CARDIAC PROCEDURES CHAP 4A&B
3C RVIT is a very useful view that frequently yields the peak tricuspid regurgitation velocity
true
Abnormal cut - off for the peak tricuspid regurgitation velocity is > 2.8 m / s .
true
If LVEF is reduced , the mitral inflow pattern can usually predict an elevated left atrial pressure
true
If diastolic function is normal , the E / A ratio remains normal with Valsalva maneuver . If a pseudonormal mitral inflor pattern is present , the E / A ratio becomes abnormal with Valsalva maneuver 62
true
In the absence of mitral valve disease , left atrial enlargement usually reflects increased left atrial pressure , of diastolic dysfunction , and is an indicator of left atrial pressure severity and chronicity
true
Inferior vena cava diameter and collapsibility index can be assessed via 2D echo or M - mode .
true
Left ventricular diastolic function evaluation is vital in patients with potential diastolic dysfunction and the results should be included in the report , particularly those with dyspnea or heart failure
true
M - mode dimensions should be acquired with the leading - edge - to - leading edge technique .
true
Normal left atrial volume index ( LAVI ) is < 34 mL / m² .
true
Normally , TDI of the mitral annulus is a mirror image of the mitral inflow PWD waveform
true
Pulmonary venous flow is dependent on the pressure difference between the pulmonary veins and left atrium as well
true
TDI of the mitral annulus measures the Doppler frequency shift of the moving myocardium .
true
Valsalva maneuver can unmask abnormal mitral inflow in the presence of a pseudonormal mitral inflow pattern .
true
Which statement supports PWD of pulmonary venous flow ?
utilize small PWD gate , ~ 1-2 cm into the pulmonary vein
Choose the correct equeations
(LVIDV-LVISV)/LVIDV)x100
How is the 2C acquired ?
.rotate 60-90 ° counter clockwise from the 4C
What is the normal right ventricular wall thickness ?
1-5 mm
What is the normal right posterior pulmonic vlave a wave dip via m-mode
2.7mm
Choose the normal range for the left ventricular internal dimension diastole Female
38-52 mm
Choose the normal range for the left ventricular diastolic wall thickness
6-10 mm(male)
Which mitral valve M - mode finding is an indication of increased left ventricular end - diastolic pressure ( LVEDP ) ?
8 bump between A & C
Choose the statement that best describes the E / e ' ratio .
<8 usually predicts normal left ventricular filling pressure
LVOT peak velocity . indicates LVOT obstruction ( LVOTO ) .
>2m/s
which statement is true refarding the anterior mitral valve leaflet (AMVL) and posterior mitral valve leaflet (PMVL)
AMVL is more mobile than the PMVL
The most accurate mitral inflow velocity measurements should be taken in the View .
AP4
Which statement supports the end diastolic right ventricular outflow tract proximal diameter?
Accuire from the anterior right ventricular wall to interventricular septal aortic junction
Choose the statement that best describes strain imaging
Adds infromation about global and regional function
Choose the statement that best describes the initial LAX LV
All of the above
Which of the following might be related to left atrial enlargment
All of the above
One way for a sonographer to know if they have a good angle for color Doppler flow is to see if the color hues are a red .
Bright
What critical information does the mitral inflow PWD provide as it pertains to diastolic function ?
E - wave peak velocity
Choose the statement that best supports right ventricular diastolic function
E exclude patients with Afib or moderate to severe tricuspid regurgitation
Left ventricular ejection fraction is the percentage of the left ventricular size reduction from diastole to systole
FALSE
microbubbles The goal of the ultrasound enhancement agent ( UEA ) is to decrease the strength of the signals returning from microbubbles
FALSE
According to the ASE M-mode dimensions are recommended over 2D dimesnsions to avoid capturing oblique angles of the ventricle
False
Doppler sweep speed should be decreased from 50 to 25 mm / s for the diastolic function parameters
False
In order to locate the LAX RVIT angle the transducer more lateral and superior from the LAX LV
False
Interatrial septum bows slighltly toward the left atrium because the rght atrial pressure is slightly greater.
False
Left atrial size is not gender dependent
False
Mitral valve planimetry has a low correlation with the anatomical MVA. True or false?
False
Normal embryonic variants known as the eustachian valve and chiaria network may be visible in the right ventricle
False
Normal end diastolic right ventricular wall thickness is 6-10 mm
False
Right ventricular dilation is reported if the right ventricle is larger than the left ventricle or if the basal diameter is <41mm and the mid diameter is < 35mm
False
The only way to determine timing of the cardia cycle is with the EKG
False
Typically the transducer indicator is toward the patients right shoulder during the SAX
False
a food place to start searching for the apical window is along the left sternal border at the 4th intercostal space
False
according to the left ventricular hypertrophy LVH severity scale, moderate LVH is defined as 11-13 mm (male)
False
accuire the inferior vena cava diameter at rest, during normal respiration,-1-2 cm distal to the left atrium
False
spectral doppler of the mitral valve is always indicated frin tge LAX LV due to the excelllent doppler angle
False
According to the ASE , left ventricular diastolic dysfunction is usually the result of
Impaired relaxation & increased chamber stiffness
Choose the patient position that typically provides the best TTE left parasternal viewas
Left Lateral Decubitus
Choose the statement that best supports the left atrium
Left atrial volume index should be assessed along with the left atrial dimension
when is end diastole captured?
