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Cardiovascular > Diagnostic approach - echocardiography > Flashcards

Diagnostic approach - echocardiography Flashcards

1
Q

What can you determine using echocardiography?

A

STRUCTURE: chamber size, valve structure, other lesions FUNCTION: systolic function, diastolic function, valve function, intracardiac pressures

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2
Q

What is echo the test of choice for?

A

Defining TYPE of heart disease

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3
Q

What is echo not the best test for?

A

Identifying HF

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4
Q

How are 2D images generated?

A

Fan-shaped beam of ultrasound Reflected waves are reconstructed (in real time) to produce tomographic image of the heart.

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5
Q

Define tomography

A

= imaging by sections using any kind of penetrating waves.

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6
Q

What are the types of echocardiography?

A

M Mode (motion mode, single point source) 2D (standard, fan shape) Colour Flow Doppler Spectral Doppler (velocity and direction of BF)

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7
Q

Describe M-mode echo. Use?

A

Basic method, good time resolution, standard way for measuring ventricular size. =distance-time graph

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8
Q

Outline 2D echo

A

Easiest to understand, therefore standard method. Image depends on where probe is pointing and the angle of the probe.

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9
Q

What is ‘BART’?

A

Acronym for understanding Colour Flow Doppler Echocardiography. Stands for: Blue Away from the transducer Red Towards the transducer (nothing to do with oxygenation, blood flow is superimposed on a B&W image)

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10
Q

What type of graph does a Spectral Doppler echo produce?

A

Velocity/time graph (i.e. velocity and timing of BF)

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11
Q

How to achieve the best echo images?

A

Most cats/dogs need no sedation. Best in lateral recumbency (air in dependent/underneath lung lobe is absorbed –> better image)

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12
Q

What view would this produce?

A

Right parasternal, long axis, 4 chamber (note the LV is a bullet-shape)

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13
Q

Define LVOT

A

Left Ventricular Outflow Tract

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14
Q

What view would this produce?

A

Right parasternal, long axis, LVOT (i.e. slightly rotated to the right parasternal, long axis, 4 chamber )

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15
Q

What is this image of?

A

Short axis, papillary muscles

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16
Q

What does this show?

A

Short axis mitral valve

17
Q

What does this show?

A

short axis left atrium/aortic valve

18
Q

T/F: mitral and aortic valve are in contact with each other

A

True (short axis, pulmonary artery echo view)

19
Q

What does this show?

A

left apical 4 chamber (note the characteristic LV bullet shape)

20
Q

What is LA enlargment a risk marker for?

A

Dogs - acquired heart disease Cats - cardiomyopathy Since it suggests increased LA pressure. Potential for CHF to follow with pulmonary oedema.

21
Q

What is the RV free wall thickness supposed to be?

A

1/3 the thickness of the LV free wall

22
Q

What measurements can be made on echo?

A

LA diameter: short axis LA/Ao (normal <1.6 in cats) LV: diameter and LV wall thickness (systole and diastole) LV systolic function (FS%)

23
Q

Describe the shape of a normalLA

A

square. As the LA enlarges, it becomes more rounded.

24
Q

What is FS%?

A

Fractional shortening % = the % change in LV diameter (i.e. an assessment of contractility). Equation: FS% =(LVDd - LVDs)/LVDd ]* 100

25
Q

What does a LV FS% of >55% suggest?

A

The LV is HYPERkinetic

26
Q

What does a LV FS% of

A

The LV is HYPOkinetic

27
Q

What characterises abnormal BF? 3

A

Direction Velocity Turbulence (On echo, green indicates abnormal BF)

28
Q

Causes of LA dilation - 3

A

VOLUME OVERLOAD: MVD, and L-R shunts SYSTOLIC DYSFUNCTION: DCM DIASTOLIC DYSFUNCTION: HCM

29
Q

Causes of LV dilation - 2

A

VOLUME OVERLOAD: MR, L-R shunts, AR SYSTOLIC DYSFUNCTION: DCM, chronic volume overload

30
Q

Causes of LV hypertrophy - 2

A

PRESSURE OVERLOAD: aortic stenosis, systemic hypertension IDIOPATHIC: HCM

31
Q

Causes of mitral valve abnormalities

A

Myxomatous valve disease (–> eccentric hypertrophy)

32
Q

Cause of aortic valve abnormality

A

Endocarditis

33
Q

Causes of RV hypertrophy - 2

A

PRESSURE OVERLOAD: pulmonic stenosis or pulmonary hypertension (can’t differentiate these with echo images)

34
Q

Most likely diagnosis?

A

MVD

35
Q

Most likely diagnosis?

A

DCM

36
Q

Most likely diagnosis?

A

Pericardial effusion (free fluid is also present on the other side of the pericardium)

37
Q

Define cardiac tamponade

A

Pressure on the heart that occurs when blood/other fluid builds up in the space between the myocardium and the pericardium.

Cardiovascular (22 decks)

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