Assessment of Ventricular Function Flashcards by Kate Grimeau

what is systolic dysfunction

the inability of the lV to contract properly

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S dysfunction is usally due to

coronary artery disease

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S dysfunction = ___ SV, ____ EF

decrease x2

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S dysf. can lead to ____

CHF

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CHF is the back up of blood behind the chamber due to its ability to contract and move blood forward = chamber ____

dilates

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depolarization (ECG/when it occurs in reference to valves)

QRS
IVCT

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contraction ECG

QT segment

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ejection (ECG/when it occurs in reference to valves)

ST segment
AV opening to closure

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visual wall motion can use a ____ or ____ approach

segmental
global

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normal systolic function implies the heart muscle moves _____ and ____ during systole

inward
thickens

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5 ways to describe wall motion

hyperkinetic
normal
hypokinetic
akinetic
dyskinetic

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hyperkinesis (what/seen with(4))

excessive wall motion

may be seen with high preload, severe valvular regurg, fever, trauma

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hypokinesis (what/may be seen with (3))

motion/wall thickening reduced

CAD, CMO, long standing valve disease

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CAD

coronary arterial disease

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CMO

cardiomyopathy

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akinesis (what/may be seen with (2))

no thickening, may have motion is tethered to moving segmetn

MI, Viral CMO

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dyskinesis (what/may be seen with (4))

wall or segment is moving the opposite direction as normal segments in systole

increased Rt heart P, pacemaker, BBB, long standing scarred segment

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8 quantitative systolic measurements

SV/CO/CI
FS/EF
strain
dP/dt
MPI

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end diastole (IV__T) meaure when on ECH

C
QRS

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end systole (IV__T) measured when on ECG

R
end of T wave

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MV/TV measured when LV dimension = __

big

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AV/PV measure when LV dimension= ____ and it is the frame ____

smallest
before MV opening

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2 formulas for SV

SV= EDV-ESV
SV= CSAxVTI

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CSA formula

CSA = 0.785 x D^2

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CO formula

SV x HR

CI formula

CO/BSA

expanded SV formula (instead of CSA use its formula)

0.785 x D^2 x VTI

EF/FS measured how in PLAX

using the line that measures ant wall, LV and post wall during diastole, then systole

LV SV images needed (doppler method)

LVOT diameter (PLAX zoom) LVOT VTI (usually A5C, sometimes A3C)

FS is what

the percentage of change in the minor axis of the LV

FS is only useful if walls are

moving together

normal FS

25-47%

EF AKA

Teichholz

EF normal

> or equal to 55EF

EF assumes what 4 things

walls contracting equally V 2x long as wide bullet shape measurement placed correctly

Simpson's EF also tells us the ____

volume itself

Simpson done in what 2 views

A4c A2C

normal Simpson's EF

male 52-72% female 54-74%

least to most accurate using (3D trace, Teicholz, Simpson's Biplane EF)

Teichholz (parasternal linear EF) Simpson's Biplane EF 3D trace (3D EF)

Teichholz parasternal linear EF gives us (2)

FS CO (SV x HR)

downside to 3D

most sonographers don't know how to use it correctly

can contrast imagine be used for LV function

yes

contrast imaging is where

you inject contrast agent

2D strain (what, used for, how)

modality used for LV S function assessment, tracks speckles within wall segment and traces them

normal 2D strain = ____ (colour) and has a ____ integer

red negative

dP/dt means

change in pressure over change in time

dP/dt used for

LV function assessment in conjunction with significant MR

significant MR = _____ preload

increased

dP/dt is ___ influenced by preload

less

to do dP/dt you measure

MR jet at 1m/s and at 3m/s

MPI stands for

myocardial performance index

MPI formula

(IVCT+IVRT) / LVET LV ejection time

in a diseased heart, ET ___ and isovolumic times ____

shortens increase

MPI uses CW?PW between what

CW between AV/MV

4 qualitative assessments of RV S function

S' TAPSE FAC RIMP

TAPSE

tricuspid annular plane systolic excursion

FAC

fractional area change

4 grades of RV

normal mildly reduced moderately reduced severely reduced

if RV is hypokinetic it will most likely also be

dilated (reduced function = blood can't exit = chamber dilates)

RV S' normal

> or equal to 9.5cm/s

RV S' SV placed where

slightly apical to TV lat annulus

TAPSE tells us what distance annulus moves ___

up and down

TAPSE SV placed

TV annulus on outer edge of image

FAC is a comparison of ____ between ____ and ___

area change systole diastole

How to do FAC

trace endocardial border in A4C starting with IVS->apex->free wall->annulus->beginning one in diastole one in systole

FAC formula

= ((EDA-ESA) / EDA) x 100

normal FAC

> or equal to 35%

EDA/ESA means

end diastolic area end systolic area

LV response to high afterload

hypertrophy (thickening)

RV response to high afterload

hypertrophy and dilate

RV response to high preload

dilate

RV dilation = cause or worsen ___