LV Systolic and Diastolic Function Flashcards
Grades of Diastolic Dysfunction
Grade I Impared Relaxation
Grade II Pseudo-Normal Filling
Grade III Restrictive Filling
Causes of Diastolic Dysfunction
Primary Myocardial disease
Secondary LV hypertrophy
Coronary Artery disease
Extrinsic Constraint
In which cases we can not mesuare th E’?
Prostetic#
Valve
Annuloplasty or Mitral Annular Calcifiaction
How to get me Maximun HR:
(220 - age) x 0.8
what is the best Stress test to evaluate Myocardial viability?
Dobutamine test
Increases HR and Contractility
Strain and Strain Rate Characterize?
Wall Deformation
E-point Septal Separation more than 10mm, Indicated:
Decreases on Ejection Fraction ( sytolic Dysfunction)
is the speckle tracing angel independent or angel dependent?
angel independent
It/s just speckel
Phases of Diastole
IVR
Early Rapid Filling
Diastasis
Late diatolic filling caused by atrial contraction
Is the Stress Test Indicated to evalued Diastolic Dysfunction? WHY?
Yes, To evaluate E’
In patient with Diastolic Dysfunction the E’ will not increases
In patient with normal Diastolic Function the E’ will Increase
Most common cause of walll motion?
CAD (isquemic heart disease)
Septal Flash:
Is an inward and then outward motion of the septum during systolic.
Indicates LBBB
Name of the finding and diagnosis?
Septal beaking in M-Mode or septal flash in 2D
LBBB
What does represent S1, S2 and AR in pulmonary vein signal?
S1: Atrial relaxation (systole Ventricular)
S2: Atrial Relaxation and Beginning of Diastole
AR: Atrial contraction
Premature closer of the Aortic valve, Indicates:
Reduced of Stroke Volume (systolic Dy
sfuntion)
Ventricular Syatolic Function and pump performance depends on:
Preload
Afterload
Contratility
ventricular Geometric
Stroke Volumen
(concept and Equation)
The amount of blood pumped by the heart on a single beat.
SV= EDV -ESV
Primary Tricuspid regurgitation, is called?
Low pressure TR
L Wave is suggestive of:
Elevated LV Preload
Pseudo-normal Filling. Grade II
Could be normal in patient with Bradycardia
what is the best stress test to evaluate Diastolic Function?
Bicycle
Increases Stroke Volume
what is considered Hypertensive responde to exercise?
During exercises:
SBP > 220mmg for men
> 190 for women
Diastolic BP > 90
for Dobutamin ST >182 / >96mmhg
Finding in Super natural filling
E/A radio > 2
IVR <
High E wave
Healthy patient
How do we calculated Maximun Workload?
HR x Systolic Blood Pressure
Normal Fractional Shortenning
LVEDD
LVESD
RWT
FS <28,5
LVEDD= M <59 W<53
LVESD= M<40 W<35
RWT <0,42
What is the cut point to define Hypertensive Response during Dobutamin Stress Echo?
SBP> 182mmhg and DBP < 96mmhg
Velocity and Displacement Characterize:
Wall Motion
What is the most common type of Dilated Cardiomyopathy?
Ischemic Cardiomyopathy
How many signal should you get during Atrial Fibrilation?
5 to 10 signal
Reduced of Anteroposterior motion of the aortic root, indicates:
Reduced Cardiac Output (systolic Dysfunction)
For wall motion Score Index, above which numer will be a bad outcome?
Anyting above 1 is adnormal, But 1,4 is bad outcome
WMSI= Score of 16 segments divided by 16
Is the TAPSE and The DTI on the evaluation of RV systolic function, Angel Dependen?
Yes, both are angle depende
increases on the E-point will lead to
Decreases in the EF
Affection of the filling and emptying of the atrial will cause?
Decreases in the cardiac output
Grades of Diastolic Dysfunction
Grade I Impared Relaxation
Grade II Pseudo-Normal Filling
Grade III Restrictive Filling
Quantitive evaluation of Systolic Function?
Fractional S
EF
Rate of Rise of pressue
MPI
How much blood passes From LA to LV during E wave, Diastasis and A wave
E wave : 70 - 80%
Diastasis: < 5%
A Wave: 15 - 25%
Which of the view will be the only one qhere we can see the Posterios and Anterior leaflet of the TV?
RV inflow
what is the best way to evalue RV ejection Fraction)
3D evaluation
How is Atrial Contraction on mitral, pulmonary flow and Mitral Annular movement singal represented:
A wave in mitral Signal
A’ in annular movement
AR in pulmonary vein flow
During an ischemic cascade which cardiac cicle is afected first?
Diastolic function: means decrease in E/A radio
The Tricuspid Valve apparatus Consists of:
The Tricuspid valve Leaflet
Annulus,
The chordae
Papilary muscle
the Hypotension in Dobutamina Stress test could be cause of?
Isquemia
Vagal Responde to DOBUTAMINA
Vasodilatation
Quantities evaluation of Sytolic Function
Race of Rise Of pressure
Miocardial Index
EF
What are the causes of Hypotension respond during Stress Test?
Three Vessels disease
Left main Stem
Vagal Respond (DST)
Vasodilatation (DST)
Strain evaluates what type of deformation?
Longitudinal deformation (it is always Negative)p
What is the Firts step for evaluation of Diatolic Dysfunction?
LV
Systolic Function (Ejection Fraction)
Short inward motion starting at the onset of QRS on M-mode:
Septal Beaking, Indicates LBBB
How to get the Maximun Workload?
HR x Systolic BP
Diastasis Depends on:
Heart Reat.
If the HR is slow the diastasis will be longer
if the HR is faster the diastasis will be shorter
how do we calculated the maximun HR?
Cardiac Output
(Concept and Equation)
The amount of blood pumped by the heart per min
CO= SV x HR
If contractility Decreases, Stroke Volume:
Decreases
Rate of Rise Of Pressure. Concept and normal Value
Evaluate The contractility
EValuate how fast the Pressure increse whitin the left Ventricle
Uses MR signal
Messuare at 1m/s and 3m/s
dP/dT = GP at 3m/s - GP at 1 m/s
Time
Uses Bernoulli equation for both time 1 and 3
Normal Value >1000mmhg/s
The shortest the time the better
During Tachycardia, how can the mitral signal can be improve to appretiate the spectral signals
Carotic Sinus massage will lead to separation of the E and A wave
How is the pulmonary vein flow signal in Grade III diastolic disfunction?
S wave Decrese because there it lees bloor entering the LA due it’s Hight pressure
D wave increases, Since all the bllod goes to the LV during rapid filling
AR is larger and increases because there is more blood going backwards to PV
What effects has the Valvalsa Maneuver in the blood flow on the heart?
It reduces the venous return to the atrium (Decrease Preload)
It happens in Fase two (4 phases in total)
most common cause of thrombus?
Dilated Cardiomiopaty
