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Fall Cardiac Theory > LVSF > Flashcards

LVSF Flashcards

1
Q

What are the CAUSES of LVSF?

A
  1. ischemic cardiac disease
  2. cardiomyopathies
  3. valvular heart disease
  4. congenital heart disease
  5. hypertension
  6. renal disease
  7. diabetes
  8. thyroid disease
  9. drug and alcohol abuse
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2
Q

What are the SIGNS of LVSF?

A
  1. reduced cardiac output
  2. pulmonary edema
  3. volume to periphery
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3
Q

What are the SYMPTOMS of reduced cardiac output?

A
  1. DOE
  2. fatigue
  3. dizziness
  4. hypotension
  5. angina
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4
Q

What are the SYMPTOMS of pulmonary edema?

A
  1. dyspnea
  2. orthopnea/PND
  3. cough/sputum/rales
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5
Q

What are the SYMPTOMS of peripheral edema?

A
  1. JVD
  2. hepatomegaly
  3. ascites
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6
Q

What MURMURS are heard?

A
  1. soft S1
  2. S3
  3. S4
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7
Q

Murmur soft S1 is quiet due to what?

A

quiet due to AV valves closing less forcefully

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8
Q

Murmur S3 is due to what?

A

diastolic flow into volume overloaded ventricle

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9
Q

Murmur S4 is due to what?

A

atrial contraction flow against a stiff non-compliant ventricle

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10
Q

What is the NORMAL range of LVSP?

A

100-140 mmHg

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11
Q

What is the equation of LVSP with no AS?

A

LVSF = Systolic BP

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12
Q

What is the equation of LVSP with AS?

What are the steps?

A

LVSF = Systolic BP + AV PPG

CW - A5 - AV - PPG - SYSTOLE

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13
Q

What is the equation of LVSP with MR?

What are the steps?

A

LVSP = 4 x MR^2 + LAP

CW - A4 - MV- PEAK VELOCITY - SYSTOLE
CW - AV PSAX - PV - EDV & find PAEDP

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14
Q

What are the 2D FINDINGS?

A
  1. reduced global contractility
  2. reduced regional contractility
  3. LVE
  4. premature closure of MV and opening of AV
  5. fractional shortening
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15
Q

What are the M MODE FINDINGS?

A
  1. increased EPSS (mitral)
  2. “B” bump as sign of elevated LVEDP (mitral)
  3. decrease motion of aortic root (aortic)
  4. LVE
  5. premature closure of MV and opening of AV
  6. fractional shortening
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16
Q

Define STRAIN

A

the extent of myocardial deformation as a percentage

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17
Q

What does it mean to “DEFORM”?

A

myocardial fibers should be lengthened during diastole and shortened during systole

18
Q

What is the equation for STRAIN?

A

strain = L - Lo / Lo x 100

L = length after deformation (short)
Lo = original length

19
Q

Define STRAIN RATE

A

rate of change in the myocardial length

20
Q

What is the EQUATION for strain rate?

A

SR = (V2-V1) /D

difference in tissue Doppler velocities between two locations divided by the distance between them**

21
Q

What MODALITIES are used for strain rate?

A
  1. quantitative TDI
  2. speckle
22
Q

What are the NORMS for Longitudinal Strain?

A

Longitudinal strain ≥ absolute 20%
Longitudinal strain rate ≥ 1 Hz

23
Q

What is LONGITUDINAL STRAIN?

A

an average of strain values captured at the segments longitudinally (A4,A3,A2)

24
Q

What is the NORMAL Stroke Volume for LVSF?

A

Normal ≥ 70 cc

25
Q

How do you calculate SV?

A

SV = .785 x d2 x VTI

26
Q

What does SV require?

A

-accurate diameter
-laminar flow
-parallel angle

27
Q

What is the EQUATION and NORM for CARDIAC OUTPUT?

  • you do once you have SV*
A

CO = SV X HR /100

Normal ≥ 4 L/min

28
Q

What is the EQUATION and NORM for CARDIAC INDEX?

A

CI = CO / BSA

Normal ≥ 2.4 L/min/m²

29
Q

What 3 factors do you need to determine SHAPE OF AORTIC or LVOT Doppler Outflow Curve?

A
  1. ejection time (ET)
  2. Ao acc time (AT)
  3. Ao decel time (DT)
30
Q

In what view(s) & modality(s) are you using to find ET/AT/DT?

A

PW LVOT or
CW A5

31
Q

What are the NORMS for:
ET?
AT?
DT?

A

< 325 msec
< 188 msec
< 230 msec

32
Q

Who would be CANDIDATES for biventricular pacemaker?

A
  1. NYHA functional class III or IV
  2. EF ≤ 35%
  3. QRS ≥ 120 ms
33
Q

What is a good indicator of dyssynchrony?

A

QRS ≥ 120 ms

34
Q

What are the 3 types of dyssynchrony?

A
  1. intraventricular
  2. interventricular
  3. atrioventricular
35
Q

What is INTRAVENTRICULAR?

A

ill timing between LV segments

36
Q

What is INTERVENTRICULAR?

A

ill timing of right to left ventricular contraction

  • should contract at same time*
37
Q

What is ATRIOVENTRICULAR?

A

ill timing of atria and ventricle contraction

38
Q

How do you rule OUT ACUTE HEART FAILURE?

A

normal levels of BNP

39
Q

What is BNP (brain natriuretic peptide)?

A

secreted by the ventricles of the heart in response to excessive stretching of heart muscle cells

40
Q

What is the MARK KARRY METHOD?

A

shortcut method in which optimal setting tends to be where r wave of ECG aligns with MV closing click

41
Q

What is the EQUATION of FRACTIONAL SHORTENING and the NORMS?

A

LVIDd - LVIDs / LVIDd x 100

Normal > 25%

Fall Cardiac Theory (18 decks)

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