luminal narrowing due to severe calcification artifact and acoustic shadowing.

However, precise hemodynamic quantification using spectral Doppler velocity criteria demonstrated an actual degree of stenosis of 60–65% (moderate severity).

❓ QUIZ TIME ??
Based on current guidelines, what is the primary management recommendation for a patient with an asymptomatic 60–65% carotid artery stenosis?

A) Immediate Carotid Endarterectomy (CEA)
B) Best Medical Therapy (BMT) with active surveillance
C) Urgent Carotid Artery Stenting (CAS)

Start now with our Carotid US MasterClass or bundle discounts 👉 https://zurl.co/QQF9i

Carotid ultrasound exam (left side only) of a 67-year-old man undergoing his first screening. (Recommended starting age: 65) He has a history of heavy smoking, stopped at 60.

Findings 🧐🔍

➡️ Right side (not shown): Some atherosclerotic plaque, but no significant stenosis or occlusion.
➡️ Left side: Relevant pathology detected – Can you tell which?
Looking at the images, which is the correct diagnosis and treatment strategy?

Choose the correct diagnosis and corresponding treatment strategy:

A) complete ECA occlusion - endarterectomy (surgery)
B) Complete ICA occlusion - only pharmacological treatment
C) High grade ICA Stenosis - Stent graft implantation
D) Complete ICA occlusion - Stent or Endarterectomy

Comment what you think!💡 Check out our bundles and our currently discounted Carotid US MasterClass 👉🏻 https://zurl.co/FiCL6

Can you connect the findings? ✍️👀

Reviewing the patient's transverse carotid ultrasound scan, which was done after the initial echocardiogram, which diagnosis best connects the findings? 🧐

A) Severe atherosclerosis of both the aortic root and the carotid
B) B) Large-vessel vasculitis (Takayasu arteritis) with circumferential wall thickening of the carotid artery and aortic arch
C) Aortic dissection extending into the carotid artery

Comment your answer and get the Carotid US MasterClass with a special discount or in a bundle with other courses now 👉 https://zurl.co/lZJ2b

We compare a patient with a normal ECG and a patient with LBBB (Left bundle branch block), both on ECG and on echo!

What is FALSE regarding LBBB? 🧐

A) Very typical for a LBBB is the so-called septal flash.
B) Patients with LBBB have an underlying cardiomyopathy that leads to LBBB
C) Ejection fraction is typically reduced in patients with LBBB

Comment what you think! If you want to learn more, check out our Echo MasterClass. We also have free lectures available 👉 https://zurl.co/9t15g

Here are some visual echo features helping you distinguish moderate from severe aortic stenosis even before performing gradient measurements. But is moderate AS actually a benign condition?

🔍 QUIZ: A patient with moderate AS asks, "If it's only moderate, why are you following me so closely?"

What is the best explanation? 🧐

A) Moderate AS frequently progresses rapidly and carries important cardiovascular risk despite not yet meeting criteria for valve replacement.
B) Moderate AS has a high risk of sudden death, similar to symptomatic severe AS.
C) Moderate AS is dangerous only if LVEF falls below 50%.

Leave your comment below! 👀 For more, check out our Guidelines in Focus course 👉 https://zurl.co/mazgK

Case Story: A 65-year-old male with dyspnea was sent to surgery 🔍‼️

Look at his images. What surgery was performed?

Post-OP: Have a look at the aortic valve and the opening motion in the PLAX. From the apical windows, do you notice any WMA? Hypertrophy? What about left ventricular function? What would be your diagnosis so far? Some device has been placed - an ICD? PM?

Tip: Look at the IVS in all loops! Now answer the following quiz question: Which procedure was performed in this patient?

A) Cardiac ablation and placement of a ICD
B) Myectomy to treat LVOT-obstruction
C) Mitral valve repair with an annuloplasty ring.

Leave your answer in a comment below! Visit our blog to get the answer 👉 https://zurl.co/HzsXB

Today is World Lunger Cancer Day! 🫁 🌍

Did you ever look at the lungs with ultrasound when performing an echo? The information you gain here can be extremely helpful.

The following 60-second case of a patient with dyspnea demonstrates this very nicely.

Do you know what the problem is?💡

Get our Lung Ultrasound MasterClass today for -40% off 👉 https://zurl.co/nHmzn

The final Part 4 of the Ultimate ECHO GAME in Alexandria 🇪🇬💡CardioAlex 🫀

Can you answer what you see on this image?

A) RV apical aneurysm
B) RV non-compaction
C) RV Endomyocardial Fibrosis
D) Arrythmogenic RV dysplasia

Let's put your echo skills to the test with this echo case from our 123ambassador Manju Sukumar 🔍

A 37-year-old female presented with shortness of breath and fatigue, requesting a cardiac evaluation to assess her fitness before beginning gym activity. She has no prior history of hypertension, diabetes, or cardiac disease, and no family history of cardiomyopathy.

Check her echo images! The echo demonstrated prominent trabeculations in the apical and mid-ventricular segments, along with deep intertrabecular recesses communicating with the left ventricular cavity.

What is the most likely diagnosis? 🧐

A) Dilated Cardiomyopathy
B) Hypertrophic Cardiomyopathy
C) Left Ventricular Noncompaction Cardiomyopathy
D) Restrictive Cardiomyopathy

Huge thanks to Manju Sukumar for sharing this fantastic case with our community! 🙌 Check her out on Instagram 👀 and -CARDIO133 on YouTube!