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Cardiology and Respiratory SA Med > Echocardiography > Flashcards

Echocardiography Flashcards

1
Q

Minimal equipment for Echo

A
  • Multiple probes of different frequencies
  • Electrocardiogram
  • Cardiac packages for flow and measures ($$$$$)
  • Printing/reporting ability
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2
Q

What are the three modes of echocardiography? (See images in the powerpoint for examples)

A
  1. ) 2 dimensional
  2. ) M mode or motion mode
  3. ) Doppler echocardiography
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3
Q

2 dimensional mode

A
  • most simplistic
  • Used to assess the structure of the heart, valve structure, and any abnormalities
  • Used for anatomic evaluation of the heart
  • Long (sagittal plane) and short axis (transverse plane) with standard views
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4
Q

M-mode (motion)

A
  • Used to provide assessment of function

- Nothing about blood flow

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5
Q

Doppler echocardiography (spectral and color)

A
  • Evaluates direction and speed (velocity) of blood flow

- Alignment is crucial - the Doppler waves need to be parallel to blood flow for accuracy

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6
Q

Spectral doppler

A
  • Measure speed of blood flow in a direction

- More quantitative

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7
Q

Color doppler

A
  • Assessment of blood flow
  • Relatively qualitative
  • Laminar or turbulent
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8
Q

Short axis view (see image)

A
  • Transverse section of the heart

- Making slides across the heart from apex to base

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9
Q

Long axis view (see image)

A
  • 4- chamber and LV outflow view
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10
Q

What information can you get from 2D views?

A
  • Anatomic evaluation of the heart

- Provides information on anomalies, chamber enlargements, pericardial effusion, etc.

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11
Q

Long axis four chamber view what can you see?

A
  • Right ventricle and right atrium
  • Tricuspid valve
  • Left ventricle and left atrium
  • Mitral valve
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12
Q

How thick should right ventricular wall thickness be?

A
  • About 1/3 the thickness of the left ventricle
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13
Q

What can you see on the long-axis LV outflow view?

A
  • Left ventricle
  • Aortic arch
  • Right pulmonary artery
  • Left atrium
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14
Q

What can you see on the mushroom view? (See images)

A
  • Left ventricle in short-axis view
  • Interventricular septum
  • Papillary muscles are visible too
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15
Q

Fish lips what can you see?

A
  • More right ventricle
  • Mitral valve
  • Left ventricle
  • Interventricular septum
  • SEE IMAGE
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16
Q

What can you see in the Mercedes benz view?

A
  • Aorta with semilunar valves
  • Heart base
  • Left atrium and auricle (The whale)
  • Right atrium and tricuspid valve
  • Right ventricle and pulmonic artery
  • Pulmonic valve
  • Tricuspid valve
  • SEE IMAGE
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17
Q

What can you see with the right parasternal long-axis 5 chamber view?

A
  • Right ventricle and tricuspid valve
  • Right atrium
  • Left atrium
  • Left ventricle
  • Mitral valve
  • Aortic semilunar valves
  • Aorta
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18
Q

Which valve is most likely to have endocarditis in a horse?

A
  • Tricuspid valve
19
Q

Where do you obtain M-mode images from?

A
  • Mushroom view (LV view)
  • Fish lips (MV view)
  • Mercedes Benz (LA:Ao view)
20
Q

What does M-mode evaluate?

A
  • Cardiac motion over time
21
Q

Why is M-mode more useful than 2-D view for measurements?

A
  • Resolution of chamber surfaces more readily defined for accurate measurements
22
Q

Make sure you know what each section is for M mode for MV view

A
  • Just do it - look at the images
23
Q

MV view on M-mode purpose

A
  • Evaluate mitral valve motion
  • Evaluates left ventricular diastolic function
  • Done with the Fish lips view
24
Q

M-mode: LA:Ao view

A
  • Mercedes benz
  • Evaluates aortic valve motion
  • Evaluates left atrial size
25
Q

Make sure you know what each section is for M mode for MV view for LA:Ao view

A
  • Just do it

- Make sure you know diastole and systole

26
Q

M-mode: LA:Ao view purpose

A
  • Might be useful for subaortic stenosis or evaluating animals with low cardiac output
27
Q

What should aortic root diameter to left atrial diameter be?

A
  • 1:1 normally
28
Q

M mode LV size and function

A
  • consistency is key
  • Measure the walls to determine hypertrophy or thinning
  • Measure the internal dimension to determine contraction (%FS)
29
Q

What is fractional shortening measuring?

A
  • Index of contractility
30
Q

How do you determine fractional shortening?

A
  • (LV Diastole - LV systole)/(LV diastole * 100%)
31
Q

What is normal FS% in dogs?

A
  • 25-40%
32
Q

What is normal FS% in cats?

A
  • 35-50%
33
Q

What does a decreased FS mean?

A
  • Reduced systolic function
34
Q

What does color Doppler measure?

A
  • Turbulence and direction of flow (qualitative)
35
Q

What does spectral Doppler measure?

A
  • Pulsed or continuous wave
  • Flow speed/velocity (quantitative) in m/sec
  • Can identify pressure gradient across a stenotic valve or shunt (and calculate cardiac chamber pressures)
36
Q

Which color is away and which is towards on Doppler?

A
  • Blue is away and red is towards (BART)
37
Q

What does green/yellow mean on Color Flow Doppler?

A
  • Turbulence and high velocity
38
Q

How do you calculate pressure gradient across a stenotic valve or shunt based on spectral Doppler?

A
  • Modified Bernoulli Equation

- 4x[(velocity)^2] = Pressure gradient

39
Q

Can you overestimate velocity with spectral Doppler?

A
  • NOPE

- You can only underestimate if you are not well-aligned with the flow

40
Q

Which view would you use to measure aortic valve velocity?

A
  • Subcostal view
41
Q

What is normal velocity across the aortic valve?

A
  • 1.5 m/sec

- Approximately

42
Q

What is normal velocity across the pulmonic valve?

A
  • 1.5 m/sec
43
Q

What is right ventricular pressure if pulmonary arterial flow is 1.1 m/sec?

A
  • 4 x (1)^2 = 4 mm Hg difference between Pulmonic artery vs RV
  • If normal pulmonic artery is 20 mmHg, then RV is 24 mmHg
  • Normal range of RV is 15-30
44
Q

What is the RV pressure if PA flow is 5M/sec

A
  • 4*(5^2) = 100 mmHg
  • normal PA is 20, meaning that RV is 120 mmHg
  • Make sure you know what this would mean for the aorta and left ventricle too

Cardiology and Respiratory SA Med (15 decks)

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