Echo tidbits

Question 1

TVI

Answer 1

(time velocity integral)

the sum of velocities of pulsatile flow during the ejection phase.

o Equal to the area enclosed by the Doppler velocity profile during one ejection period

Question 1

B Bump

Answer 1

where closure of the MV is delayed following atrial contraction

late diastole in M-mode images of mitral valve

indicates increased LV (and LA) end diastolic pressure

Question 2

Closing click

Answer 2

• To record the closing “click” of the aortic valve at end-systole, position your sample volume at the level of the aortic annulus, approximately 3-5 mm proximal to the valve using the left apical 5 chamber view

Question 3

Pressure 1/2 time

Answer 3

• Patients with mitral stenosis will have a long pressure half-time of mitral inflow E wave
  o Pressure half-time equals the time required for the peak pressure gradient to be reduced by one half
   = time required for initial velocity to decrease to a value of peak velocity divided by 1.4 (= Vmax x 0.7)

Question 4

dP/dt

Answer 4

• dP/dt can be measured using MR acceleration velocity by measuring the time interval between 1 m/sec and 3 m/sec on the MR jet. dP/dt is equal to 32/time interval.

Question 5

AI and PI severity

Answer 5

• As the severity of aortic or pulmonic regurgitation increases, the slope of the CW Doppler jet becomes steeper

Question 6

Coanda effect

Answer 6

tendency of a fluid jet to be attracted to a nearby surface

such as eccentric MR jets

Question 7

Flying W

Answer 7

PW Doppler PV signal with severe PAH