Final Exam Numbers and Figures

Question 1

MAC Severity

Answer 1

Mild is 1.5-5mm
Moderate is 6-10mm
Severe is >10mm

Question 2

Mitral Valve Stenosis values (based on MVA)

Answer 2

Normal MVA 4-6 cm2
Mild MS >1.5 cm2
Moderate MS 1.0 - 1.5 cm2
Severe MS <1.0 cm2

Question 3

Pressure Half Time (PHT)

Answer 3

Normal 30-60 msec
Mild 90 -150 msec
Moderate 150 - 219 msec
Severe > or equal to 220 msec

Question 4

Method for pressure half time

Answer 4

Get CW of MV inflow
Measure peak E velocity (Vmax)
Divide Vmax by 1.4 to get VPHT
Draw line down from Vmax and VPHT
Time difference between 2 velocities
MVA = 220 / PHT

Question 5

MVA =

Answer 5

220 / PHT

or 750 / deceleration time

Question 6

Pressure Half Time (2 steps)

Answer 6

Half pressure = Peak velocity divided by 1.4

(then MVA = 220 divided by pressure half time)

Question 7

3 measurements… FOR CONTINUITY

Answer 7

1. VTI - trace Doppler from mitral inflow site with CW
2. VTI trace of Doppler from LVOT (PW)
3. CSA of LVOT (0.785 x LVOT diameter2)

Question 8

Continuity equation to calculate MVA

Answer 8

MVA = CSALVOTsquared x VTILVOT (PW) divided by VTIMV (CW)

Question 9

PISA measurements

Answer 9

Color Doppler from apical 4
Alias velocity - shift baseline down to around 30 cm/s
Radius - measure from vena contract to 1st color (Measure radius of color flow at peak diastole from vena contract to first color alias)
VTI - peak MR waveform with CW

MVA = 2(3.14)r2 x (angle/180) x Valiased / Speak

Question 10

Mean Pressure Gradient (Grading MS - MS values)

Answer 10

mild is <5mmHg
moderate is 5-10 mmHg
severe is > 10mmHg

Question 11

MEMORIZE FORMULAS FROM AORTIC VALVE DZ OUTLINE PAGE 2

Answer 11

did you spend time memorizing? be honest.

Question 12

Continuity equation to calculate AVA (same as MVA just make one minor adjustment)

Answer 12

CSALVOTsquared X VTILVOT / VTIAO
where CSA = .785 xLVOTsquared

Question 13

when using Bernoulli equation (simplified and modified) you get the

Answer 13

peak gradient of whatever valve you’re measuring for

Question 14

AVA values with normal EF (values to refer to after computing AVA using the continuity equation)

Answer 14

below 1.0 cm2 is severe
1.0 - 1.5 cm2 is moderate
>1.5 cm2 is mild