image Flashcards
Left atrial Mixoma
tipycaly seen Reverberation of the Mitral valve Leflet
Tamponade
There’s not D Wave
Hepatic Vein obstruction
Stunned Myocardium
It’s an acute decreased of perffusion to the myicardiuma that will go back to normal about 72 hrs
During Stress Echo there is low Wall motion anormality at the begining butit will improved at higher dosis
Tamponade.
look the RV diastole colapse and the pericardial effusion
P2 Tethering (restrictive)
SAM (in sam the MR is posterior)
Severe Trycuspid Stenosis (even though there’s a TR the focus of the image is on TVS)
Severe TVS
MPG> 5mmhhg
PHT > 190
TVA < 1 with continuty equat
Moderate to severe Pulmonary regurgitation
Because in severe PHT < 100
it would be more triangular and more dense
Bicuspid valve
Post open heart Surgery
Abnormal eptal motion during systole.
you can see during systole the IVS going up when it should be going down
Pansystole MR always gonna have more Regurgitation volume than Late systole MR (prolapse Valve) even though they have the same EROA
True
how to calculated PADP? is take from the TR + RAP
From PR + RAP
PADP= 4(PR)2 +RAP
B - To dark increase the gain
Too White decrease output power
Severe aortic Stenosis
PEak velocity more than 4
PG 112
Rehumatic Valve
Severe AR
PHT > 200
trialgular signal
Restrective Cardiomeopathy
Always look above the base line and compare with the ECG
Insoiration is the green line going up
there’s a flow reversal in inspiration this is restricte cardiomeopathy
#
Range Ambiguity Artifact
This is Aortic and LVOT signal
LVH
This also could be SAM but the nothing of the Anterior leaflet of the MV with the suptun can be seeing in patient with LVH. Eje. HTN or Apical Isquemia
AR. look at the time with the ECG and the turbulance flow during diastole
For calculation always has to be in cm. so convet it because mostly tehy will give in m/s
Fenistration of the AV. the av valve has a hole.
the only patology qhere you can see the flatter in diastole
Decrease E wave DT
Mid LVOT obstruction
Lobster sign
Whats does the B-Bump means?
High LVEDP
MV vegetation or
Thrombus
Low EF
LVEDP
Characteristic of Severe TR
Systole flow reversal on Hepatic V
Paradoxcial septal movement (because RV overload)
LOW Calculated RVSP (because in severe TR the Velocite of the regurg is low)
Beam with Artifact
ITs beam with artifact because those are MV and AV signal with are parallel to each other
if these were are AV and LVOT it will be range ambiguity because there are in the same path AXIS
Premature of the AV
clasical sign for Acute Aortic Regurgitation
how is the EDSD after stress echo in a patient with isquemia
EDSP increases after echo strees
Because the thicknes of the lv will reduced
MV Flail and MV prolapse
MV Flail has the hammocking in early sistole while the MV prolapse is late systole
Atrial Septum Aneurysms
Grade 2 diastole disfunction
Constrictive Pericarditis
DX
Normal M-Mode. the little flatter is normal
Flow reversal During Expiration
Constrcite Pericarditis or Tamponade
Flow reversal increase during inspiracion in hepatic vein
Restricte Cardiomyopaty
B. because is close to the AS
MV Flail
Supracristal (because its Oulet)
Dilated Cardiomiopathy
Coartation of the Aorta
continuos flow during diaslote
Type A aortic Disection
Eccentric MR. the anterios wall of the LA is toching the valve
b
Wall filter allows High amplituted signal
Mid systolic Closure
HOCM
It’s like Late systole hammocking but on the AV
Constrictive Pericardiatis
Look above the baseline first and in experitation there is flow reversal
Grade 2 Diastole Dysfunction
ATrail Fibrilation. tehere is not A wave and also look at the ECG
Aortic Regurgitation
There’s fluttering of the mitral valve. there is an Eccentri Aortic Regurgitation that is hitting the MV
Coumadin Ridge or Warfarin Ridge
Late systole Hammocking- MR- MV prolapse
