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peak atrial reversal velocity
Find the peak atrial reversal velocity
cardiac output/body surface area
How is cardiac index calculated?
decrease doppler gain
How would you eliminate the artifact?
onset of diastole
Left ventricular pressure is lowest during
early ventricular diastole
Letter B represents what part of the IVC flow
MR
________ is usually present in patient's with hypertrophic obstructive cardiomyopathy bc of the pressure changes caused by obstruction to flow leaving the LV through the LVOT
bicuspid aorta
a 28 yr old male has a systolic murmur. 2D imaging is limited, EF is normal. AV vel is 4m/s with peak pressure of 64mmHg, no AI detected. Which is likely the etiology?
Grade II
a 50yr man has chest pain. EF 35% LV hypertrophy E/A ratio 1.7 Septal E' 6cm/s,lateral E' 8cm/s E/E' = 16 TR = 3.1m/s LAVI=36ml/m2
balloon mitral valvotomy
a new asd is a complication commonly seen with what procedure?
A steep acceleration slope and a less steep deceleration slope
a normal doppler tracing from the LVOT will demonstrate
2MHz
a patient that is 6'3" and 320lbs is getting an echo. what transducer do you choose
dilated cardiomyopathy
duchenne muscular dystrophy is associated with what myocardial abnormality?
cardiac tamponade
dyspnea, chest pain, and pulsus paradoxus are common symptoms of
120 mmHg
eisenmenger syndrome will usually occur when the RVSP exceeds what?
rheumatic disease
for patients who demonstrate calcification, degeneration, fibrosis and/or stenosis on both MV and AV, the most common etiology would be?
mechanical heart valves
hemolytic anemia can be caused by
759/decel time =xcm^2
how do you solve mitral decel time?
measure the time it takes for the MR velocity to go from 1m/s to 3m/s
how is the measurement of the dp/dt of the MR tracing performed?
pulmonary stenosis
if ___ is present, the RVSP calculation from the TR gradient is inaccurate as the measurement of the PA pressure.
increased RV pressure
if a ventricular septum is bowed to the L throughout the cardiac cycle
80 mL, 67%
if the Left ventricular end systolic vol. is 40mL and the end diastolic volume is 120mL. what is the stroke vol. and EF?
increased RA pressure
if the atrial septum is bowed to the left throughout the cardiac cycle
blockage of the right coronary artery ostium
immediately after a transcatheter AV is deployed, the RV and inferior left ventricular wall demonstrate hypokinesis. This finding means..
left ventricular hypertrophy
pheochromocytomas, friedreich ataxia and fabry disease commonly demonstrate what?
an oval appearance of the left ventricle in short axis
placing the transducer at the 5th intercostal space on the patient's chest can lead to__
amount of blood entering the heart amount of resistance as the heart ejects blood
preload refers to: afterload refers to:
tips of the valve leaflets, entire valve leaflet
rheumatic disease causes abnormal thickening of the ________, while carcinoid disease causes abnormal thickening of the ______
mod/severe pulmonary insufficiency
right ventricular enlargement, decreased right ventricular compliance, interventricular septal dyskinesis/flattening
p wave
the ____ on the EKG normally occurs just prior to the atrial contraction
systolic BP below 100mmHg or greater than 200mmHg
the dobutamin infusion for a stress echo is stopped when the HR reaches 85%. what is a secondary reason for it to be stopped?
left anterior descending artery
the echo demonstrates akinesis of the anterior septal wall. What coronary artery is most likely affected by coronary artery disease?
Occurs after the R wave on the EKG
the isovolumetric contraction period:
2.5cm2
the mitral decel time is 300msec. What is the valve area?
the formation of a loculated pericardial effusion
the most common preliminary sign of metastatic disease in the heart is
lateral wall of the RV
the motion of what wall segment can be evaluated in the 4CH view?
symmetric asymmetric
the pattern of wall hypertrophy in hypertensive heart disease is _________, and in hypertrophic cardiomyopathy the pattern is usually____.
36 mmHg
the peak vel. across the AV is 3m/s. what is the peak pressure gradient?
parasternal long axis
what 2D view can be used to diagnose MVP?
height in cm and weight in kilograms
what PT parameters are required to calc. the body surface area?
3 pap muscles instead of 2 tri-leaflet apical displacement of the TV triangular apex
what are features of the RV
bjork shiley
what bioprosthetic valve can be used to replace the MV, TV and AV?
increase transmit power
what can be used to improve beam penetration on cases of high body mass index?
vena contracta MR vena contrata AR
what can be used to measure this in PLAX?
they have a higher risk of rupture than an LV aneurysm
what correctly describes a LV pseudoaneurysm?
