Diastolic Dysfuntion

Question 1

What are the 4 phases of diastole in order?

Answer 1

1. IVRT (right before E wave) < 100ms
2. Early Filling ( E wave)
3. Diastasis
4. Atrial Contraction ( A wave)

Question 2

A majority of ventricular filling occurs during?

Answer 2

The first 3rd of diastole

Question 3

What are the 3 abnormal filling patterns?

Answer 3

1. Abnormal relaxation
2. Pusedonormal
3. Restrictive

Question 4

Which represents IVRT?

1. After the a wave
2. Closure of the MV, opening of the AV
3. Opening of the MV, closing of the AV

Answer 4

3. MV opens as AV closes to allow for diastolic filling

Question 5

Which represents IVCT?

1. After the E wave
2. Closure of the MV, opening of the AV
3. Opening of the MV, closing of the AV

Answer 5

2. MV closes, as AV opens

Question 6

If a patient has a normal MV inflow, but a decreased S & D wave is the pulmonary veins what should you consider?

Answer 6

They may have a pseudo normal filling pattern

Question 7

In elderly patients > ____ the A wave is normally ___ to or higher than the ____ wave.

Answer 7

60; equal ; E

Question 8

What does an abnormal relaxation filling pattern look like?

Answer 8

Blunted E wave. Normal A.

Question 9

What does an pseudonormal filling pattern look like?

Answer 9

It looks normal. Regular E wave, regular A wave.

Question 10

What does an restrictive filling pattern look like?

Answer 10

High narrow E wave, small A wave

Question 11

For the MV inflow what chamber should you do your Doppler

Answer 11

4ch

Question 12

For the MV inflow what chamber should you do your Doppler

Answer 12

4ch

Question 13

For MV inflow you should use ____ Doppler, ____ frequency and ___ gain.

Answer 13

PW ; low ; low

Question 14

For MV inflow what should your sample volume size be?

Answer 14

<2mm

Question 15

For MV inflow where should you place your Doppler?

Answer 15

At leaflets tips

Question 16

For pulmonary veins what chamber should you Doppler them?

Answer 16

Ap4

Question 17

For pulmonary veins inflow you should use ____ Doppler, ____ frequency and ___ gain.

Answer 17

PW ; low ; low

Question 18

Where should sample volume be for your pulmonary veins ?

Answer 18

3-4mm

Question 19

How far should you place your Doppler into the pulmonary veins?

Answer 19

1-2cm

Question 20

How would you determine if a patient has a constrictive verses restrictive disease?

1.2D strain imaging
2. pulmonary venous flow
3. MV inflow with respiration variation
4. TV inflow with respiration variation

Answer 20

3. MV inflow with respiration variation

Question 21

In constrictive pericarditis does the E wave increase or decrease with inspiration?

Answer 21

Decrease

Question 22

With constrictive pericarditis the waveform will look similar to the ____ waveform. However the only difference is the E wave will ___ with inspiration while the restrictive waveform will stay the same with inspiration.

Answer 22

Restrictive ; decrease