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Cardio > Echo > Flashcards

Echo Flashcards

1
Q

Normal LV dimensions

A

40/60-2

35/50+2

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2
Q

Normal LA size in Plax and A4C

A

4and 5.2

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3
Q

PAH formulas for Mean PAP

A
  1. 79-(0.45xAcclrn time)
  2. 4V2 PEAK PR+ RAP
  3. VTI of TR jet +RAP
  4. 90- 0.62 x Acclrn time
  5. Mean = 2/3 PADP+1/3 PASP
  6. 0.61 x PASP +2

Rough estimate-80-(0.5xAT)

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4
Q

In acute MR echo precaution..

A

Can have misleadingly small central jets

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5
Q

Venae contracta width reflects the

A

ROA

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6
Q

How to look for VCW

A

PLAX or A4C:: (40-70 cm/s-Nyquist limit)

For PISA 15-40

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7
Q

How to do PISA

A
  1. A4C view
  2. 15-40 cm/s - Nyquist limit
  3. Midsystole
  4. Find PISA radius
  5. Now measure MR VTI
  6. Machine will give EROA;

Later calculate Regurgitant Vol somehow 😬😬
EROA-most robust parameter

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8
Q

PASP from TR jet probability of PAH

A

Upto 2.8 m/s -Low probability

  1. 5m/s or more-High probability
  2. 9 -3.4 - intermediate probability

Gradient values corresponding is 31 (2.8)and 49 (3.5)without RAP

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9
Q

In Afib how many beats are to be taken to get average RVSP

A

8 beats

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10
Q

In presence of RVOT obstruction or PS how can u use TR jet to assess PASP?

A

Minus the RVOT gradient from the TR gradient

ie TR gradient - RVOT gradient

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11
Q

Faster the heart rate –—–the frame rate for assessing Regurgitant jets

A

Higher

Min frame rate required is 20

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12
Q

Doppler sweep speed for assessing PR/TR jets

A

100 mm/s

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13
Q

RVOT acclrn time and PAH

A

> 130 ms is normal
<100 highly suggestive of PAH

CAN calculate MEAN pressure from AT

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14
Q

In ebsteins the displacement index is

A

More than8 mm/m2 ie per BSA

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15
Q

How to demonstrate LEFT SVC in TTE

A

Agitated saline injection through LEFT antecubital vein

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16
Q

Severe biatrial enlargement is seen in RCM or CP?

A

In RCM

In CP Bi atrial enlargement is moderate

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17
Q

Type of delivery preferred in Pregnancy and heart disease

A

Vaginal delivery:Minimise Valsalva-ie “Cardiac delivery “

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18
Q

Velocity of PW at Pulmonary valve level

A

0.8-1.2 m/s

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19
Q

Normal PV acceleration time

A

More than 130 ms

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20
Q

PV Acceleration time of —- indicates severe PAH

A

Less than 80 ms

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21
Q

Grading of PAH by PASP

A

Mild >40
Moderate >50
Severe > 60

From 1,2,3 sonography

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22
Q

Familial RCMP is a different phenotypic expression of

A

Familial HCM 😳

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23
Q

Deceleration time in Gd3DD

A

Less than 140 ms

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24
Q

Echo clues of Sarcoidosis

A

1.BASAL LV abnormalities- RWMA in basal post, lat segments

LV aneurysms mostly basal

  1. Septal thinning; Hyperechoic septum
  2. May resemble HCM
  3. RV dilatation, hypokinesis
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25
Q

Initial test for Primary Aldosteronism

A

PAC/PRA ratio

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26
Q

A condition where there is dissociation between Short and long axis systolic function

A

Amyloid cardiomyopathy

Do strain rate imaging

Long axis dysfunction is far greater than in HCM, Aortic stenosis etc

Severe impairment of basal strain with preserved Apical strain is typical of Amyloidosis

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27
Q

Sparkling myocardium is seen in —% of Amyloid cardiomyopathy

A

30% only

Specificity only 75%

Atrial septal thickening is a feature of Amyloidosis- addln point

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28
Q

Paradoxical septal motion means

A

SYSTOLIC movt of IVS towards RV

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29
Q

Paradoxical septal motion and PR

A

Simple sign of SEVERE PR

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30
Q

PHT of ____ms indicates significant PR

A

< 100 ms

From a PPT

31
Q

In A4C AML is located near

A

SEPTUM

PML is located at the lateral annulus

ASS-Anterior leaflet near Septum-ASs

32
Q

Normal thickness of Mitral valve

A

4-5 mm

33
Q

Score of 2 in Wilkins score means

A

Only upto 1/3 rd is involved

M- mid and base moves well ; distal 1/3 rd affected

S- upto 1/3 rd of chordae involved

C- upto 1/3rd of leaflet. If it extends to mid it becomes next grade

T- upto 1/3 rd is thickened.