Left ventricle at larges dimension
Choose the tricuspid valve leaflet that is not visualized in the LAX RVIT
Medial/ septal
dialeated coronary sinus can easily be confused with the descending aorta however, the coronary sinus is located_________ and the aorta is a seperate structure posterior to the left atrium
Myocardium
choos the best statement that best supports the main pulmonary artery
Normally smaller than the aorta
Mitral inflow velocities are obtained using Doppler
Pulse Wave
Choose a known diastolic function parameter .
TDI of mitral annulus
Choose the right ventricular diastolic function parameter .
Tricuspid inflow E/A and deceleration time
According to the ASE , an aortic valve peak velocity s 2,5 m / s with mild thickening and / or calcification indica stenosis
True
According to the IAC, a limited TTE should be performed when the patient recently had a complete TTE and there is no clinical reason to suspect changes other than a specific area of interest
True
Biplane method of disk summation provides a reliable estimate of left ventricular volume
True
End diastolic and end systolic left ventricular dimensions can be accuired from the LAX LV
True
For LAVI acquisition , planimeter the left atrial blood - tissue interface 1-2 frames prior to the mitral valve opening .
True
If the tricuspid regurgitation envelope is not filling in adequately, reposition the patient, try a different winow, or administer agitated IV saline or contrast to improve signal
True
Infundibulum is the smooth walled, funnel shaped portion of the right ventricular inflow tract at the entrance of the pulmonary trunk
True
LAX AO is typically located more proximal to the strernum and up an intercostal space from the LSX LV
True
Left ventricular dimensions should be aquired perpendicular to the structures in a straight line just beyond the tips of the mitral valve leaflets, with the calipers placed at the myocardial wall cavity interface and wall pericardium interface
True
Right ventricular systole pressure has a strong correlation with the noninvasively acquired left atrial pressure .
True
Right ventrile is more anterior, more trabeculated, more triangular, and larger than the left ventricle
True
SUB DAO and SUPRA LAX help rule out dilatation of the aorta .
True
Tapse <17 mm indicates decreased right ventricular function
True
aortic valve non coronary cusp is adjacent to the interatrial septum in SAX BASE
True
if indicated aquire the end diastolic pulmonic regurgitation velocity and calculate the EDPR gradient with the modified Bernoulli equation
True
sonographer can use the central venous pressure or the inferior vena cava diameter and inspiratory collapse to estimate the mean atrial right pressure
True
which statement supports the tricuspid annular plane systolic excursion (TAPSE)
a simple but good estimate of right ventricular global funtion
Choose the statement that supports the LAX AO dimensions
acquire the aortic valve anulus diameter at peak systole I-I
Choose the statement that best describes how to acquire the LVEF
all of the above
Choose the statement that supports the right atrial single plane area - length volume .
all of the above
Choose the statment that represents the left atrial appendage
all of the above
Whe is the M-mode sweep aquired?
all of the above
When should agitated saline be available ?
all of the above
Which statement supports the mitral inflow E - wave deceleration time ?
all of the above
choose the statement that best describes the left ventricular outflow tract LVOT dimension
all of the above
which statement supports the right ventricular outflow tract RVOT?
all of the above
Choose the statement that best supports the UEA .
attenuation & swirling are common artifacts
Venous return , stroke volume , and cardiac output during the strain phase of Valsalva and during the release phase
decrease increase
Choose the statement that best supports the SAX LV
demonstrates all of the left ventricular walls simultaneously
Choose the statement that best represents the LAVi via the biplane method of disks .
exclude the left atrial appendage pulmonary vein inlets & just beneath the mitral valve
Aortic sclerosis always leads to aortic stenosis .
false
Descending aorta can be seen from the 2C as a separate structure , anterior to the left atrium .
false
During LAVi acquisition , the left atrial length is acquired from the 4C and 2C , and the two measurements should be within 1 mm of each other .
false
Pulmonary venous S - wave increases and D - wave decreases when the left atrial pressure increases and / or compliance decreases
false
Tissue harmonic imaging is not recommended during the agitated saline study .
false
When the transducer is angled more lateral from the 4C , the aortic valve is visualized .
false
Which statement best describes a LVOTO ?
late peaking systolic jet that sounds like a sponge being wrung out
If LVEF = 60 % , TDI e ' ( lateral wall ) = 15 cm / s , E / e ' ( average lateral & septal wall ) = 10 , LAVI = 28 mL / m² , and peak TRV = 2.4 m / s ; how would you report diastolic function ?
normal diastolic function
Choose the statement that best supports the mitral inflow E - wave peak velocity .
represents the early diastolic left atrial - left ventricular PG
Pulmonary vein velocities are typically taken from the
right upper
In the absence of right ventricular outflow tract aobstruction, aquire the peak tricuspid regurgitation velocity and calculate
right ventricular systolic pressure
