Aortic Valve Disease Flashcards
What is Aortic Regurgitation (AR)?
Backflow of blood through the aortic valve during ventricular diastole
Aortic Regurgitation is also known as AR.
During which phase of the cardiac cycle does Aortic Regurgitation occur?
Ventricular diastole
Ventricular diastole is the phase when the heart’s ventricles relax and fill with blood.
What are the types of congenital native valve etiology related to leaflets?
Bicuspid AV, Quadracuspid, Unicuspid
These conditions refer to the number of leaflets in the aortic valve.
What congenital condition is associated with aortic dilation?
Annuloaortic ectasia
This condition is linked to connective tissue diseases such as Marfan syndrome, Loeys-Dietz syndrome, and Ehlers-Danlos syndrome.
Which connective tissue diseases are associated with annuloaortic ectasia?
Marfan syndrome, Loeys-Dietz syndrome, Ehlers-Danlos syndrome
These syndromes can lead to dilation of the aorta.
What are the acquired causes of native valve etiology related to leaflets?
Senile thickening, Infective endocarditis, Rheumatic disease, Radiation-induced valvulopathy, Carcinoid
These conditions can affect the structure and function of heart valves.
What systemic condition can lead to acquired aortic dilation?
Systemic hypertension
This is caused by increased pressure or resistance in the blood vessels.
Which inflammatory condition is associated with acquired aortic dilation?
Ankylosing spondylitis
This is a chronic inflammatory arthritis that can affect the aorta.
What type of aortitis can lead to acquired aortic dilation?
Syphilitic aortitis
This is caused by the infection of syphilis affecting the aorta.
What are some causes of aortic dilation related to trauma?
Aortic dissection, Trauma
These conditions can lead to structural changes in the aorta.
True or False: Rheumatic disease is a common acquired cause of native valve etiology.
False
Rheumatic disease is considered rare in this context.
What is a central jet murmur?
High-pitched, blowing, decrescendo diastolic murmur
You do not hear trace or mild aortic regurgitation (AR) with this murmur.
What characterizes an Austin Flint murmur?
Low-pitched diastolic ‘rumble’ at the apex associated with severe eccentric aortic regurgitation
This murmur is distinct from other types due to its association with severe AR.
What does CW Doppler measure in the assessment of AR?
-Density of jet
-mean pressure gradient
-velocity of jet(blood flowing through AoV
CW Doppler refers to Continuous Wave Doppler.
What is flow convergence in AR assessment?
A qualitative method used to evaluate the severity of the regurgitation.
What is assessed using PW Doppler in AR evaluation?
Flow reversal in abdominal Ao, proximal descending aorta, and aortic valve
Ao stands for Aorta.
What is a semi-quantitative method for assessing AR?
-Vena Contracta Width (VCW)
-flow convergence
VCW is a measurement used to evaluate the severity of AR.
What is the role of beta blockers in medical treatment?
Slows heart rate and increases preload
Beta blockers are commonly used in various cardiovascular conditions to manage heart rate and improve cardiac output.
Name three types of medications used in the medical treatment of heart conditions.
- ACE inhibitors
- Antiarrhythmic agents
- Diuretics
These medications serve different purposes in managing heart conditions, including blood pressure regulation and fluid management.
What should be avoided to prevent worsening of heart conditions?
Heavy physical exertion
Engaging in intense physical activity can exacerbate symptoms and lead to increased severity of the condition.
Under what conditions is surgical replacement indicated?
- Symptomatic
- LV EF < 50%
- Hemodynamic instability (acute)
- Heart size increased at end-diastole > 7.5 cm; end-systole > 5.5 cm (measured by echo)
These criteria help determine the need for surgical intervention in patients with significant heart dysfunction.
What are the two types of AR jet direction?
- Central jet
- Eccentric jet
A central jet points directly toward the mitral valve, while an eccentric jet points toward the septum.
What is the significance of Vena Contracta (VC) in assessing AR?
It measures how wide the jet is in the PLAX view
Vena contracta is the narrowest part of the jet and indicates the severity of regurgitation.
What Vena Contracta width indicates mild Aortic Regurgitation?
< 0.30
A wider Vena Contracta suggests more severe regurgitation.
Fill in the blank: The _______ measures how far the jet extends into the left ventricle.
Flow Convergence
This measurement helps assess the severity of the regurgitation.
What is the width criterion for VC in Mild AR?
< 0.3 cm
What is the maximum width of the Central Jet for Mild AR?
< 25% of LVOT
What type of flow convergence is expected in Mild AR?
Small or no flow convergence
What is the PHT threshold for Mild AR?
> 500 ms
What is a flail valve?
A condition in which a valve does not close properly, leading to significant regurgitation.
What is the VC width criteria for severe AR?
VC width > 0.6 cm
What is the central jet width in severe AR?
Central Jet width ≥ 65% of LVOT
What is the PHT threshold for severe AR?
PHT < 200 ms
What does prominent holodiastolic flow reversal in the descending aorta indicate?
It is a sign of severe aortic regurgitation.
What is the expected left ventricle condition in severe AR?
Enlarged LV with normal function.
What is one effect of M-Mode findings in significant, highly eccentric AR?
Creates ‘fluttering’ on the leaflet
Fluttering is an observable phenomenon indicative of leaflet motion.
What does jet density indicate in the context of CW Doppler evaluation of AR?
The more bright/complete the signal indicates more significant AR
AR stands for aortic regurgitation.
What is pressure half-time (PHT) in relation to AR?
Half the time it takes for the AR slope to meet the zero Doppler baseline
PHT is a useful measure in assessing the severity of aortic regurgitation.
What does a steeper AR slope indicate?
The more severe the AR
A steeper slope suggests a faster decline in pressure, indicating greater severity.
What is holo-diastolic flow reversal in the proximal descending thoracic aorta indicative of?
Severe aortic regurgitation (AR)
Holo-diastolic flow reversal is a significant finding in Doppler assessments for diagnosing severe AR.
What is the significance of an increase in LVOT velocity greater than 1.5 m/sec?
It indicates severe aortic regurgitation (AR)
LVOT stands for Left Ventricular Outflow Tract.
What does an increase in LVOT VTI greater than 40 cm suggest?
Severe aortic regurgitation (AR)
VTI stands for Velocity Time Integral, which is a measure used in echocardiography.
