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Adult Echocardiography > CHD Causing Stenosis/Regurgitation > Flashcards

CHD Causing Stenosis/Regurgitation Flashcards

1
Q

Which valvular stenosis is most commonly congenital (other 3 valves most commonly acquired)

A

PV stenosis

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2
Q

What is a bicuspid AV?

A

Typically fusion of RCC and LCC, with a resultant “2” cusps

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3
Q

What is the most common CHD found in adulthood?

A

Bicuspid AV?

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4
Q

Describe the murmur associated with a bicuspid AV

A

systolic ejection “click” right after S1

  • if there is associated AS, we would also hear systolic crescendo decrescendo murmur
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5
Q

Describe the motion of the 2 cusps of a bicuspid AV during the cardiac cycle

A

“doming” concave during systole

“hammock” convex during diastole

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6
Q

What would we see on M-Mode with a bicuspid AV?

A

Eccentric closure

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7
Q

Is AI or AS more commonly associated with a bicuspid AV?

A

AI is more common, but AS can occur

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8
Q

What is associated with bicuspid AV?

A

CoAo
Dilated Ao
Marfan’s syndrome (connective tissue disorder)

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9
Q

What is membranous subvalvular AS?

A

Membrane/ridge of tissue in the LVOT, near the AV causing LVOT obstruction

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10
Q

What might we see with subvalvular AS? (think LV and AV)

A

LVH (increased pressure)

Early systolic closure of AV (m-mode) from pressure changes

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11
Q

Is the AV normal or abnormal with isolated subvalvular AS?

A

Normal valve opening

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12
Q

What is supravalvular AS?

A

Narrowed AoR causing stenosis

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13
Q

Is supravalvular AS common?

A

No

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14
Q

What would a congenital cause of supravalvular AS be? What about acquired?

A

Congenital - William’s syndrome

Acquired - accumulated fibrous tissue/inflammation (ie. from takayasu arteritis)

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15
Q

Is the AV normal or abnormal with supravalvular AS?

A

Normal valve opening

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16
Q

Will the continuity equation be accurate when supravalvular or subvalvular AS is present? Why?

A

No because the AV is normal. The values would be a false representation of the stenosis because the stenosis is NOT caused by the AV itself

17
Q

What is AV prolapse? (AVP)

A

Downward displacement of the AV cusps below the AV/sinotubular junction

18
Q

What is AVP most commonly seen with?

A

Bicuspid AV

19
Q

What is associated with AVP?

A

AoR dilation, MVP, severe MR, perimembranous VSD

20
Q

What will 100% be seen with AVP?

A

AI

21
Q

What is a Cleft MV?

A

A division in the AMVL

22
Q

What is most commonly seen with a cleft MV?

A

Partial AVCD

*also seen with primum ASD

23
Q

Describe the motion of the AMVL of a cleft MV during diastole

A

“Doming” during diastole with no stenosis

24
Q

What results from a Cleft MV?

A

MR

25
Q

What is a Parachute MV?

A

One pap (usually only posteromedial) attaches to both sets of chordae

26
Q

What does Parachute MV present similar to?

A

MS

27
Q

What is a double orifice (outlet) MV

A

Accessory orifice - like 2 MV’s

28
Q

What does a double outlet MV cause?

A

Can be normal or result in MS or MR

29
Q

What is Cor Triatriatum?

A

Membrane across the mid LA that disrupts flow

Looks like a 3rd atrium

30
Q

What kind of MS can occur from Cor Triatriatum?

A

Supravalvular MS

31
Q

What does the presentation of Aor Triatriatum mimic?

A

It mimics MS with turbulence, increased PSV and PPV

32
Q

80% of those with Cor Triatriatum also have what?

A

ASD

33
Q

Is Cor Triatriatum more common in the LA or RA? What is it called when seen in the RA?

A

LA more common

Cor Triatriatum dexter if in RA

34
Q

What is Supravalvular MS (Ring)

A

A membrane or tissue thickening, at the level of the MV annuli causing an LVIT obstruction

35
Q

What is associated with Supravalvular (Ring) MS?

A

ASD
VSD
CoAo
Persistent LSVC
Shone Complex

36
Q

What is MV Prolapse? (MVP)

A

A prolapsing leaflet (doesn’t coapt properly) resulting in MR

**Usually congenital but doesn’t present until later in life

37
Q

What is Pulmonary Vein Stenosis? (PVS)

A

Narrowing of 1 or more PV’s at the entrance to the LA

38
Q

What does PVS cause?

A

PHTN (increased pulmonary pressures), resulting in RVH, RV + RA dilation

39
Q

What would we see on PW with PVS?

A

Increased S + D waves with flow reversal in between the systolic and diastolic flow

Adult Echocardiography (10 decks)

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