Assessment of Ventricular Function Flashcards
what is systolic dysfunction
the inability of the lV to contract properly
S dysfunction is usally due to
coronary artery disease
S dysfunction = ___ SV, ____ EF
decrease x2
S dysf. can lead to ____
CHF
CHF is the back up of blood behind the chamber due to its ability to contract and move blood forward = chamber ____
dilates
depolarization (ECG/when it occurs in reference to valves)
QRS
IVCT
contraction ECG
QT segment
ejection (ECG/when it occurs in reference to valves)
ST segment
AV opening to closure
visual wall motion can use a ____ or ____ approach
segmental
global
normal systolic function implies the heart muscle moves _____ and ____ during systole
inward
thickens
5 ways to describe wall motion
hyperkinetic
normal
hypokinetic
akinetic
dyskinetic
hyperkinesis (what/seen with(5))
excessive wall motion
may be seen with high preload, severe valvular regurg, fever, trauma
hypokinesis (what/may be seen with (3))
motion/wall thickening reduced
CAD, CMO, long standing valve disease
CAD
coronary arterial disease
CMO
cardiomyopathy
akinesis (what/may be seen with (2))
no thickening, may have motion is tethered to moving segmetn
MI, Viral CMO
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
8 quantitative systolic measurements
SV/CO/CI
FS/EF
strain
dP/dt
MPI
end diastole (IV__T) meaure when on ECH
C
QRS
end systole (IV__T) measured when on ECG
R
end of T wave
MV/TV measured when LV dimension = __
big
AV/PV measure when LV dimension= ____ and it is the frame ____
smallest
before MV opening
2 formulas for SV
SV= EDV-ESV
SV= CSAxVTI
CSA formula
CSA = 0.785 x D^2
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 ___
TR
