AS Quiz Flashcards
What is the purpose of the Dobutamine stress test?
to challenge the patient’s cardiac performance, myocardial viability and contractile reserve.
What is the equation for Aortic valve area?
Continuity equation:
CSA (lvot) x VTI (lvot) / VTI (ao) = Ao Valve Area cm2
what are the three ways to calculate CSA?
CSA= ∏ r2 CSA= (D/2)2 ∏ CSA= 0.785 x D2
What is the equation for DVI?
LVOT (VTI) / Ao (VTI) = DVI
can also use the velocities of LVOT and AO as the ratios are the same.
What are the grades of severity based on DVI?
≤ 0.25 = Severe
0.5 - 0.25 = Mild
≥ 0.5 - 1.0 = Mild
hint: 0.25 to 1.0 in 3 parts
What is the Gorlin formula for calculating Aortic Valve area?
AVA = Cardia output / SEP x HR x 44.3 √G
SEP is systolic ejection period
HR is heart rate
G is Mn Pressure gradient
What constitutes decreased excursion of the mitral leaflet in M-Mode?
< 11mm or 1.1cm is decreased AMVL excursion
What constitutes SAM?
Systolic Anterior Motion
> 30% systolic MV leaflet to Septal contact
≤ 10mm of anterior motion = Moderate SAM
What are the 2 equations to determine peak and Mean pressure gradients?
4 (jet velocity2) = Pk PG
2.4 (jet velocity2) = Mn PG
What is the progression of LV failure due to hemodynamically significant AS? How does the LV respond?
The LV will first respond with Hypertrophy due to the pressure overload.
LVH will create diastolic dysfunction leading to diastolic failure.
Diastolic failure will lead to LV systolic failure.
What produces a dagger shaped LVOT doppler velocity profile?
LVOT obstruction produces a dynamic pressure gradient and this generates a dagger shaped profile.
What is pulsus alterans?
Varied amplitude of the EKG R wave.
What EKG changes might you see in AS>
Inverted T waves, AFib, BBB, signs of LVH
(increased amplitude of S in V1 and V2, increased amplitude of R in V5 and V6
