In a recent issue of the Journal of Ultrasound through AIUM, Weekes et al. (and Kendall et al in AM J EM) talk about a hot topic that emergency and critical care physicians hold dear to them – the EPSS , or E-point septal separation – the minimal distance between the anterior mitral valve leaflet and the interventricular septum in the parasternal long view of the cardiac echo during diastole using M-Mode.

Now, EPSS is not a part of point of care echo right now (i know, phew!), but there are conversations about whether it should be.

The reason is because it is thought that EPSS is a good tool for LV function delineation, possibly better than simple visualization, despite knowing the risks of underestimating ejection fraction due to endocardial output limitations (see below).

Yeah, I know, that’s a lot of words and it took me a year to really understand what the above meant. So, let’s talk about it, especially as it is included in the updated RUSH protocol by Seif, Perera, et al.

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