echo questions Flashcards
Reduced E-F slope of the MV on m-mode
Stenosis, decreased transvalvular flow
Increased EPSS
LV dilation, mitral stenosis, AR
Delayed closure of MV tells us what?
B bump reflects elevated LV diastolic pressures resulting in delayed MV closure. Occurs in animals where diastolic pressures exceed 39mmHg. B bump is a diastolic event whereas SAM is a systolic event
Hyperechoic subendocardium
Recurrent ischemia, infiltration, infarction, myocarditis, amyloidosis.
Septal flattening diastolic versus systolic?
Diastolic: rv volume overload, systolic: rv pressure overload
What are the labels of m mode mitral valve motion. And what do d-f and e-f slopes tell us and what the hell is a b bump?
C- mitral valve closure
D- point before mitral valve opening
E- maximum diastolic excursion of filling
F- point at the end of the e wave
A- atrial contraction
EPSS- e point to septal separation is a measurement of volume overload. <4 in cats
DF- slope is proportional to the rate that blood from LA to LV during early diastolic filling.
EF - mid diastolic closure rate. Slope Will decrease (gets longer) with decreased LV compliance, PHT, mitral stenosis.
B bump/shoulder- premature closure of the mitral valve with anterior movement. Indicative of a stiff, non-compliant ventricle with high end diastolic pressure
What is Coanda effect!
Regurg jets that slide along lateral wall tend to flatten out. This reduces the visualized size of the jet an appear smaller.
2D and M-mode features of MR
Degenerate valve lesions.
LV and LA dilation
Exaggerated IVS and LVFW motion
Delayed MV closure (b bump)
Possible gradual AV closure (triangle vs box shape)
Systolic index (normally 70 with moderate and >100 with severe failure. (JVIM 07, 08- Borgarelli)
Reverse bernheim effect
An example of ventricular independence with severe LV compression secondary to severe RV disease
Paradoxical septal motion cause
ONLY with volume overload
What does E wave deceleration time tell us?
Correlates well with early diastolic function. In dogs with DCM, decel time shortens when about to go into heart failure.
High Ea versus low Ea
high Ea …. High volume
Low Ea… High filling pressures
What are axial and lateral resolution and what are the determinants of each?
Axial is differentiating two objects along a beam and lateral is diff two objects next to each other in a beam.
Axial determinants: pulse length and frequency
Lateral: beam width, depth and gain
What are determinants of temporal resolution?
Sweep angle, depth, pulse repetition frequency
Nysquist= PRF/2
What is the main determinant of chf and what variables on echo correlate to chf?
LV filling pressure is the primary determinant. Estimate by 1. E:Ea, (combined assessment of e:a and e:ea better than either alone), 2. E:IVRT (in dogs, more reliable than e:ea, IVRT alone is linearly related to tau, except at severe elevation of LVP), 3. Pulmonary vein A wave retrograde flow duration (ARdur) is increased , A wave forward flow duration is decreased (Adur:ARdur is decreased)
