Diastolic dysfunction

Question 1

When does diastole occur in EKG

Answer 1

Between onset of T-wave and QRS complex

Question 2

What are the four stages of diastole?

Answer 2

1) IVRT
2) Early LV filling (passive)
3) Diastasis
4) Late LV filling (atrial contraction)

Question 3

Which phases of diastole do the E and A waves correspond to?

Answer 3

E - early LV filling

A - late LV filling from atrial contraction

Question 4

Name the waves of PV flow?

Answer 4

S - systolic; D - diastolic; A - atrial contraction

Question 5

What are the three diastolic patterns? What are the mitral inflow and pulmonary vein flow characteristics of each?

Answer 5

1) Normal (E>A, S>D)
2) Impaired relaxation (ED)
3) Pseudonormal (E>A, S>A)

Question 6

How does the deceleration time differ between normal and pseudonormal patterns?

Answer 6

Shorter deceleration time in pseudonormal.

Question 7

Name two situation where E/A ratios are not reliable?

Answer 7

1) Afib

2) MV disease

Question 8

What does the E/e’ ratio denote?

Answer 8

Estimate of LV filling pressure. E/e’ <8 is normal.

Question 9

Where is the best location to measure e’?

Answer 9

Laterally at mitral annulus