No 0 score in Wilkins. Min score is 4

34
Q

Score 3 of Wilkins is

A 
Involvement of middle 1/3 rd or more
M- mid doesn't move
S- mid and more
C- mid and more
T- is different, entire valve 5-8 mm

Score 4 is entire valve involved
Score 1 is near normal
Score 2 is upto 1/3 involved

35
Q

RA finding in tamponade

A

RA Systolic collapse more than 1/3 rd of Systole . Collapse starts in End diastole

Highly sensitive and specific

Transient RA collapse can occur without tamponade

RV collapse starts in early diastole

36
Q

Doppler finding in tamponade

A

> 25% variation in Mitral E velocity

An inspiratory reduction of at least 25%

37
Q

Collapse in Cardiac tamponade

A

Late diastolic RA &

Early diastolic RV

38
Q

Hepatic vein Doppler in Constriction and Restriction

A

Constriction- Expiratory diastolic flow reversal

Restriction - Inspiratory diastolic flow reversal

39
Q

Normal respiratory variation in tricuspid,Mitral inflows and Pulmonary, Aortic outflows

A

Tricuspid-25% or less
Mitral-15% or less
Aortic and Pulmonary-10% or less

40
Q

The diastolic collapse of RA/RV free walls is more during

A

Expiration

41
Q

Fluid required for Pericardial effusion to be evident on CXR

A

400-500 ml

42
Q

Tricuspid annular systolic motion velocity < …….is abnormal

A

10cm/s

43
Q

PSAX- RCA is seen at ——-position and LCx at ———/

A

RCA -11 O clock in 45% - rest nearby
LCA- 4 O clock in around 45% -rest nearby.

So roughly 11 and 4

44
Q

Nagueh formula

A

1.24 x e/e’(septal+lateral/2) + 1.9

<8 normal
>15 elevated filling pressure
8-15 - grey zone

45
Q

MPA is measured at

A

Bifurcation level below Pulm Valve or at RPA level

2.2 cm is DILATED

46
Q

Normal LA size AP dimensions

A

Max 3.8 /4 : females/ males respective

ASE 2015 Guidelines

M mode or 2D same value

47
Q

LA length is also known as———/ And is measured from ———-to ——-

A

Major dimension

Mitral annulus level to LA ceiling

LA minor dimension is from lateral wall to IAS

Both in A4C view

RA major and minor also similarly

48
Q

RV inflow view will show ———-and ———— walls of RV

A

Anterior and Inferior

49
Q

RV dimension at its base is measured in which view

A

RV focused view from Apex

50
Q

RA volume upper limit ASE 2015

A

33 and 39 ml/ m2 ::female/ male

51
Q

RV size values -abnormal is

A

MORE THAN 41/35/86

Prox/Dist- 33/27

52
Q

RV measurement in ARVD is at

A

RVOT Prox in PLAX

53
Q

RV size versus LV size Qualitative evaln

A

Normal RV-< 2/3 of LV
MODERATE: RV > LV
SEVERE: when RV forms apex

54
Q

Maximum normal RV wall thickness is

A

5 mm

ASE 2015

55
Q

Minimum TAPSE in a normal RV

A

17 mm

56
Q

Minimum S’ of normal RV is

A

9.5 cm/s.

Less than this is abnormal

57
Q

Minimum RV FAC in a normal RV

A

35%

Less than this is abnormal

If u take RVEF(3D)- it’s 45%

2015

58
Q

Abnormal MPI of RV is

A

> 0.43 by PW (TR jet required). or Use RVOT ejection time separately

             OR > 0.54 by Tissue Doppler

ASE 2015

59
Q

MPI is (Myocardial Performance Index) ratio of

A

Isovolumic time to Ejection time

60
Q

Abnormal RV E/e’ is

A

MORE THAN 6

61
Q

PE echo findings are seen ——-% of PE patients

A

30-40%

62
Q

60/60 sign means

A

RVSP < 60 by TR jet. (Untrained RV cannot acutely generate high pressures)

PA acceleration time < 60 msec ( ends fast because of high impedance)

63
Q

RA pressure from IVC ,; numbers to remember

A

2.1, 50%, 3,8,15

64
Q

Mild / Mod/ Severe PAH classfn

A

No clear recommendation /data for same

35/50/70 used by many

65
Q

Inverted T sign in Echo is used to differentiate——from ——-

A

IWMI from PE

66
Q

LA normal dimensions

A

AP view-3.8/4.00 female/male

LA biplane vol- 34ml/m2 or less

67
Q

Normal RA size

A

Major axis-M/F- 2.8/2.7 cm/ m2
Minor axis- M/F- 2.2 cm/m2

RA volume single plane-M/F- 27/32ml/m2

ASE 2015

68
Q

Why TEE should not be used for LA size

A

Entire LA cannot be seen in TEE

69
Q

LA should be measured at end of

A

LV systole

70
Q

Precautions while measuring LA size

A

Base of LA should be at its largest size.
LA length should be maximized
And take the Mitral annulus plane and not Mitral leaflets

For biplane difference in length in 2 views should be less than 5 mm. Shortest of the two is taken

No use doing LA area . Go for Volume . But LA area is more representative than AP only

71
Q

Difference between LA volume single and biplane

A

Single is lower by 1-2 ml/m2

72
Q

LA max size in A4C

A

Major- 52/54 female/male
Minor- 44/43

2015 -ACCHA

N.B- rounded off values

73
Q

Diastolic dysfunction echo parameters-2016 ASE guidelines

A

e’-7/10; E/e’-14;TR-2.8,LA-34 ml/m2

For patients with normal LV

For those with reduced EF/ or with DD to grade DD-
Use the last 3 parameters - to identify whether Gd1or 2or cannot determine
Before that do E/A-<=0.8/50cm/s; is Gd1 >=2 is Gd3.
To grade it from 1-3

74
Q

LA volume formula - biplane area length method

A

A1xA2x 0.85 /L

Cardio (36 decks)

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