E/A ratio of <0.8
what describes the mitral valve doppler tracing for hypertrophic cardiomyopathy?
frequency of the electrical excitation voltage
what determines the frequency of waves produced by a continuous wave transducer?
rounded apex
what feature is a characteristic of the LV?
Grade 3
what grade diastolic dysfunction is E/A >or equal to 2 e' <<8cm/s E/e' >15
restrictive filling Grade 3
what grade diastolic dysfunction is this?
Grade I
what grade of diastolic dysfunction is most commonly associated with chronic systemic HTN?
increases
what happens to the amplitude of the E wave on the doppler display of a PT with MS?
IAS
what is #1
left ventricle
what is #7
posterior leaflet MV
what is 4
carcinoid deposits
what is a cause of Pulmonary regurg?
suboptimal parasternal view causing overestimation of the LVOt diameter
what is a following potential cause for underestimation of aortic stenosis when calculating the AVA for the continuity equation?
flail MV leaflet aortic dissection apical LV thrombus
what is considered critical findings?
peak flow velocity
what is displayed with spectral doppler, but not color doppler?
atrial fibrillation
what is the cardiac abnormality?
Pulmonary hypertension
what is the most common cause of tricuspid regurg?
amyloidosis
what is the most common type of infiltrative cardiomyopathy?
= (v)^2 x 4
what is the peak pressure gradient formula?
intra-aortic balloon pump
what is this
left ventricular assist device
what is this
the membranous type of VSD is located at the junction of the LVOT and the muscular portion of the septum
what is true regarding VSDs?
left ventricular wall thickness
what is unaffected by moderated mitral stenosis
Lipomatous hypertrophy of the interatrial septum
what is wrong with this echo?
Hydrocortosone
what item should be in the echo room incase a patient has an anaphylactic response to UEA?
transducer
what system component determines the initial amplitude of the ultrasound wave?
lateral resolution and gain settings
what technical factors can neg. affect the 2D planimetry of the MV?
TEE
what technique is best for eval of aortic dissection?
axial
what type of resolution improves with short pulse duration?
multiple muscular VSDs
what type of vsd has a "swiss cheese" appearance?
pulmonary valve
what valve is normally positioned most anterior within the chest?
aortic stenosis
what will increase LVSP?
the MV closes and ends when the AV opens
when does the isovolumetric contraction period begin?
b-notch
when end diastolic pressures increase in the LV, _______ is demonstrated on the M-mode eval of the MV
early systole
when is the blood volume in the RA the lowest?
calculate body surface area
when is the responsibility of the sonographer before the TTE begins?
2cm below the left clavicle
when placing the electrodes for a 12 lead EKG for a stress test, the electrode for Left arm is placed..
peak velocity of TR
when right heart dysfunction is identified, how is peak pulmonary artery pressure estimated?
TV opens
when the RV pressure drops below the RA pressure, what happens?
Atrioventricular valves will open
when the ventricular pressure drops below the atrial pressure.. what happens?
high pitched, early diastolic murmur
which describes the murmur associated with severe pulmonary insufficiency with pulmonary artery systolic pressure over 70mmHg?
mean pressure gradient
which doppler flow parameter is most accurate when assessing aortic stenosis in a PT with AR?
psax
which echo view is preferred for evaluating the flow of the pulmonary system from a PDA?
endocardium
which layer of the heart is most affected by staphylococcus aureus infection?
AV leaflet motion in patients with LV assist devices
while m-mode is not the preferred method for calculation of the EF, it is recommended when evaluating..
A. activate the zoom function over the mitral valve
while scanning an obese PT, you apply color to the MV in AP4C. When you adjust, there is a delay. How can you correct this?
the RV pressure exceeds the normal LVSP of 120 mmHg, the shunt will reverse and move from right to left
why does the shunt change directions to R to L in eisenmenger's syndrome?
shift the color baseline up between 20-40cm/s to allow aliasing
you are performing MR on a TEE by measuring the PISA radius of the jet, After optimizing the color flow of the MR, which of the following console adjustments should be made before freezing the image?
early systole
The largest antegrade flow component seen on a Doppler tracing of a normal hepatic vein is identified during what part of the cardiac cycle?
Grade 2 diastolic dysfunction
What grade diastolic dysfunction is this?
Subvalvular stenosis Late peaking dagger
What is D
E/A >or equal to .8 e' >or equal to 8cm/s E/a' <8
What is a 0 grade diastolic dysfunction
EF% = EDV-ESV/EDV
What is the equation for EF?
pressure half time
What is the most commonly performed method of estimating mitral valve area?
Stroke vol = EDV-ESV
What is the stroke volume equation?
Find the chamber attached to the mitral valve
When evaluating an adult with suspected congenital heart disease, how do you identify the left ventricle?
scan rightward with a slight anterior angulation
When evaluating the aortic arch in the suprasternal notch view, how do you manipulate the transducer to image the superior vena cava?
