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ECHO > Echo bit of everything > Flashcards

Echo bit of everything Flashcards

1
Q

Pulsus Paradoxus

A

During INSPIRATION the RV shift the IVS towards the LV in diastole
During EXPIRATION the LV shift the IVS towards the RV

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2
Q

DX

A

Penetrating Ulcer

It’s an atherosclerotic ulcer that penetrated the intima tunica until rich the media tunica

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3
Q

Echo free space Anterior to Descending aorta, is called?

A

Pericalrdial effusion

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4
Q

DX

A

Pericarditis

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5
Q

DX

A

Apical HCMP

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6
Q

DX

A

Dilated Cardiomyopathy or
LBBB

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7
Q

Firts thing to evaluated in dilated Cardiomyophaty

A

Systolic function

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8
Q

How to know if the patient has a intrapulmonary shunt after contrast study?

A

If the bubbles appers in the LA and LV after 5 beast (counting from the full oapcification of the RA and RV)

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9
Q

Small pocket of Pericardium surrounding the great arteries posterioly

A

the transvers sinus

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10
Q

DX

A

Restricitve CDP

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11
Q

When could it be considered an atrial spetal aneurysms?

A

if the bulge is more than 1 cm

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12
Q

Does high output power destroid the microbubles?

A

yes, so careful adjustmen of instrument power O is needed during contrast study.

Usually MEchanical index aboit 0,5

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13
Q

Early Echo sing of Tamponade?

A

Right atrial Systolic collapse

Ealy sign because the right atrial has the lowets pressure

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14
Q

How to know if the patient has a intracardiac shunt after contrast study?

A

If the bubbles appers in the LA and LV before 3 beast

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15
Q

When the term Aneurysm is used on the Aorta?

A

when the dilatation of the aorta Exceeds the expected diameter by 50% or more

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16
Q

What are the most cause of death from Aortic Aneurysms?

A

Dissection and Ruptures

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17
Q

B bump indicated:

A

Systolic Disfunction:
Dilated cardiomyopathy

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18
Q

Echo finding on Cardiac Tamponade

A

-RA systolic collapse greater than one-third of systole
-RV diastoly collapse
-Severe IVC dilatation
-Reciprocal Respiratoy changes >25% in RV and LV filling
-Reciprocal respiratory changes in RV and LV volumen (septal Shifting)
-Reduce E’ in TDI

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19
Q

Classification of HOCM?

A

not obstructive, PG < 30mmhg
Obstuctive, PG > 30mmhhg
Provacate or latent, PG <30mmhg but the obstruction occurs just with excercise

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20
Q

what can it cause a Sweinging Heart? and is it demostrated in ECG

A

Large pericardial E.

In ECG, there is an alternation of QRS. one high and another small.

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21
Q

Vessels tha supply bood to the vessel?

A

Vaso Vasorum vessel

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22
Q

DX

A

RA Systole Collapse more than one-third of systole. Cardiac Tamponade

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23
Q

DX

A
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24
Q

DX

A

SAM

Preture closure of the mitral valve. and it looks like subvalvular aortic but at the end of the signal opens a bit more

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25
Q

Can pericarditis be diagnosed just with ECho?

A

Not, it a clinical DX
Echo is looking for effusion, tamponade or thickening of the pericqrdium

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26
Q

Contraindication of contrast study?

A

Hypersensitivity to contrast agent or ingredients

It’s the only contraindication

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27
Q

DX

A

RV diastole collapase. Cardiac Tamponade

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28
Q

What are the BLIND SPOT of the Aorta in TTE?

A

Distal part of the Ao
Anterior part of the Arch

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29
Q

DX

A

Sinus of Valvasa Aneurysms on TEE

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30
Q

Types of Contrast Agent

A

Agitated Saline (right Heart)
Microbubles (LV and miocadial opacification)

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31
Q

DX

A

Cardiac Amyloidosis

symmetrci LV hyperttophy and it looks like speckel

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32
Q

DX

A

Aortic Arch Dissection

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33
Q

The echo contrast is mainly used for evaluation of what orifice in the atrial?

A

ostium secundum

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34
Q

DX

A

Pulsus alternans
Indicated Systolic disfunction

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35
Q

Name of th sign and DX

A

Cobweb sign

aortic dissection, the cobweb is always pointing towards the false lumen

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36
Q

Typical findings in marfan syndrome?

A

Effacement of the Sinotubular junction
Dilated Ao
MR
LV Enlargment

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37
Q

DX

A

Dinamic obstruction
SAM
Dagger Shaped

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38
Q

how many bubbles do you have to see when using Agitated SC in order to be severe?

A

1 - 9 small
10- 30 moderated
>30 SEVERE

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39
Q

DX

A

Intramural Hematoma

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40
Q

DX

A

Restrictive CDP

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41
Q

If there is a bulge in the Atrial septal lees than 1 cm, how is it called?

