Table 1 Description of the mnemonic A-F algorithm
Letter | Description | Question | Possible diagnosis (if the answer is YES) |
|---|---|---|---|
A | Aorta | Is aortic root dilated? | Aortic root dilatation/aneurysm |
Is proximal aortic diameter > 4 cm? | Ascending aortic dilatation/aneurysm | ||
Is dissection flap seen? | Aortic dissection | ||
B | Both ventricles | Is there RV overload present? | Pulmonary embolism |
RV/LV > 1 | Pulmonary hypertension | ||
D-sign | RV infarction | ||
C | Contractility | Is LV contractility impaired? | |
Depressed global systolic function | LV heart failure | ||
Regional wall motion abnormalities | Acute myocardial infarction | ||
Is RV contractility impaired? | |||
Depressed global systolic function | RV heart failure; RV infarction; pulmonary embolism | ||
D | Dimensions | Are there any abnormal dimensions? | |
Ascending aorta > 4 cm | Aortic dilatation/aneurysm (look for aortic dissection) | ||
LV end-diastolic dimension > 6 cm | LV dilatation (assess global LV function) | ||
RV end-diastolic dimension > 4.2 cm | RV dilatation (look for the RV overload) | ||
LA anteroposterior dimension > 4.5 cm | LA dilatation | ||
RA major > 5.4 cm and/or minor dimension > 4.4 cm | RA dilatation (look for RV overload) | ||
E | Effusion | Is pericardial effusion present? | Pericardial effusion |
Are there any signs of cardiac tamponade? | Cardiac tamponade | ||
RA end-systolic or diastolic collapse | |||
RV diastolic collapse | |||
Vena cava plethora | |||
Is there pleural effusion? | Pleural effusion | ||
F | Further abnormalities | Any other abnormal findings not listed above? |