Apical Doppler: Part I Flashcards
diastolic function assesses how well the heart ____ and ___
rests
fills
3 phases of diastole
early filling
diastasis
atrial kick
TDI
tissue doppler imaging
5 things assessed with doppler for apical MV inflow
E wave
A wave
E/A ratio
deceleration time (DT)
IVRT
3 things assessed with doppler for apical PV
S wave
D wave
A wave reversal
2 things assessed with doppler for apical MV annulus TDI
e prime (e’)
E/e’ ratio
2 other measurements we can use for diastolic assessment
LA volume index
TR max velocity
A4C MV colour column of blood entering LV is ____ with ___ between leaflet tips
red
yellow
A4C MV colour inflow jets angles slightly ______
laterally to anterolateral wall
for A4C MV colour you will put the sample volume _____
a bit lateral as thats where the inflow jet goes
pulsed wave of the MV inflow sample volume is placed where
at the tips of the MV when open, in the middle of the red column of blood (may be slightly laterally)
pulsed wave of the MV inflow has baseline set where
1/4-1/3 from bottom
what do we measure on the A4C MV PW
E
A
decel time
normal E:
0.6-1.3m/s
normal E/A:
0.8-2.0
normal DT:
160-220ms
___ after T, ___ after P (using the two measurements for A4C MV PW) (T and P in ECG)
E
A
early filling is the ____ wave and has ____% filling (A4C MV PW)
E
70
late filling is the __ wave, and has ____% filling (A4C MV PW)
30
height of E wave is influenced by:
amount of blood entering the LV
MV inflow is _____ dependent (increased _____ = increased velocities)
volume
volume
what is diastasis on the A4C MV PW
gap between end of E wave and start of A wave
very little to no flow seen on spectral
late filling is the ___ wave, and is the result of atrial ____. It is normally _____ than the E wave
A
contraction
smaller
E/A reversal can be normal in _____ patients. Many fit young people have E/A ratios _____ which is normal
older
>2.0
normal E/S ratio reverses near the ____ decade of life
6th
does A (late filling) have a specified normal
no
IVRT is the time between (LV pressure is _____)
AV closure and MV opening
falling
IVRT SV placed betwwen ___ and ____ and the normal is _____
LV outlfow
MV inflow
50-100ms
why do we use CW instead of PW
super high velocities in the cases of stenosis/regurg
in mitral stenosis the MV opening is _____ = blow flow velocity ____
smaller
increases
do we ue CW or PW with mitral inflwo with MS
CW due to high velocities
CW of MR lasts throughout ____ and _____. it travels near _____
systole
both isovolumic periods
5-7m/s
Colour of MV assesses _____ flow for MS, and assesses ____ flow MR
diastolic
systolic
as the LV expands in diastole it lengthens from ____ to ____
base
apex
For our MV TDI we look at the _______ changes of the LV
longitudinal
4 ways LV changes it shape
radially
circumferentially
longitudinally
torsion
What does TDI measure
how quickly the tissue moves (how fast the LV expands or contracts
A4C MV TDI medial where do you place caliper and what does it measure
e’
right after systole (early filling) on ECG but measure on spectral trace
normal TDI medial e’ =
≥ 7cm/sec
normal TDI lateral e’ =
≥ 10cm/sec
E/e’ ratio normal
≤ 14
which wall of MV annulus has more freedom of movement and why
lateral as it is not attached to right side of heart
E/e’ ratio is the ________ divided the average _____
MV PW peak E
TDI e’
pulmonary veins fill the LA during (3)
ventricular systole
early diastole
diastasis
flow is ____ in the pulmonary veins during atrial systole
reversed
we use PW in ____ PV normally
right upper (RUPV)
for PV vein colour you want to _____ scale and ______ colour gain
decrease
increase
A4C RUPV PW 2 measurements
S wave (systole)
D wave (diastole)
systolic wave is normally ____ than D wave velocity
greater
A wave reversal
blood temporarily flows back into the PV from the LA due to lack of a valve
caused by atrial contraction
pulmonary vein flow is ______. Where one wave ends, the other ____
continuous
begins
MV inflow E point normal
0.6-1.3m/s
E/A ratio normal
0.8-2.0
IVRT normal
50-100 ms
e’ medial normal
≥ 7cm/s
e’ lateral normal
≥ 10 cm/s
E/e’ ratio normal
≤ 14
