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VET433: Cardio/Respiratory > Echocardiography > Flashcards

Echocardiography Flashcards

1
Q

echocardiography

A

real time ultrasonographic imaging of the heart used to localize and diagnose cardiac disease

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2
Q

what is echocardiogram able to do

A
  1. diagnose ALL cardiac disease
  2. estimates chamber size and wall thickness
  3. estimates cardiac function
  4. estimates hemodynamic data - CO, pressures
  5. provides prognostic and treatment information
  6. identifies RIGHT heart failure + PERICARDIAL disease
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3
Q

can echocardiogram diagnose left heart failure

A

NO - requires thoracic radiographs

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4
Q

can echocardiogram image the great vessels well

A

no

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5
Q

what is the best positioning for an echocardiogram

A

lateral recumbency

R lateral –> view R side of the heart

L lateral –> view L side of the heart

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6
Q

2D echocardiography

A

real time 2D cross sectional view of single or multiple parts of the heart in their anatomically correct position during multiple cardiac cycles

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7
Q

does 2D echo provide information on blood flow velocity or direction

A

no - requires doppler

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8
Q

what size should the LA be in comparison to the RA in a R parasternal long axis 4 chamber view

A

about equal

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9
Q

what size should the LV be in comparison to the RV in a R parasternal long axis 4 chamber view

A

LV = 3 x RV

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10
Q

M-mode

A

creates a time-motion graph by correlating change in structure with timing in the cardiac cycle (ECG)

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11
Q

what is M-mode used for

A

evaluating IVS and LVFW thickness

calculating fractional shortening to estimate systolic function

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12
Q

doppler echo

A

assesses blood flow at valves, defects +/- vessels

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13
Q

functions of doppler echo

A

detects direction, velocity, character/quality, and timing of movement

can be used to calculate pressure gradients across valves, shunts, etc

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14
Q

limitations of doppler echo

A

HIGHLY angle dependent

cursor alignment MUST be within 15-20 degrees of flow/movement

if at too much of an angle –> will underestimate velocity

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15
Q

what kinds of doppler are there

A

color
spectral (pulsed wave, continuous wave)
tissue

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16
Q

color flow doppler

A

applies color to shifts in frequency to rapidly detect abnormal flow

BART
- blue = away
- red = toward

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17
Q

what is the velocity of laminar flow

A

appears as red and blue

100 cm/s (1 m/s)

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18
Q

what is the velocity of abnormal flow

A

appears as rainbow flow (many different directions and velocities)

> 100 cm/s

19
Q

spectral doppler

A

uses a baseline to detect direction, velocity, and timing of blood flow

20
Q

function of spectral doppler

A

calculates pressure gradients

21
Q

direction on spectral doppler

A

+ is towards the probe
- is away from the probe

22
Q

velocity on spectral doppler

A

Y axis of the tracing in m/s or cm/s

23
Q

timing on spectral doppler

A

uses ECG to correlate blood flow changes to timing in the cardiac cycle

systolic –> just after QRS
diastolic –> during T to QRS

24
Q

how to calculate pressure gradient

A

Bernoulli’s equation
deltaP = 4 x velocity^2

25
Q

pulse wave spectral doppler

A

measures velocity and direction of flow at a specific point along the cursor

allows for velocity assessment at a region of interest

26
Q

when to use pulse wave doppler

A

low (normal) velocity blood flow within the heart

can only assess velocities <2 m/s
- once over that, cannot determine direction

27
Q

continuous wave spectral doppler

A

measures velocity and direction of flow along entire cursor

cannot localize the site of peak velocity

28
Q

when to use continuous wave doppler

A

high (abnormal) velocity blood flow within the heart

can assess ANY velocity with accurate direction assessment

29
Q

LA:Ao ratio

A

used to measure L atrial size

quantifies atrial enlargement INDEPENDENT of weight

LA diameter / Ao diameter

30
Q

normal vs enlarged LA:Ao ratio

A

normal: LA:Ao < 1.6
enlarged: LA:Ao > 1.6

31
Q

fractional shortening

A

used to measure left ventricular function

%FS = (LVIDd - LVIDs) / (LVIDd) x 100

32
Q

what is normal fractional shortening in dogs and cats

A

dogs: 30-40%
cats: 40-60%

33
Q

what view is fractional shortening measured in

A

M-mode right parasternal short axis LV

34
Q

how to evaluate concentric and eccentric hypertrophy

A

ventricle diameter and wall thickness in 2D or M mode

35
Q

what is normal velocity across outflow tracts

A

<2 m/s

36
Q

inflow velocity

A

assesses AV valves during diastole

E wave + A wave on spectral doppler

37
Q

E wave

A

early wave

indicates early passive filling of ventricles

38
Q

A wave

A

late wave; indicates late active “atrial kick” filling of ventricles

39
Q

how to assess E and A wave

A

used to assess diastolic function

E wave should be > A wave in normal animals due to majority of filling coming from passive flow down pressure gradient

40
Q

what does an E wave < A wave indicate

A

non compliant ventricles relying on atrial contraction to fill (ex. HCM)

41
Q

what is the normal velocity across semilunar valves

A

1 m/s

42
Q

what is a normal pressure gradient across semilunar valves

A

delta P = 4 x 1^2 = 4 mmHg

43
Q

if aortic pressure is 120 mmHg, how much pressure does the LV need to generate to eject blood into aorta

A

120 + 4 = 124 mmHg

44
Q

how do you use tricuspid regurgitation velocity (5 m/s) to estimate systolic pulmonary arterial pressure

A

calculate the pressure gradient across the regurgitant valve:
- dP = 4 x 5^2 = 100 mmHg

calculate the right ventricular systolic pressure if there is NO atrial enlargement (RASP = 5) :
- RVSP = dP + RASP
- RVSP = 100 + 5 = 105 mmHg

if there is NO evidence of pulmonary stenosis on echo, then:
- sPAP = RVSP
- sPAP = 105 mmHg
(normal sPAP = 25 mmHg)

indicates severe pulmonary hypertension

VET433: Cardio/Respiratory (17 decks)

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