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2. CARDIAC > CARDIAC Section 3: Valves > Flashcards

CARDIAC Section 3: Valves Flashcards

1
Q

What does this image demonstrate?

What’s the diagnosis?

A

Regurgitant jet in a Three chamber cardia MR still image

Aortic Regurgitation

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2
Q

What planes do you use to see the Stenotic/regurgitant Flow jets

A

Orthogonal planes

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3
Q

What is a set parameter of phase-contrast imaging used for quantifying the velocity of flowing blood?

A

Velocity-encoded cine MR (VENC)

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4
Q

In VENC, what happens if the velocity range is too low?

How should you set it?

A

You will get the classic ALIASING artifact

Select a velocity 20-25% highger than the expected maximum

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5
Q

Identify the valve

A

Aortic valve

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6
Q

What is the most SUPERIOR valve of the heart?

A

Pulmonic valve

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7
Q

What is the most ANTERIOR valve of the heart?

A

Tricuspid Valve

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8
Q

What’s above and What’s below?

A

Aortic above

Mitral belowW

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9
Q

What modality is the best first choice to look at the valveS?

A

ECHO

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10
Q

What MRI slices allow you to quantify the regurgitant volume?

When is it measured?

A

Transverse slices positioned at the valve - during diastole

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11
Q

What causes AORTIC STENOSIS?

A

Congenital - BISCUPID

Acquired - Degenerative or Rheumatic Heart

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12
Q

What cardiac condition is linked with increased afterload and concentric LV hypertrophy?

A

Aortic stenosis.

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13
Q

What imaging technique is used to quantify the velocity of blood flow in aortic stenosis?

A

Velocity-encoded cine MR imaging (VENC) or phase-contrast imaging.

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14
Q

What causes dilation of the ascending aorta in aortic stenosis?

A

Jet phenomenon related to a stenotic valve.

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15
Q

Name the three types of aortic stenosis.

A

Valvular, subvalvular, and supravalvular.

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16
Q

What syndrome is associated with supra-valvular aortic stenosis?

A

Williams Syndrome.

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17
Q

What condition is indicated by bicuspid aortic valve and coarctation?

A

Turner’s Syndrome.

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18
Q

What percentage of the general population is affected by bicuspid aortic valve?

A

Nearly 2%.

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19
Q

What is the most common congenital heart disease?

A

Bicuspid aortic valve.

20
Q

What is a significant complication of bicuspid aortic valve?

A

Aortic stenosis.

21
Q

What syndrome is associated with bicuspid aortic valve?

A

Cystic Medial Necrosis
Tuerners Syndrome
Coarctation
AD Polycystic Kidney Disease

22
Q

What is the most common Variant of Bicuspid Aortic Valve?

A

Type I Variant

23
Q

What is an independent risk factor of aortic aneurysm

A

Bicuspid Aortic Valve

24
Q

What are some causes of aortic regurgitation?

A

Bicuspid aortic valves, bacterial endocarditis, Marfan’s syndrome, hypertension-caused aortic root dilation, and aortic dissection.

25
Q

What determines the hemodynamic impact of aortic regurgitation?

A

The rapidity of onset.
“Austin Flint Murmur”

26
Q

What is the most common cause of mitral stenosis?

A

Rheumatic heart disease.

27
Q

What are some radiological signs of mitral stenosis on a chest X-ray?

A

Double density sign, splaying of the carina, posterior esophageal displacement, walking man sign

Basically LA cardiomegaly

28
Q

Name the three types of pulmonary stenosis.

A

Valvular, subvalvular, and supravalvular.

29
Q

What syndrome is associated with valvular pulmonary stenosis?

A

Noonan’s Syndrome

30
Q

What syndrome is associated with SUPRA-valvular pulmonary stenosis?

A

William’s Syndrome

31
Q

What syndrome is associated with SUBalvular pulmonary stenosis?

A

TOF

32
Q

What condition is commonly seen with Alagille syndrome?

A

Peripheral pulmonary stenosis.

33
Q

What is the primary complication following TOF repair?

A

Pulmonary regurgitation.

34
Q

What is crucial for timing the repair of pulmonary regurgitation?

A

Cardiac MRI, to assess RV dilation.

35
Q

What involves patch repari of the VSD and relief of the RV outlet obstruction?

A

TOF repair involves patch repair of the VSD and relief of the RV outlet obstruction.

36
Q

What is the most common form of tricuspid disease?

A

Tricuspid Regurgitation (weak annulus compared to mitral)

37
Q

What are some causes of tricuspid regurgitation?

A

Pulmonary arterial hypertension (MOST COMMON)
Endocarditis (especially in IV drug users),
Carcinoid syndrome (serotonin degrades the valve)

38
Q

What is the effect of tricuspid regurgitation on the right ventricle?

A

It causes RV dilation, not RV hypertrophy.

39
Q

What are the common vavles involved in Rheumatic heart disease?

A

MV
AV

40
Q

When there is Multivalve disease, think of?

A

Rheumatic Fever!

41
Q

What heart disease is an immune modulated response to Group A- Beta hemolytic strep?

A

Rheumatic Heart Disease

42
Q

What maternal factor is associated with Ebstein Anomaly in children?

A

Use of Lithium during pregnancy.

43
Q

Describe the cardiac abnormalities in Ebstein Anomaly.

A

Hypoplastic tricuspid valve, apically displaced posterior leaf (downward), enlarged right atrium, decreased right ventricle (“atrialized”), and tricuspid regurgitation.

44
Q

Diagnosis?

A

Ebstein Anomaly

45
Q

What effect does carcinoid syndrome have on heart valves?

A

It causes valvular disease, typically affecting the tricuspid and pulmonic valves, due to serotonin degrading the valves.

46
Q

When is left-sided valvular disease seen in carcinoid syndrome, and what are two scenarios to consider?

A

Left-sided disease is rare and suggests either a primary bronchial carcinoid or right-to-left cardiac shunts.

2. CARDIAC (13 decks)

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