A

Redundant Atrial Septum

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42
Q

DX

A

HTN .: Findings
1- LV Hypertrophy
2- AV Sclerosis
3- Calcificated MV
4- Ao dilatation

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43
Q

Effacement of the sinutubular junction is characteristis of:

A

Marfan syndrome

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44
Q

Does the Micarobubles (Agent contrats) have a lower impidence than the blood

A

true

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45
Q

DX

A

Systoly disfunction
Decrease on Anteroo-posterio movement of the Aortic root
Premature clusure of the AV

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46
Q

DX

A

Left Ventricle non compaction cardiomyopathy

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47
Q

DX

A

Intramural Hematoma. it’s demostrated as a thick wall betwwen the lumen of the vessel and the brignnes of the adventicia tunica on the botton

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48
Q

Autoinmune system responde causing pericarditis after damage to a hear tissue?

Also called, Post Miocardial Infarctation Syndrome

A

Dressler’s Syndorme

49
Q

Name of the effects that creates SAM

A

Drag Effect or Venturi Effect

50
Q

The Reciprocal Respiratory changes in volumen is Known as:

A

Pulsus Paradoxus

51
Q

most common cause of Atrial enlargment?

A

HTN

52
Q

DX

A

Mid LVOT obstruction (lobster signal)

53
Q

how differenciate between Ascites and pericardial Effusion?

A

the Falciform ligamente is floating in ascites

54
Q

Measurements of the aorta are made at:

A

End diastole, inner edge to inner edge

55
Q

DX

A

Eustacian valve. localized superior to the IVC

56
Q

Dx

A

Stranding in purulent effusion

57
Q

Sign of Aortic Dissection?

A

Ao dilatation
Ao regurgitation
Pericardial Effusion
A new regional wall motion abnormality

58
Q

Most sensitive Echo finding in Cardiac Tamponade?

A

IVC dilated
(whiout it, there is not cardiac Tamponade)

59
Q

indicates hemorrghe, malignat etiology or infamatory desiase

A

Stranding

often seeing in infected pericardiatis

60
Q

Name of the Cardiomyphathy produced by strees

A

TAKOTSUBO cardiomyopathy
or octopus

61
Q

Debakey Aortic Dissection Classification?

A

Tipe I: includes ascending, Arch and Descending

Tipe II: includes Just the ascending Aorta

Tipe III: includes just the Descending Aorta

62
Q

Atherosclerosis of the Aorta may lead to:

A

Dilatation
Aneurysm
Dissection

63
Q

how much is the normal pericardial Fluid?

A

5 to 10 ml between Visceral and Parietal pericardium

64
Q

Causes of Aortic Dilatation?

A

HTN
BIcuspid Valve
Marfan Syndrome

65
Q

Dilated cardiomyopathy is known as:

A

HFrEF: hear failure with reduced ejection fraction

IT is a systolic failure

66
Q

What is this?

A

Coumadin Ridge, is part of the LA that lies between the LA appendage and the Left superior pulmonary vein

67
Q

DX

A

SAM

“it may look like Late systolic hammocking but the C-D slope in Sam goes up and in late systolic H just goes down@

68
Q

DX

A

Thoracic Aortic Aneurysms

69
Q

Stanford Classificacion of Aorta Dissection?

A

Stanford A: Just the Ascending but may propagates to the arch and the descending Ao

Stanford B: Just Descending Ao

70
Q

What is the best view to evaluated Pericardial Effusion?

A

Subcostal view
PF could be evaluated in
4CV
PSAX
Subcostal view (best one)

71
Q

DX

A

Atrial spetal aneurysms

72
Q

Characteristic of Constrictive Pericarditis

A

Impared Diastolic filling
Early diastolic Filling is rapid which leads E/A radio >2
Grade 3 diastole disfunction (restrictie pattern but with normal E’)
Normal E’ but E wave bigger than A wave like in patient with Super nomal filling

73
Q

Increasing in the pericardial Pressure excciding the cardiac pressure chambers without IVC dilatation

A

Tamponade physiology

74
Q

Acumulation of cell or proteins in the myocardial will lead to:

A

Restrictive CDP
Amyloidosis
Sarcoidosis
Hemocromatosis
Scleroderma

75
Q

Severity of the Pericardial Effusion?

A

Small PF <0,5cm
Moderate PF 0,5 to 2 cm
Severe PF >2cm

76
Q

Characteristic of True lumen in Ao dissection?

A

Concave
Large in Ascending and Aortic Root
Small is Descending Ao
never has a coweb
Rare formation of thrombus
The true lumen expand in systole

77
Q

DX

A

Pericardial Cist

78
Q

Hypotension, decrease in the CO and pericardial pressure above cardiac chambers pressure, with dilation of the IVC

A

Cardiac Tamponade

79
Q

Explain this image

A

Reciporcal variation changes during diastole in LV inflow

during experiation the lv inflow and the lvot outflow decreases while the rv inflow and pulmonary inflow increases.

