EchoBridgeMD Pearl #5: EPSS -- A Rapid Bedside Clue to Reduced Left Ventricular Systolic Function

When evaluating a patient with suspected left ventricular (LV) systolic dysfunction, E-point septal separation (EPSS) provides a rapid, quantitative estimate of left ventricular ejection fraction.

In the parasternal long-axis view using M-mode, EPSS is measured as the shortest distance between the anterior mitral valve leaflet at its maximal early diastolic excursion (E-point) and the interventricular septum.

As LV systolic function declines, the mitral valve opens less widely while the LV progressively dilates, increasing the EPSS distance.

An EPSS > 7–8 mm is generally considered abnormal and should raise suspicion for reduced LV ejection fraction.

Reference:

📖 Alerhand S, Adrian RJ, Taylor LA. Cardiac Point-of-Care Ultrasound: An Emergency Medicine Review. Emerg Med Clin North Am. 2024.

https://pubmed.ncbi.nlm.nih.gov/39326985/

🔗 Free email subscription — receive future EchoBridgeMD educational content by email: https://www.echobridgemd.com/blog