Echo Final Handout Pg Flashcards
PLAX view name wall segments seen and the coronary artery that supplies it:
Antero-septum (LAD); Infero-lateral (Cx or RCA)
PSAX view of LV name wall segments seen and the coronary artery that supplies it:
Anterior IVS (LAD); Anterior LV (LAD); Anterolateral (Cx); Inferolateral (Cx); Inferior (RCA); Inferior IVS (RCA)
Wall segments seen in Apical 4 and which coronary supplies it:
Anterolateral (Cx); Apex (LAD); Inferior IVS (RCA)
Wall segments seen in Apical 2 and which coronary artery supplies it:
Anterior (LAD); Apex (LAD); Inferior (RCA)
Where is the moderator band?
RV
Where is the Eustachian valve?
RA
Where is the Chiari network?
RA
Where is the crista terminalis?
RA
Trabeculae carneae (trabeculations) and in which chambers?
Ventricles
Pectinate muscle is located where?
Atria; especially atrial appendage
Normal amount of fluid in the pericardial sac:?
20 to 50 mL
The oblique sinus is located behind the atria or ventricles?
Potential space posterior to the atria
The definition for Stroke Volume is:
EDV - ESV or CSA x VTI
Frequency (f) most useful in an obese patient, COPD patient is?
Lowest frequency
Maneuvers which result in a decrease in venous return:
Valsalva strain, Amyl nitrate, Supine to standing, Expiration
Maneuvers which result in an increase in venous return:
Valsalva release phase, standing to supine, Inspiration
Agitated saline contrast for ASD
Saline in LA within 3-5 beats after injection or Negative contrast effect makes the diagnosis
Simpsons method of discs (MOD) biplane is used to determine what?
Volumes
Preferred view for diagnosing MVP?
PLAX
View in which the tricuspid valve may be visualized?
RA-RV; PSAX of Aov; Apical 4 and Subcostal 4
Smallest size of a vegetation that TTE may visualize?
3 mm (or for TEE 1mm)
Findings for RVPO (Right Ventricular Pressure Overload)
RVH, Flattened IVS throughout the cardiac cycle
What does EDV - ESV / EDV x 100 =
EF
EDV - ESV =
SV
What is the valsalva maneuver?
Strain phase reduces venous return- useful in HCM; Release phase increases venous return - PFO and ASD
Chronic MR results in what?
LAE, LVE, LVVO pattern
Causes of MR are?
Functional vs Anatomic
Pulmonary vein finding in significant MR is?
S wave reversal
How to determine the severity of MR using CW Doppler?
Spectral strength and duration
Components of a turbulent jet?
PISA, Vena Contracta, Turbulent region, Relaminarization
How to differentiate MVP from flail MV?
Flail = leaflet tip points to LA and lack of coaptation
Most common etiology of MS?
Rheumatic fever
M-mode findings in MS are?
Thickened leaflets, decreased E-F slope, Anterior motion of PMVL (posterior MV leaflet)
MVA for severe MS?
Less than 1.0 cm squared
Secondary findings for MS are?
LAE, Pul. htn
Doming of the anterior mitral valve suggests?
Valve Stenosis
MPG in severe MS is?
Greater than 10 mmHg
Classic MVP finding of the MV leaflets?
Classic = Thick, Redundant, Myxomatous
2-D findings in arotic stenosis?
LVH, Post-stenotic dilation of aorta
Findings for chronic AR?
LVE, LVVO patern
Fine diastolic flutter of the MV suggests?
AR
Premature closure of the MV in acute AR suggests?
Increased LVEDP
What is the PHT in severe AR?
less than 200 msec is severe and greater than 500 mild
Using color flow in AR how do you determine severity?
JW/LVOTW; Holodiastolic flow reversal in the DTA or AA
Most common etiology of TS?
Rheumatic fever
Significant TR effect on the hepatic vein flow using PW Doppler?
S wave reversal
2-D findings for chronic TR?
RAE, RVE, RVVO pattern
Equation for RVSP and SPAP using the TR velocity?
4 x TR peak velocity squared + RAP
Description of the TV in carcinoid is?
Thick, Retracted
Significant chroni PR results in?
RVE, RVVO pattern
The equation for PAEDP using the end-diastolic velocity of PR?
4 x PREDV squared + RAP
Most common etiology of valvular PS?
Congenital
2-D findings for valvular PS?
RVH
Findings for infective endocarditis?
Vegetation, Abscess, Perforation, Fistula, Regurgiation
Usual location for vegetation for MV and TV?
Atrial side, low pressure side, upstream side
Aortic ring abscess is?
