Aortic Valve Pathology Flashcards
AI occurs during
diastole
the AI jet will appear
blue in PLAX
red in apical 5
what is the vena contracta
the width of the narrowest segment of the regurg
most accurate in PLAX
mild vena contracta measurement for AI
3mm
moderate vena contracta measurement for AI
3-6mm
severe vena contracta measurement for AI
greater than 6mm
AI is evaluated with
CW in AP5 and AP3 and appears above the baseline
the steeper the slope for AI…
the more severe the AI and the shorter the PHT
AI PHT mild
greater than 500 msec
AI PHT moderate
350-500 msec
severe AI PHT
less than 200 msec
AV regurg pressures
LVEDP
can be calculated from the CW
the velocity represents the pressure difference between the LV and the aorta at ED by using the bernoulli equation
normal LVEDP
12-15mmHg
severe AI will cause flow reversal in the …
descending aorta seen in suprasternal notch
normal AV area
2-4 cm squared
severe AS
- the more severe the more pressure will be exerted and the higher the pressure gradient across the valve
- more time it takes for maximum pressure to be reached
mild AS
early peaking of AV pressure
AS flow
high velocity and peaks later in systole
AS max pressure gradient mild
27-34 mmHg
AS max pressure gradient moderate
36-64 mmHg
AS MAX pressure gradient SEVERE
greater than 64 mmHg
Severe AS velocity
> 4.0 m/s
AVA area by continuity equation
- LVOT diamteter
- LVOT VTI AP5, AP3 pw
- AV VTI SP5 of AP3
normal AVA by continuity
greater than 2.0 cm squared
times where the pressure gradient measured by continuity will be inaccurate
the most common primary valve disease
aortic stenosis
normal aortic cusp seperation
1.5 - 2.6
bernoullis equation
4(v)squared
peak velocity for severe AS
> 4.0 m/s
austin flint murmur
rumble at the apex due to severe AI
AI symptoms
chest pain
dizziness
exertional dyspnea
syncope due to decreased cardiac output
Severe AI can cause AMVL
flutter!!
AS causes an increase in the
afterload causing the LV to work harder
AVA continuity equation
LVOT VTI x LVOT CSA/ AV VTI
bernoulis equation
4v2
mild AS velocity
2.6 - 2.9
mild AVA for AS
> 1.5
severe AVA
<1.0
mild mean PG for AS
<20
Severe mean PG for AS
> 40
calculating AS velocity ratio
velocity lvot/ velocity AOV
AS CWD curve for mild obtruction
early systolic peak
AS cwd curve for severe obstruction
peak velocity later in systole
curvature in shape
AS cwd curve for dynamic sub aortic lvot obstruction
late peaking systolic jet
severe AR pht
<200
mild AR pht
> 500
Lvedp equation w/ AI
Diastolic bp- ai gradient at end diastole
