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Cardiac ultrasound, or echocardiography, can be one of the most powerful noninvasive diagnostic tools available to the clinician in emergency situations involving critically ill or potentially critically ill patients. It is important to consider the positioning of the examiner and scanner relative to the patient. When a cardiologist or sonographer performs an echo, it is typically done from the left side of the patient, with the probe held in the examiner's left hand. It is also important to understand the imaging conventions used in cardiology compared to other ultrasound. Probe selection and equipment are important in obtaining quality images. Patient body habitus and comorbid conditions may limit imaging. The most common echo pitfall is that physiological pericardial fluid and/or epicardial fat may be misinterpreted as a pericardial effusion. Artifacts are common in ultrasound and may be seen in cardiac echo.
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