Midterm questions Echo
Pulse wave at the mitral valve leaflet tips provide
-lv diastolic function, -pressure half time/deceleration time -MVA
We interrogate the tricuspid valve in every available view to quantitative:
-tricuspid stenosis -pulmonary artery pressure -tricuspid regurgitation
IVS thickness
0.6-1.1 cm
IVC normal diameter
1.2-2.1 cm or 12-21 mm
EROA formula
2 pie (PISAr) squared x VA / MR VMAX
MVA formula
220/ PHT
What equation gives you MVA?
220/pht
RVSP formula
4V2 + RAP
Modified Bernoulli Equation
4V^2
Stroke volume normal range
70-100 mL
Normal oxygen in left atrium is?
98%
Simplified Continuity Equation via peak velocity
A lvot = (.785 (lvot d) squared AVA = (A lvot) (V lvot) / V aov
Normal systolic flow from these values ___________ and _________ appear below the baseline.
AOV and pulmonary
Structures of the mitral valve apparatus include all of the following EXCEPT: A. Mitral annulus B. Sinuses of Valsalva C. Left ventricular walls D. Papillary muscles
B. sinuses of Valsalva
__________ is usually congenital and is frequently part of a more complex system
BAV
Continuity equation via VTI (preferred by ASE)
CSA= pie( lvot d/2) squared AVA (VTI lvot) (CSA lvot) / VTI aov)
PVA formula
CSA= pie(RVOT d/2) squared (VTI rvot) (CSA rvot d) / VTI pv
At apical 5, we can measure velocity through the AV valve. We use ____________.
CW
MR volume formula
EROA x MR VTI
In the event of semivalvular stenosis, the lower cardiac chamber must work harder to pump blood through the stenotic valve. This may result in?
LVH
What technique would give me effective regurgitant orifice area of MV?
PISA
Two views where we evaluate TV?
PSAX AO and RVIT
When measuring flow through the MV looking to evaluate diastolic function, We measure normal flow using _________ a the MV ______________ tips.
PW; leaflet
When obtaining the PLAX view what chambers do we see?
RV, LV and LA
__________ and ___________ is part of the pulmonary circulatory system and carries deoxy blood.
Ra atrium and pulmonary artery
In severe MR, the __________ wave becomes markedly reversed.
S
A ____________ view of the LV at the papillary level presents with a small D-shaped left ventricle
SAX
3 components to measure severe PHTN
TR Vmax, RAP=RVSP=SPAP
AS velocity ratio formula
V lvot / V aov
MV prolapse can affect _________ and __________ leaflets.
anterior and posterior
MV papillary muscle two names
anterior lateral and posterior medial
This murmur creates a high pitched blowing, diastolic decrescendo murmur at the left sternal border.
aortic regurgitation
Most primary valvular disease is?
aortic stenosis
This murmur creates a systolic crescendo, decrescendo murmur best heard at the right upper sternal border and radiates to the carotids.
aortic stenosis
A-point of the mitral valve on m-mode waveform occurs during?
atrial kick and late diastole
The heart's own ability to initiate an electrical impulse without being stimulated by another source is?
automaticity
Which structure empties blood into the right atrium?
coronary sinus, IVC and SVC
Pulmonic regurgitation occurs during ______________.
diastole
How to measure aortic cusp separation?
early systole, inner to inner
True or False Diastolic doming of the AMVP can create a hockey stick appearance. This is associated with MR.
false
True or False: TTE is superior to TEE in assessing the valve.
false
True or false: Aortic cusp separation is measured in diastole
false
True or false: Mitral stenosis causes increased cardiac output
false
When obtaining the flax view, we increase depth to look for?
fluid collection and pleural effusion/masses
The flow convergence is the area of ___________ flow velocity before the regurgitant orifice.
increased
______________and ______________is a complication of AS.
increased afterload and pressure overload
MR leads to
left atrial volume overload and increased preload
Cause of MVP?
lupus/marfans disease
What part of the cardiac cycle do we measure LVOT diameter?
mid-systole
Creates a holosystolic murmur that radiates to the axilla. May be described as a blowing/ high pitched murmur.
mitral regurgitation
This murmur creates a low pitched diastolic rumble with an opening snap
mitral stenosis
This murmur creates a mid systolic click with or without a systolic murmur.
mitral valve prolapse
Loud SI is associated with
ms
In a typical subarctic stenosis, the aortic valve itself is
normal
How we you measure PR?
peak velocity
RVSP=
pulmonary artery pressure
This murmur creates a low pitched diastolic murmur that may increase with inspiration
pulmonary regurg
This murmur creates a high pitched blowing diastolic murmur and may be heard when PH is present.( Graham-Steele murmur)
pulmonary regurg w/ PH
This murmur creates a harsh systolic ejection murmur heard at the left upper sternal border. Thrill may be present.
pulmonary stenosis
Aliasing occurs when velocity is > 2m/sec while using _________ wave.
pulsed
Causes of mitral stenosis
rheumatic fever d-shaped septum pulmonary hypertension
Where is the moderator band located?
right ventricle
This murmur creates a low pitched mid diastolic rumble at the apex. (Austin Flint murmur)
severe aortic regurgitation
The primary pacemaker of the heart is the
sinoatrial node (SA node)
LAP formula =
systolic bp - MR gradient
If we zoom in on the SAX MV adn notice mitral stenosis, what is the next step?
trace the MV in diastole
This murmur creates a diastolic rumble that varies with inspiration and has a opening snap
tricuspid stenosis
