Know It Pt & Flashcards
What are the five phases of diastole?
1.IVRT
2. E wave - early filling
3. Diastasis
4. A wave- atrial contraction
5. IVCT
During IVRT which valves are open and closed?
AV closed
MV opens
The majority of ventricular filling occurs during?
A) IVRT
B) IVCT
C) first third of diastole
D) atrial contraction
C
What valves are open during IVCT?
-AV open
-MV closed
What are the three abnormal filling patterns?
- abnormal relaxation -grade 1
-pseudo normal - grade 2
-Restrictive - grade 3
Which abnormal filling pattern represents grade 1 diastolic dysfunction
Abnormal relaxation
Which abnormal filling pattern represents grade 2 diastolic dysfunction
Pseudo normal
Which abnormal filling pattern represents grade 3 diastolic dysfunction
Restrictive
Which abnormal filling pattern represents grade 4 diastolic dysfunction
Grade 4 - is dependent on whether or not a restrictive grade 3 inflow pattern normalizes with Valsalva or persists
If the restrictive flow pattern persists even with Valsalva, this is known as great 4 and is irreversible
A patient comes into the Ecolab with grade 3 diastolic dysfunction. what maneuver do you perform to determine if it is irreversible?
Valsalva maneuver
A patient comes into the Ecolab with grade 3 diastolic dysfunction. You ask the patient to Valsalva and the restrictive flow pattern persists what is this classified as?
Grade 4 - irreversible
If a patient has a normal mitral valve inflow, but their pulmonary veins show a decreased S wave and D wave what might you consider they have??
Pseudo normal pattern
In elderly patients > ___ the a-wave is normally ___ to or ____ than the E -wave
60; Equal ; higher
What’s does an abnormal relaxation grade 1 diastolic dysfunction pattern look like?
Blunted E , normal A
What’s does an pseudo normal grade 2 diastolic dysfunction pattern look like?
Normal looking E & A
What’s does a restrictive grade 3 diastolic dysfunction pattern look like?
Narrow, tall E, long diastasis, small A
what is a normal E/e’?
<14 cm/sec
What should a normal lateral e’ be?
> or equal to 10cm/s
What should a normal septal e’ be?
> or equal to 7cm/s
What’s a normal LA volume?
<34ml
What should your e/a ratio be?
> 1
What’s a normal Decel time?
<220m/sec
How long should your IVRT be?
<100m/s
What is the ratio of your S& D wave on your pulmonary veins?
> 1
What should your A duration be for your pulmonary vein a wave?
<20ms
If you have a patient that has a normal septal and lateral e’ but a slightly enlarged LA what would be classify this in terms of diastolic dysfunction?
Athletes heart or constriction
A E/A ratio of 0.8-1.5 means?
Grade 2 -pseudonormal diastolic dysfunction
A E/A ratio of > 2 means?
Grade 3- restrictive diastolic dysfunction
A decel time of >200 means?
Grade 1 -abnormal relaxation
A decel time of 160-200ms is a sign of?
Grade 2- pseudo normal diastolic dysfunction
A decel time of <160ms is a sign of?
Grade 3- restrictive diastolic dysfunction
If 2 out of 3 diastolic dysfunction criteria are negative we consider it?
Normal or grade 1
Out of the 3 diastolic dysfunction criteria if 1 is positive and 1 is negative. We consider this?
Unable to determine
Out of the diastolic dysfunction criteria if 2 are positive or 3 are positive we consider this?
Grade 2
If the E/A ratio of > or equal to 2 we consider this?
Grade 3
When dopplering your MV inflow. You should do it in your __ view. Use ____ wave. Ensure you sample volume is at _____mm and place it at the ____tips.
Ap4; PW; <2mm; leaflet
When dopplering your MV inflow. Your frequency and gain should be?
Low
What should the sample size be for mitral inflow Doppler?
<2mm
When dopplering your pulmonary veins. You should use ____ wave. Make sure your sample volume is at ____mm
PW, 3-4mm
What should your sample size be for pulmonary vein Doppler?
3-4mm
When using Doppler at the pulmonary veins, you should be ___ to ___cm into the pulm veins
1-2cm
What is the difference with the mitral valve info pattern between construction and restriction disease?
MV inflow changes with respiration with constrictive disease
How would you determine if a patient has constrictive versus restrictive disease?
A) strain Imaging
B) pulmonary venous flow
C) mitral valve flow with respiratory variation
D) tricuspid valve inflow with respiratory variation
C
With constrictive pericarditis does the E wave in a mitral valve flow pattern increase or decrease with inspiration?
Decrease
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