Figure 21.2 Determination of volaemic status using echo—potential pitfalls. (a) Subcostal view, TTE showing a dilated, non-collapsing IVC in a patient with tamponade. This patient may respond to volume loading acutely. (b) PSAX view in a patient with right ventricular infarction (note the dilated right heart, compared with the left heart). This patient had a dilated, non-collapsing IVC but had been volume-loaded as the LV was small and non-dilated. However, they did not respond to volume loading. (c) A4C view in a patient with cardiogenic shock. The LV is dilated, with regional wall thinning (basal septum, arrow) and apical thrombus (asterisk). Despite the dilated LV, the patient was profoundly hypovolaemic and responded well to volume resuscitation. (d) Short-axis view (TOE) of the LV in a patient resuscitated from cardiac arrest. The patient was hypovolaemic, but the LV remained small, as it was encased in tumour (T). IVC, inferior vena cava; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle; T, tumour.