Module 6 : PLAX Color and Spectral Doppler Flashcards
1
Q
why do you we take the specific order of pictures (2D, Color, Spectral)
A
- 2D = images the structures
- Color = tells if leaking or stenotic (qualitative)
- Spectral = both quantifies normal and abnormal flows in the hear (quantitative)
2
Q
Use of doppler in PLAX
A
- 2D as normal
- Zoom + Color
+ MV , AV
3
Q
use of doppler in RVIT
A
- 2D as usual
- Color TV
- CW through the TV
4
Q
why do we zoom on the Mitral valve
A
- easier to see ruptured chordae
- mitral valve prolapse
- need to see color from annulus to pap muscle
- and leakage/regurge
5
Q
RVIT doppler
A
- make color box only as wide as the annulus
- assess for regurge
6
Q
tricuspid valve spectral with CW
A
- measure the peak velocity of the spectral CW trace on the TV
- since velocity is directly proportional to the pressure the modified Bernoulli equation applies
7
Q
modified Bernoulli equation
A
used to find the pressure gradient
pressure gradient = 4 (V^2)
8
Q
pressure gradient
A
- difference between an atria and its corresponding ventricle
- use peak velocity
- only can be assessed with CW because PW will alias
9
Q
Right Ventricle Systolic Pressure (RVSP)
A
- MUST ADD THE RIGHT ATRIAL PRESSURE
RVSP = 4(V^2) + RAP
RVSP = SPAP (systolic pulmonary artery pressure) in absence of RV obstruction to outflow
10
Q
What 2 things do we need to calculate the RVSP
A
- the peak TR velocity
- IVC cine sniff test
11
Q
Right Atrial Pressure RAP
A
- assessed by performing a sniff test in subcostal 4 chamber view
- we assume the IVC has the same pressure as the right atrium chamber
12
Q
what is the normal response of IVC with sniff test
A
- IVC should collapse >50%
13
Q
if RA pressure increases how is the IVC affected
A
- it could be dilated
- non collapsing
14
Q
Calculating the RAP
A
- assess the IVC diameter is normal or abnormal
- assess if IVC collapsing is normal or abnormal
- use the corresponding value as your RAP
15
Q
NORMAL IVC DIAMETER
A
= 21mm
