Abnormal Cardiac Doppler Flow Patterns Flashcards
What is the least common type of regurgitation to see in a normal patient?
Aortic
In what part of the cardiac cycle does TV and MV regurgitation occur?
Systole
In what part of the cardiac cycle do PulmV and AoV regurgitation occur?
Diastole
2-D imaging features of valvular regurgitation
- Dilated chambers
- Calcific valves
- Prolapse
Is a more gradual slope of regurgitation indicative of mild or severe regurgitation?
Mild - more gradual slope means a slower change in pressure and not as significant
What cardiac abnormality may be caused by rheumatic fever?
Valve stenosis
T or F? Valve stenosis decreases afterload
FALSE: A stenotic valve creates more work of the ventricle to open and push blood flow which would create a HIGHER afterload as the ventricle must work harder
T or F? Valve stenosis creates a larger pressure gradient from one side of the valve to the other
True
What is an eccentric jet?
Jets going off in different directions
What abnormality should be suspected with the lack of E’ and A’ wave during m-mode?
MV stenosis
“Hockey stick” appearance of the MV is due to what?
Rheumatic fever
2-D imaging features of valve stenosis
- Hyperechoic, thick valves
- Hypertrophy of ventricles due to increased afterload and ventricle having to work harder - more muscle needed
- Reduced valve excursion - No clear E’ or A’ wave
- Potenital atrial dilation
What valve annulus is most commonly used in the continuity rule equation?
Aortic valve
What is V1?
LVOT VTI
What is V2?
Peak AV VTI
As flow energy increases, what happens to pressure energy?
Decreases
The increase in pressure drop occurs due to? (hint: bernoulli equation)
Increasing velocity
Is highest velocity flow proximal, at, or distal to stenosis?
AT stenosis
Solving for bernoulli’s equation gives what?
The pressure difference between two chambers at a specific point in time
What does RVSP stand for?
Right Ventricular Systolic Pressure
Velocity in bernoulli’s equation is generated from what?
Vmax in tricuspid regurgitation peak velocity
How is the RAP assigned?
The visualized level of collapse of the IVC and it’s widest diameter
When there is pan diastolic flow reversal seen in the abdominal aorta, what is that an indication of?
Severe AoV Regurgitation
Is normal flow in the abdominal aorta seen above or below the baseline?
Above
Is normal hepatic vein flow above or below the baseline?
Below as blood is carried from HV to IVC which is away from the transducer
How many waveforms are seen in normal hepatic vein flow on PW doppler?
4
What abnormality indicates systolic flow reversal with no systolic forward flow in the hepatic vein?
Severe tricuspid regurgitation
What severity of regurgitation is when it is restricted to the area immediately adjacent to valve closure?
Mild/trivial/physiological
Higher than normal velocities and larger pressure gradients will be visible on spectral doppler with that abnormality?
Valve stenosis
In what abnormality will you lose diastasis?
MV stenosis - lose the E’ and A’ wave
Fluttering of the anterior MV leaflet’s E/A excursion in diastole seen in M-mode can indicate what?
Aortic regurgitation