Pulsus paradoxus.

80
Q

Echo free space posterior to Descending Aorta, is called?

A

Pleural effusion

81
Q

Microbables contrast agent size

A

5 micros

82
Q

Characteristic of False lumen in Ao Dissection?

A

Convex
Small in Ascending and Aortic Root
Larger in Descending Ao
Cobweb 100%
Higt risk of Thrombus
the false lumen compress in systole

83
Q

DX

A

Pulsus Paradoxus, Cardiac Tamponade

84
Q

Excessive Bublle Destruction in the near field. (Apex) during contraste study

A

SWIRLING
Solution:
Decrease MI
Increase contrast dose
MOVe the focus

85
Q

The physiologic consecuences of fluid in the pericardial space depend on:

A

the volume
Th rate of fluid accumulation (time)

86
Q

How much the respiratory Variation in diastolic filling has to be in order to be considerate Cardiac Tamponade?

A

> 25%

87
Q

Autoinmune Tissue Disorder that can cause aneurysms of the Ao and it’s characterized by Effacement of the sinutubular junction and enlargment of the sinusus of Valvasa, in adition to Dilation of the Ao. is called?

A

Marfan Syndrome

88
Q

Dessises of the Aorta?

A

Dilatation
Aneurysmsn
dissection of the aorta
Intramural Hematoma
Penetraring Ulcer

89
Q

Name the anatomy

A
90
Q

DX

A

Restrictive Cardiomyopathy

91
Q

DX

A

Contrast study showing Apical Hypertrophy C

92
Q

Common feature of all Hypertophy CMP patterns?

A

Normal thickness of the Basal Posterios Lv Wall

93
Q

DX

A

Dilated coronary sinus

94
Q

DX

A

LV non-compacted miocardial with contrast

95
Q

Pattern and Degree of the Hypertrophy Cardiomyopathy? classification

A

Septal or sigmoidel predominat
Reversal Septal contour
Apical HCM
Neutral HCM

96
Q

Pandiastolic Filling Restriction?

A

Tamponade
The blood goes during the whole diaslote

97
Q

DX

A

Mind and apical Hypertrophy with Aneurysm

98
Q

Biphasic Filling Restriction?

A

Constrictive Pericarditis

99
Q

DX

A

Subvalvular Aortic Stenosis. look how the leaflet flutter

100
Q

What are the Differential Diagnosis of HCMP?

A

HTN
Aortic Stenosis
Athletes heart
Subaortic Stenosis
LV noncompaction
Cardiac Amyloidosis

101
Q

How does the microbubles can be administrated?

A

Dilution (most common) 1vias of contrast in 9 cc saline
Infusion
Bolus

102
Q

What organs control the pressure of the heart chambers?

A

the pericardium

103
Q

Caracteristic of the Hypertrophy cardiomipathy

A

Asimetric Hypertophy of the LV >1,5cm
Diastolic disfunction
sistolic preserve
LA enlargment
Dinamic LVOT obstruction

104
Q

How is the E’ signal TDI in Constritive Pericarditis?

A

Normal, but the mitral inflow signal is a restrictive pattern E wave bigger than A wave

105
Q

pericardium that extends posterioly to LA, between the four pulmonary veins?

A

oblique sinus

106
Q

Types of Cardiomyopathy?

A

Dilated
Hypertrophic
restrictve

107
Q

when Peripartum Cardiomyopathy happend

A

During the final month of pregancy and after 5 month of delivery

108
Q

DX

A

D reversal in Constrictive Pericarditis.

its tipical to see you a Swave in cardiac tamponade

109
Q

Obove which number Aneurysms can be considered?

A

Above 50% of it’s regular meassure

110
Q

Inflamation of the pericardium?

A

pericarditis

111
Q

tipical finfind in HTN heart Desiase?

A

Atrail enlargment
LV hypertrophy
Dilated Ascending Aorta
AV esclerosis
MVC Mitral valve calcificacion

112
Q

DX

A

pulsed alternate

indication of Diastole disfunction

113
Q

Types of Aneurysm?

A

Succular
Fusiform (most common)

114
Q

what is the main difference between Eccentric or Concentric hypertrophy and Hypertrophy cardiomeopathy?

A

In concentric hypertrophy the thickness increases because the myocitis are add parallel or in series but in Hypertropy CDM are disorganized

115
Q

Dilated cardiomyophaty is caracterized by

A

Impared LV contractility
Reduce cardiac output
Eleveted LVEDP

116
Q

Risk of factor for Aortic dissection

A

HTN
Atherosclerosis

117
Q

How to diagnosis pericarditis?

A

At least 2 criterias?
ST elevation
Chest Pain (like IM)
New or increased Pericardial Effusion
Pericardial rub on auscultation

118
Q

DX

A

Aneurysms of the ascending aorta

it’s causing a compression of the RA

ECHO (4 decks)

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