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2nd Year Echo > Case Study Format and Analysis > Flashcards

Case Study Format and Analysis Flashcards

1
Q

What is the first step in analysis ( before and after the collation of dimensions, doppler values and other observations)?

A

Read the Clinical Overview / History and/or presentation for this particular patient.

  • Do this before gathering the information from the exam. *Do this again before committing to any comments.
  • Do this again to be certain your evaluation fits the patient presentation.
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2
Q

What is the first question regarding M-Mode?

A

Is this a complete or incomplete M-Mode?

A complete M-Mode consists of the Ao/LA, the Mitral Valve and the Left Ventricle motion and dimensions.

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3
Q

What are the questions to be answered in M-Mode regarding the Ao?

A

Ao size? (normal, dilated, aneurysmal)
Ao wall thickness? (normal, thickened)
Ao root motion? (normal, increased or decreased)
-any abnormalities regarding the Ao, such as aneurysm or dissection.

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4
Q

What are the questions to be answered in M-Mode regarding the Ao Valve?

A

Ao valve motion?
Cusp thickness?
Closure line?
Any visible fluttering?

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5
Q

What are the questions to be answered in M-Mode regarding the Mitral valve?

A 
Mitral valve motion?
Mitral leaflet excursion?
What is the EPSS?
Any early or premature closure of the leaflets?
Any fluttering of the MV leaflets?
Is there any MAC?
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6
Q

What are the questions to be answered in M-Mode regarding the Left Ventricle?

A 
LV size? 
Wall motion?
Any septal wall motion abnormalities?
RVOT dimension?
Any LVH
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7
Q

What is the format for 2D comments?

A 
Chambers
Valves
Vessels
Pericardial/Pleural Effusions?
Mass, Thrombus, Vegetations?
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8
Q

What are the questions to be answered for 2D comments regarding the LV?

A 
LV size
LV shape
Wall thickness
Wall motion
LVOT size
Overall LV performance (EF)
Any abnormalities, aneurysm, scarring, thinning?
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9
Q

What are the questions to be answered for 2D comments regarding the LA/IAS?

A

LA size and appearance
LA function
IAS appearance
IAS motion

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10
Q

What are the questions to be answered for 2D comments regarding the RV?

A 
RV size
RV shape
RV wall thickness
RV wall motion
RV function (TAPSE)
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11
Q

What are the questions to be answered in M-Mode regarding the RV performance?

A

TAPSE

NL: 16-28mm

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12
Q

What are the questions to be answered for 2D comments regarding the RA?

A

RA size

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13
Q

What are the questions to be answered for 2D comments regarding all valves?

A

For all valves, be certain to comment on the supporting apparatus, including annulus, cusps, commissures, chordae,etc.

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14
Q

What are the questions to be answered for 2D comments regarding Ao valve?

A 
valve appearance
valve motion
cusp thickness
closure line
commissures
any abnormalities
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15
Q

What are the questions to be answered for 2D comments regarding the MV valve?

A 
MV valve appearance
leaflet excursion
leaflet thickness
valve annulus
chordae
coaptation
pap muscles
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16
Q

What are the questions to be answered for 2D comments regarding the Tricuspid valve?

A 
TV valve appearance
leaflet excursion
leaflet thickness
valve annulus
chordae
coaptation
pap muscles
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17
Q

What are the questions to be answered for 2D comments regarding the Pulmonic valve?

A 
PV valve appearance
leaflet excursion
leaflet thickness
valve annulus
M-Mode of leaflet motion?
18
Q

What are the questions to be answered for 2D comments for the Great Vessels, which vessels are to be addressed?

A 
Aorta, ascending, transverse, descending (thoracic) abdominal. 
Pulmonary Artery (including left and right branches)
IVC and SVC
19
Q

What are the questions to be answered for 2D comments for the Aorta?

A 
Ao size
Abnormal motion or lack of motion
wall thickness
sinuses of Valsalva
Sinotubular Junction
evidence of aneurysm
evidence of dissection
evidence of coarctation
20
Q

What are the questions to be answered for 2D comments for the PA?

A

Pa size
Vessel diameter
Wall thickness
Branch diameters

21
Q

What are the questions to be answered for 2D comments for Pericardial Effusions or Pleural Effusions?

A

Location
Size
Grade of severity
Any evidence of tamponade

22
Q

What are the questions to be answered for 2D comments for Mass/Thrombus/Vegetations?

A

Location
Size
Shape
Motion

23
Q

What are the questions to be answered for 2D comments for the IVC?

A

IVC diameter
Wall thickness
Collapse on Inspiration

24
Q

What is the purpose for Color Flow?

A

To evaluate blood flow across all valves, verifying laminar flow or identifying and qualifying turbulent and abnormal flow.

25
Q

Regarding color flow, in addition to flow across valves, where else do you evaluate flow with color?

A 
LVOT
RVOT
Great vessels
Apical regions of ventricles
IVC and Hepatics
Pulmonary Veins
26
Q

What critical measurement uses color flow to quantify regurgitation?

A

PISA

Proximal Isovelocity Area

27
Q

What are the questions to be answered with Doppler?

A 
Velocities and PG across all valves
(normal, increased, decreased)
What do abnormal findings indicate?
Valve Areas, grade of stenosic lesion
Evidence of regurgitation
Evidence of PTHN
Cardiac filling pressures
LV Diastolic function
28
Q

What is the equation to determine PG across a valve?

A

4(velocity2)=mmHg

29
Q

What is the equation for determining valve area?

A

CSA (lvot) X VTI (lvot) / MV VTI = cm2

30
Q

What is the equation for RVSP?

A

4(TR velocity2) + RAP

31
Q

What is the equation for MPAP utilizing the rvot accel time?

A

80-(0.5 x rvot accel time) = mmHg

32
Q

What is the equation for ERO?

A

effective regurgitant orifice
concept: regurgitant flow rate/regurge peak velocity
equation (MR):
6.28 X r2 X aliasing velocity/MR peak velocity

33
Q

What is the equation for LAP?

A

E/eā€™ x 1.25 + 1.9 = mmHg

34
Q

What is the equation for PVR?

A

TR Velocity/ RVOT VTI x 10 +0.16 = WU

35
Q

What is the equation for PAEDP?

A

4(PR-end diastolic velocity2)+RAP = mmHg

36
Q

What is the equation for Mean PG?

A

2.4(velocity2)=mmHg

37
Q

What is the equation for the Dimensionless Valve Index?

A

LVOT velocity/ Ao velocity = DVI

DVI <25 indicates stenosis

38
Q

What is the equation for MPAP utilizing the PR velocity?

A

4 x (PR velocity2) = mmHg

39
Q

What are the two ways to calculate MPAP and what pressure is this also estimating?

A

80 - (0.5 rvot accel time) = mmHg
4 x ( PR peak velocity2) = mmHg
pulmonary wedge pressure

40
Q

What are the grades of aortic regurgitation based on Vena Contracta?

A 
<3mm = Mild
4-5mm = Moderte
6mm = Severe
41
Q

What are the grades of aortic regurgitation based on Pisa Radius?

A

10mm = Severe

2nd Year Echo (9 decks)

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