all of them
we shift the baseline down to see more aliasing (flow convertion) but the normal is around 50 and we bring it down to 30 to see more flow convertion
but if even with 50 we see a big flow convertion this mean that the regurgition is big so severe
Aortic Ring abscess (seen is Endocarditis)
Bleb >congenital CX originated fro RCA
Vegetation
Early diastole septal DIP. Severe MS
LVH
Increase IVR
Grade II
Remember to follow the algoritm
mitral anular Calcification
if the thickness is more than 1cm it’s severe mitral calcification
in order is Early sistolic notching, mind systole notching, late systole notching
Subvalvular Stenosis, HOCM, Premature closer
Impared Relaxiation if the VP is <45
Dinamic LVOT obttruction where the arrow is pointed + MR obstrucciton
This is SAM
Talking about bicuspid valve
B and C are true
Bicuspid valve
This px may have
Atrail septal Deffect
Wolf parkison / white syndrome
TR
ebstein anormality
LBBB
RV lead Pacemaker
RV preexcitation
Constricte pericarditis
D is the correct anwser
Because in patient with Holosytolic MR there is more flow going back than Patient with Late systole MR (late systole Hammockin -Prolapse Valve)
Methalic Mitral Valve.
see the reberveration and on 2D there is not leaflet
Atrail Flatter.
Inatrial fibrillation there is not P wave so there is not A wave( which is atrial contraction)
but in atrial flutter there is P wave but bigger so the atrial contract 3 or 4 time. so you see more A wave
M-Mode accros the Atrial Septum
Aneurysms
>1cm aneurysmas
<1cm redundan
Subvalvular AS
Early sistole noching
Severe MS
PG 22
AVA<1
Constrictive Pericartidis
Look how thick is the pericardio and the septal shiff or septal shudder during diastole
A
Because of the shodowing or reverberation that mechanical Valve will produce. the best window to evalute is PLAX
Grade II diastoly dysfunction
A acroos a not obtruictive
we use this equationjust in obstructive valve
Pansystolic MR. the red is diastole which is normal and the Tubulance is during the whole sistole ventricular
Restrictive Posterior Wall Diastole movement
Look how is diastole the posterior wall is flat and it should be more rounded
Ascending Aorta Aneurysms
Flow reversal that is not affected by inspiration of expiration is
Severe TR late systole
Pericardial Fat. Because look at the time. it is in systole so at the Posterios wall thereis just a bit of fluis which it is normal
which value do you take in order to calculate RVSP,
56mmhg. if you have the velocity in gradiant you can use gradiant mmhg
Severe MR
Dense jet
E wave more than 1,2 (quality evealuation)
(semiquantitive evaluation)
Severe Pulmonary Stenosis
Peak Velocity > 4
Peag Grandiante > 64 mmhg
Tamponade
Look the RV collapse during Diastole
Pulmonary HTN
If the flow reversasl is in inspiration and expiration it’s Pulmonary HTN
Low Velocity Radio
this is a AV stenosis
Remember the evaluation of severety of AVS
propagation Velocity high
C
F
G
Posterior Basal. o any basal (inferolateral or inferior
PDA
IT’s usually between the aorta and the Righ coronary artery
if the Vp (propagation Velocity) is more than 200 its constrictive pericarditis
There is not A wave so the answers are:
Atrial Fibrilation
Acute Aortic Regurgitation (the lv is so full than there is a premature closer of the MV
Severe MR
look the E wave more than 1.2
even though the Regurgitation is not triangular
This is MR no severe because the E waves is less than 1.2m/s (semiquantite evaluation of MR)
ALso this is aliasing
Aliasing is always gonna be seeing if the velocity of it is more than 2m/s
Vegetation or Cardiac Mass on Pulmonary valve TEE
This is compatible with Hepatic V systole flow reversal (typically seen in TR)
Heart F with a device. you can see two normal y one abnormal
Pulmonary HTN
Thoracic Aorta Anyurisms
Dinamic LVOT obstruction
Dagger Shape
