29 Echocardiographic assessment of common clinical presentation of patients Flashcards
In patients with dyspnoea, what are the common TTE characteristics?
The causes include HF, ischemic heart disease, valvular heart disease and lung disease.
The TTE characteristics include LV dilatation, LV systolic and diastolic dysfunction, decreased LVEF, LA dilatation, RV dilatation, RV dysfunction, increased pulmonary artery pressure and valvular abnormalities.
In patients with arrhythmias, what are the common TTE characteristics?
The causes of AF include ischemic heart disease, valvular heart disease, cardiomyopathies, hypertension, pulmonary disease, PE, myocarditis and pericarditis.
The causes of VT include myocardial ischemia and myocardial infarction, valvular heart disease and cardiomyopathies.
LA dilatation, LV systolic and diastolic dysfunction, septal hypertrophy (HCM), valvular disease.
In patients with ejection systolic murmurs, what are the common TTE characteristics?
The causes include AS, BAV, PS, HOCM and increased blood flow across the AV or PV in hyperdynamic states (e.g. exercise, anaemia, pregnancy and/or thyrotoxicosis).
The TTE characteristics include AS with thickened AVs and increased AV velocities, PS, HCM with septal hypertrophy and LVOT obstruction.
In patients with hypertension, what are the common TTE characteristics?
Normally, the cause is idiopathic.
The TTE characteristics include LV hypertrophy, LV diastolic dysfunction, LA dilatation, aortic root dilatation and AR.
In patients with renal failure, what are the common TTE characteristics?
Renal disease can be caused by amyloidosis.
The TTE characteristics include LV hypertrophy, LV diastolic dysfunction, mitral annular calcification, pericardial effusions, volume overload and chamber dilatation, and CAD and LV systolic dysfunction.
In patients with stroke, what are the common TTE characteristics?
LA dilatation, LA thrombus, LV thrombus, LA tumours, IE, aortic atheroma, LV systolic and MI, valvular heart disease, PFO or ASD, VSD, DCM, prosthetic heart valves and AF.
In patients with Marfan syndrome, Ehlers–Danlos syndrome and systemic sclerosis, what are the common TTE characteristics?
Marfan syndrome is characterised by aortic root dilatation (SOV and STJ), MVP, MV calcification, pulmonary artery dilatation and/or descending aorta dilatation or dissection. Marfan syndrome also causes ascending aorta dilatation and aortic arch dilatation.
Ehlers–Danlos syndrome is characterised by MVP and possibly aortic aneurysms.
Systemic sclerosis is characterised by pulmonary hypertension, pericardial effusions, LV diastolic dysfunction, myocardial fibrosis and decreased myocardial strain and valvular disease.
What is peri-partum cardiomyopathy?
Peripartum cardiomyopathy is defined as an LVEF of <45% in the later months of pregnancy or within 5 months of delivery and is a cardiomyopathy that may develop during pregnancy. It is characterised by LV dilatation, LV thrombus, RV dilatation and dysfunction, MR and/or TR.
What are the effects of pregnancy on the heart?
During pregnancy, the volume overload increases LVESV, LVEDV, LV mass, RV size, LA and RA size, MV, TV and PV orifice area (increasing the risk of MR, TR and PR) but cardiac pressures are normal throughout.
During pregnancy, CO increases, secondary to increases in HR and SV, peaking at the end of the second trimester, then plateaus, but, at delivery, CO increases further, secondary to increased venous return, decreased pressure on the IVC and return of blood from the uterus to the circulation, then CO normalises within 2 weeks.
During pregnancy, the preload depends on maternal position with decreased preload when the mum is supine because the uterus compresses the IVC and decreases venous return. During pregnancy, the afterload decreases, secondary to decreased SVR, in the second trimester and increases in the third trimester. The LVEF depends on preload and afterload.
During pregnancy, the transmitral A wave velocity increases. In early pregnancy, the transmitral E wave velocity and E:A ratio increase, and in late pregnancy, decrease, in line with increased then decreased diastolic function.