Usually seen as a clear echo lucent area around the valve ring
Ross procedure is?
Autograft (PV to the aortic position with homograft to the PV position)
Dehiscence is?
Excessive rocking motion of PHV usually due to infective endocarditis?
Pannu is?
Excessive ingrowth of tissue which may result in PHV regurgitation or stenosis
Beleaflet tilting disc?
St. Jude’s
How to evaluate a MVR?
As if a stenotic valve
2-D findings for constrictive preicarditis?
Thickened pericardium, Septal bounce
IVC allows evaluation of the pressure in the?
RAP
Most reliable 2-D finding for cardiac tamponade is?
RV early diastolic collapse
Respiratory variation of the AV valves in cardiac tamponade and constrictive pericarditis
TV increases w/ inspiration and MV decreases w/ expiration and vice versa
Hepatic vein flow in cardiac tamponade and constrictive pericarditis?
Diastolic flow reversal with expiration
What structure determines Pericaridal effusion vs left pleural effusion?
DTA
2-D findins for systemic hypertension?
LAE, LVH, Dilatation of the aorta and MAC
PV M-mode finding for pulmonary hypertension is?
Absent A wave; flying W
2-D echo findings for pulmonary hypertension are?
RVH, RVE, Flattened IVS throughout the cardiac cycle
Same is associated with?
HOCM
CW dagger of the LVOT suggests?
Dynamic obstruction
2-D findings for dilated cardiomyopathy?
4 chamber dilatation with reduced global systolic function
Most common regurgitation present in dilated cardiomyopathy?
MR
Causes of restrictive cardiomyopathy?
Amyloid, Sarcoid, Hemochromatosis, Endocardial fibroelastosis
2-D echo findings for amyloidosis?
All walls are thick, LAE, Pericardial effusion, pleural effusion, low voltage by EKG
Echo findings for AIDS?
Dilated cardiomyopathy
Most specific finding for CAD?
Systolic wall motion or systolic wall thickening (Thickening most important)
Wall score of 3 = ?
Akinetic
Stunned myocaridium vs hibernating myocardium?
stunned is immediate post-MI
Stress test used to identify hibernating myocardium?
Low dose dobutamine
Pseudoaneurysm vs True aneurysm?
Pseudoanuerysm has a narrow neck; True has a wide neck
2-D findinds for RV infarction?
RVE, SWMA
Dumb-bell shaped IAS?
Lipomatous hypertrophy
Most common primary benign intracardiac tumor in the adult?
Myxoma
Most common primary malignant intracardiac tumor in the adult?
Sarcoma
EDD - ESD / EDD x 100
Fractional shortening
E/A reversal = Grade?
Grade I impaired relaxation
Normal E/A ratio w/ abnormal E/E’ ratio is Grade ?
Grade II (Pseudo-normal)
Grade IIIa and IIIb?
Restrictive reversible and irreversible
Post-op septum =
paradoxical
Pulmonary embolism 2-D findings?
RVE, Flattened IVS thorughout the cardiac cycle, McConnell’s sign
View of choices for Ebstein’s?
Apical 4
Down’s syndrome is associated with?
Complete AV canal defect
Effect of VSD on the heart?
LAE, LVE, LVVO pattern
View of choice for ASD?
Subcostal due to echo dropout in apical 4
Primary finding of Uhl’s anomaly?
RV dysplasia with normal insertion of TV
Effect of PDA on the heart?
Same as VSD (LAE, LVE, LVVO pattern)
Equation for RVSP and SPAP using the VSD peak velocity?
SBP - 4 x VSD peak velocity squared
Narrowing of the aorta in the region of the aortic isthmus:
Aortic coarctation; Associated with AoV, VSD
Four defects of tetralogy of Fallot?
RVH, Over-riding Ao, Mal-alignment VSD, RVOT obstruction
Causes of Eisenmenger’s syndrome?
Intracardiac shunt which results in increased PAP
Findings for Marfans?
Aortic aneurysm (especially the sinuses of Valsalva), MVP, MR, AR, Ao dissection
Findings for aortic disseciton?
Dilated aorta, Intimal flap seen in 2 orthogonal views, Per. Eff. Pleural eff. AR
Most common sinus of Valsalva involved in sinus of Valsalva aneurysm?
???
Bernoulli Equation?
4 x V2 (squared)
MVA equation?
220/PHT
AVA using the continuity equation?
.785 x LVOD (Squared) x LVOT VTI / AoV VTI
Calculation of CO using cardiac Doppler?
CSA x VTI x HR
Regurgitant fraction (RF) and Regurgitant Volume (RV) for AR?
Pocket Reference pages 360-361