High Yield PTEeXAM Review Part 21-23 Flashcards
What are who aspects that increase significance of pressure recovery?
- Increased Aortic Stenosis severity
- Decrease in aortic root size (Women and children)
When you are performing a cath-derived peak pressure, how does that comprae to doppler derived gradients?
Pressure Recovery
CWD > Cath
Cath derived are measured distl to areaa of “low” pressure yielding lower pressure graadients than the actual peaka
What is the doppler equation?
Change in F = V cos (angle) 2 Ft / C
What is a normal MPI (Myocardial Performance Index)?
< 0.35
What is a MPI (Myocardial Performance Index) that represents LV dysfunction?
>0.5
Does MPI (Myocardial Performance Index) a measure of systolic or diastolic function?
BOTH
Is MPI (Myocardial Performance Index) load dependent?
NOT load dependent
What is the MPI (Myocardial Performance Index) equation?
[IVRT + IVCT] /ET
What TEE view do you need to obtain MPI (Myocardial Performance Index)?
TG Deep 5 chamber
What is the answer to the photo?
B = Isovolumetric Contraction Time
A RV MPI above WHAT was found to be predictive of hemodynamic instability and mortality afater cardiac valvular surgery?
0.5
What view is needed to get RV MPI values?
Deep TG RV outflow
What ultrasound modality allows us to see movement not speed or direction?
Power Doppler
What is the velocity of sound in units (mm/microsecond)?
1.54 mm / microsecond
1540 m/sec is other units
How does the PWD shift if you move the cursor from the distal LA to the MV annulus?
- Peak E wave change?
- Deceleration time change?
- Peak E wave increases
- Deceleration time decreases
What is the neck of a true anuerysm of the LV?
Wide
What is the neck of a pseudoanuerysm of the LV?
Narrow Neck
What is the neck/aneurysm diameter of a pseudoanuerysm of the LV?
<0.5
What is the neck/aneurysm diameter of a true aneurysm of the LV?
Neck/Aneurysm size >0.5
What does the myocardial to aneurysm transition look like for aneurysm vs. pseudoaneurysm?
Aneurysm = Gradual transition
Pseudoaneurysm = Abrupt transition
What does the angle between normal myocardium and aneurysm look like for aneurysm vs. pseudoaneurysm?
Aneurysm = Wide angle
Pseudo = Narrow angle
If you are given RAP and Peajk velocity of AV, what other information is needed to calculate LAP?
Peak PFO velocity
If you are given RAP and BP, what other information is needed to calculate LAP?
Peak MR velocity
LVSP - LAP = Delta P = (VMR)2
For MHz (Mega Hz), this is one cycle per what unit of time?
1 cycle = 1 microsecond
For MHz (Mega Hz), how many cycles are in one second?
1 million cycle / second
What tricuspid valve leaflets are seen here?
Left = Septal / Posterior leaflet
Right = Anterior
What is the least likely location of a myxoma?
Attached to aortic valve
What is the most common location of primary cardiac myxoma?
LA attached to interatrial septum
What is the formula for fractional area change?
[End distolic area - End systolic area*] / *End Diastolic area
Rank the following media in order of increasing ultrasound velocity (highest velocity medium last)
Air
Bone
Fat
Lung
Soft Tissue
Air < Lung < Fat < Soft Tissue < Bone
What are the echocardiographic inclusion criteria for Mitraclip for:
Coaptation length
Coaptation Length > 2mm
What are the echocardiographic inclusion criteria for Mitraclip for:
Coaptation Depth
Coaptation Depth <11 mm
What are the echocardiographic inclusion criteria for Mitraclip for:
Flail Gap
Flail Gap < 10 mm
What are the echocardiographic inclusion criteria for Mitraclip for:
Flail Width
Flail width < 15 mm
What are the anatomic inclusion criteria for Mitraclip for:
MR jet associated with what two leaflets?
A2 and P2 segments
What hasa to be absent of the mitral valve in order to be considered for a MitraClip?
Absent:
- Severe Mitral Calcification
- Leaflet calcificaation in the grasping area
- Significant cleft or leaflet perforation
- Restricted Posterior Leaflet
What are the anatomic inclusion criteria for Mitraclip for:
LVEF has to be above what?
LVEF >20% in order to get a MitraClip
What are the anatomic inclusion criteria for Mitraclip for:
Leaflet thickness
Leaflet thickness <5 mm
What are the anatomic inclusion criteria for Mitraclip for:
LV End Diastolic dimension?
LV End Diastolic dimension < 60 mm
What are the anatomic inclusion criteria for Mitraclip for:
Mitral Valve area?
MVA > 4 cm2 to get a MitraClip
Answer = A
Relaxation is impaired
LAP is low or normal
