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DMST 253 Adult Echocardiography 1 > Apical Doppler: Part 2 > Flashcards

Apical Doppler: Part 2 Flashcards

1
Q

RT heart doppler mostly consists of what kind of images of the tricuspid valve?

A

Colour and spectral doppler

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2
Q

Which valve is rarely seen from the apical view do to what kind of position they have have?

A

The pulmonary valve is rarely seen because of its anterior position

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3
Q

When we get at A4C right heart doppler image what do we assess? 2

A

The TV inflow as well as regurgitation
1. Assess TV inflow with colour doppler looking for aliasing
2. Assess with CW on the TV looking for TR

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4
Q

When getting a A4C TV colour image how should we keep the colour box?

A

Just as wide as annulus, this keeps frame rate high

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5
Q

Approximately how many people have tricuspid regurgitation?

A

~80% of people have some sort of TR

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6
Q

Which population of people have more TR on average? Why?

A

Athletes due to slight TV annular dilation. This is normal and an adaptation to increased cardiac output with exercise

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7
Q

When is physiologic/ trace/ TR usually seen?

A

First half of systole

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8
Q

TR occurs almost the same time as what?

A

MR

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9
Q

What is CW used for in terms of a A4C CW TV image?

A

CW is able to capture both inflow and regurgitation on the same image

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10
Q

Inflow velocity for A4C CW of the TV looks like what?

A

Looks small (E and A waves).

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11
Q

When getting a A4C CW of the TV do we normally measure TV inflow?

A

No

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12
Q

Where do we place the CW cursor for a A4C CW of the TV?

A

Place the CW cursor through the TR jet at the valve.

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13
Q

TR velocity is highest where?

A

At the valve

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14
Q

What do we measure to calculate RVSP?

A

Peak velocity

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15
Q

When we get a A4C TV CW where do we put the base line?

A
  1. 1/4-1/3 from the top
  2. Scale 2.4 m/s below baseline
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16
Q

Do we normally take a A4C TV PW?

A

Rarely done

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17
Q

What is normal E wave velocity?

A

<0.7 m/s

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18
Q

Where do we place the sample volume for RV annulus TDI images?

A

Sample volume should be placed on the TV annulus of the RV free wall

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19
Q

What do we measure during a RV annulus TDI?

A

S prime

20
Q

For a RV annulus TDI image where do we measure?

A
  1. S valve above baseline
  2. Measurement of RV systolic function similar to how TAPSE works
21
Q

What is the normal RV S prime value?

A

> 9.5 cm/sec

22
Q

What order should we assess A5C doppler in? 3

A
  1. LVOT/AV/Aorta Colour doppler
  2. LVOT - PW doppler
  3. AV - CW doppler
23
Q

What is LVOT PW doppler used to assess?

A

LVOT obstruction and obtain VTI for calculations

24
Q

What is AV -CW doppler used to assess?

A

Regurgitation and stenosis if present

25
Q

What are some tips for getting a A5C AV colour image? 4

A
  1. When in doubt go back to A5C 2D
  2. Long colour box over LVOT, AV + Aorta
  3. Some aliasing is normal
  4. Watch FR
26
Q

When we place the colour box in A5C AV colour view, what should we look for?

A

Make sure you can see AV and past AV into ascending aorta

27
Q

How should we adjust the A5C PW 2D image prior to PW? 3

A
  1. Place SV in the middle of LVOT
  2. 5mm inferior to AV cusps
  3. SV gate size = 3-5 mm
28
Q

What are some tips for getting a A5C LVOT PW image? 4

A
  1. Must be aligned
  2. Make baseline 1/4- 1/3 from tops
  3. Adjust scale to size of signal
  4. Should see AV closing click vertical line
29
Q

What do we measure in A5C LVOT PW?

A

Trace VTI

30
Q

What are some tips to getting A5C AV CW? 4

A
  1. Make sure you are aligned
  2. Set baseline 1/4-1/3 from top
  3. Adjust scale to size of signal
  4. Careful of gain
31
Q

What do we measure for A5C AV CW? 2

A

Trace VTI
1. AV Vmax
2 AV peak and mean PG

32
Q

What is LVOT velocity normal values?

A

< 1.5 m/s

33
Q

What is LVOT diameter and calculated AVA values?

A
  1. 1.6- 2.3 cm
  2. 2.5 - 4.5 cm^2
34
Q

What is the AV velocity and AV VTI?

A

<2 m/s and 18-25cm

35
Q

What is AV peak gradient normal volume?

A

<10 mmHg

36
Q

What is AV mean gradient?

A

<5 mmHg

37
Q

What should A2C MV color image show?

A

MV inflow

38
Q

What do we sweep and assess for during a A2C MV colour?

A

Sweep and assess for MR

39
Q

How should we place the box for the A2C MV colour?

A

Just as wide as MV annulus

40
Q

To keep FR high we need to take two images of what?

A

A3C colour doppler

41
Q

What should the FR be for A3C MV colour?

A

> 20hz

42
Q

If you saw MR in the other views you should see it where?

A

A3C MV colour

43
Q

IF you saw MR/AI in the other views what should we see A3c?

A

A3C AV colour images

44
Q

All of the A3C spectral parameters are exactly the same as which other image?

A

It was A5C

45
Q

If there is a stenosis, you may be able to obtain a better angle or clear view from the A3C why?

A

So it can be useful to take the measurement again in attempt to obtain a higher velocity

46
Q

AV peak velocity should be what?

A

<2.0 m/sec

DMST 253 Adult Echocardiography 1 (27 decks)

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