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Echo > Module 15 : Intro to Systolic Function > Flashcards

Module 15 : Intro to Systolic Function Flashcards

1
Q

what are the apical views for assessing wall motion

A
  • PLAX
  • PSAX LV base
  • Apical 2 chamber
  • apical 4 chamber
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2
Q

quantitative assessment of LV systolic function

A
  • MEASURING
  • SV/EF/CO
  • simpsons
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3
Q

qualitative assessment of LV systolic function

A
  • visual/descriptive
  • visual EF
  • segmental wall motion analysis
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4
Q

wall motion can be describes as

A
  • hyperkinetic
  • normal
  • hypokinetic
  • akinetic
  • dyskinetic
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5
Q

segmental VS global approach **

A
  • you can describe visual wall motion as segmental or global
    + global= entire heart effected
    + segmental = just one region of heart effected
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6
Q

hyperkinesis

A
  • excessive wall motion
  • high preload
  • severe regurgitation
  • fever
  • trauma
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7
Q

hypokinesis

A
  • motion/wall thickening is reduced

- not normal but not akinetic

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8
Q

factors leading to hypokinesis

A
  • CAD = coronary artery disease
  • CMO = cardiomyopathy
  • long standing valve disease
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9
Q

akinetic

A
  • no thickening
  • may have motion if tethered to a moving segment adjacent to it
  • look for thickening
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10
Q

factors causing akinesis

A
  • MI = myocardial infarction

- viral CMO = viral cardiomyopathy

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11
Q

dyskinetic

A
  • wall or segment is moving the OPPOSITE DIRECTION as normal segments in systole
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12
Q

factors causing dyskinesis

A
  • increased right heart pressure
  • pacemaker
  • BBB = bundle branch block
  • longstanding scarred segment
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13
Q

ways to assess LV EF - least to most accurate

A 
- Teicholz (parasternal - EF) or LINEAR
   \+ FS (LVIDd) - dimension 
   \+ CO (SV x HR)
- Simpsons Biplane EF 
   \+ recommended 
- 3D trace (3D EF)
   \+ only most accurate when performed by well experienced staff
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14
Q

volumetric assessment of LV function (quantification)

A 
- Simpsons Biplane 
   \+ end diastolic trace 
   \+ end systole volume 
 - then get STROKE VOLUME and EF
- then combine SV with HR to get CARDIAC OUTPUT
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15
Q

images needed to calculate LV stroke volume DOPPLER METHOD

A
  • LVOT diameter (PLAX)

- LVOT VTI (apical 5 PW of LVOT)

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16
Q

3 ways to determine end diastole in 2D scanning

A

1) onset of QRS complex
2) FRAME AFTER MV CLOSURE (both valves closed)
3) Frame where LV dimension if largest

17
Q

3 ways to determine end systole in 2D scanning

A

1) THE FRAM PRECEDING MV OPENING (both valves closed)
2) when the LV is at its smallest
3) near the end of the T wave

18
Q

triplane EF

A
  • uses 3D
  • gives real time volume info
  • volume changes over time
  • uses 3D echo probe
19
Q

ASE recommendations for EF

A
  • use modified simpsons EF with biplane apical approach for the measurement of EF
    + felt to be quite accurate and most studied
    + more universal than 3D
    + 3D more accurate when done well
20
Q

systolic dysfunction

A
  • inability to contract

+ usually due to CAD (coronary arterial disease)

21
Q

decrease in systolic function causes what to happen

A
  • decrease in SV/EF

- due to inadequate contraction to meet the demands of the body

22
Q

decrease in SV/EF due to systolic dysfunction can lead to what

A
  • congestive heart failure
23
Q

congestive heart failure

A
  • chambers state to dilate when there is a back up of blood behind the chamber due to its inability to contract and move forward
24
Q

qualitative assessment of RV systolic function

A
  • eyeball
25
Q

quantitative assessment of RV systolic function

A
  • FAC = fractional area change
  • TAPSE = tricuspid annular plane systolic excursion
  • S prime = doppler TDI (tissue doppler imaging)
26
Q

eyeball method - RV grades

A
  • normal
  • mildly reduced
  • moderately reduced
  • severely reduced
27
Q

what will a hypokinetic RV look like

A
  • it will be dilated
28
Q

fractional area change FAC

A
  • comparison of area change between systole and diastole

+ not a volumetric change like simpsons

29
Q

calculating FAC

A
  • trace endocardial border surface in apical 4 chamber in
    + END DIASTOLIC AREA
    + END SYSTOLIC AREA
  • trace along IVS from base to apex then along RV free wall to annulus then back to beginning
30
Q

FAC formula

A

FAC=[(EDA-ESA) / EDA] x 100

31
Q

normal FAC value

A

> 35%

32
Q

3D images with contrast used when

A
  • used when regular 2D imaging is poor but need an EF
33
Q

Thethering

A

A normal LV segment dragging a nearby akinetic segment making it look normal

Echo (19 decks)

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