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Reguritation ESP Book > MR > Flashcards

MR Flashcards

1
Q

What are 4 etiologies of MR?

A
  • primary valve disease like MVP, rheumatic, endocarditis, Myxomatous mitral valve degeneration
  • pap muscle dysfunction
    -chordal tendineae rupture
    -annulus dilation/ calcification
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2
Q

Another name for MVP IS?

A

Barlows disease

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3
Q

What 2 pathophysiology things occur with MR?

A
  • LA dilation /overload
    -LV dilation/ overload
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4
Q

What murmur is associated with MR?

A

Holosystolic murmur that radiates to axilla

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5
Q

What physical signs are seen with MR?

A

-CHF symptoms
- PHTN/ w longstanding Mr
- Holosystolic murmur that radiates to axilla

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6
Q

What 4 echo signs are seen with MR on echo?

A
  • LAE
    -LV dilation
  • LV hypercontracility
  • Mitral abnormalities like MVP, rheumatic, MAC, myxomatous leafelets
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7
Q

What are some mitral abnormalities?

A

-MVP
-MAC
-Rheumatic disease
-Myxomatous leaflets

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8
Q

What are Myxomatous leaflets?

A

A valve disease associated with many other disease like MVP and rheumatic disease. It causes thick MV leaflets that can affect the chordae tendineae causing loss of leaflet integrity

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9
Q

What I the narrowest part of a MR jet?

A

Vena contracta

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10
Q

What is the severe measurement of a vena contracts to indicate severe MR?

A

> or equal to 0.7cm

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11
Q

What are the 4 parts of a MR jet?

A
  1. Zone of convergence
    2 Vena contracta
  2. jet size (turbulence)
    4 Downstream effect (pulm vein reversal flow)
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12
Q

What 3 things will you see on Doppler with MR?

A
  • systolic turbulence in LA
  • Conda effect
  • MV inflow of >1.5 m/sec with mod-severe MR
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13
Q

A MV inflow of ____ m/sec may indicate mod-serve MR in the absence of _____

A

> 1.5m/sec
MS

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14
Q

What is called when: Eccentric jets adhere to LA walls causing the jet to look smaller resulting in underestimation

A

Conda effect

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15
Q

What’s the Conda effect?

A

When Eccentric jets adhere to LA walls causing the jet to look smaller resulting in underestimation

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16
Q

True or false- the Conda effect causes overestimation of MR jet

A

False. It causes underestimation

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17
Q

What is JA/LAA stand for?

A

Jet area / Left atrial area

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18
Q

How do you acquire the JA/LAA?

A

From AP4 & AP2

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19
Q

What should the color scale nyquist limit be set at when measuring JA/LAA?

A

50-60cm/s

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20
Q

What’s the mild JA/LAA?

A

<20%

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21
Q

What’s the serve JA/LAA ?

A

> 40%

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22
Q

What’s the moderate JA/LAA?

A

21-39%

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23
Q

Pulmonary vein flow reversal indicates?

A

Severe MR

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24
Q

What is the greatest source of error in measuring PISA?

A

Radius of the flow convergence

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25
Q

What does PISA stand for?

A

Proximal Isovelocity Surface Area

26
Q

What direction do you shift the baseline in when measuring PISA?

A

Downward

27
Q

What should you change your nyquist limit of the color scale to when measuring Pisa?

A

30-40cm/s

28
Q

True or false- when measuring PISA you should color compare. Providing an image with and without color.

A

True

29
Q

True or false- when measuring PISA you should NOT acquire images over multiple beats

A

False

30
Q

What 3 things do you need to calculate PISA and EROA?

A
  1. PISA radius
  2. VTI of MR jet
  3. VMAX of MR jet
31
Q

What is the mild Vena Contracta measurement?

A

<0.3cm

32
Q

What is the moderate Vena contracta measurement?

A

0.3-0.69cm

33
Q

What is the mild EROA measurement?

A

<0.2cm

34
Q

What is the moderate EROA measurement?

A

0.2-0.39cm

35
Q

What is the severe EROA measurement?

A

> or equal to 0.4cm

36
Q

What is the mild regur volume measurement?

A

<30ml

37
Q

What is the mod regur volume measurement?

A

30-59ml

38
Q

What is the severe regur volume measurement?

A

> or equal to 60ml

39
Q

PISA is measured from the ____ to the____

A

Vena contracts to the dome

40
Q

What does dp/dt stand for?

A

Change in pressure / change in time

41
Q

Dp/dt is a measure of?

A

Directional LV contractility

42
Q

True or false- it is easy to measure the dp/dt even in the cath lab?

A

False it’s difficult to measure even in the cath lab

43
Q

Dp/dt is the ___ of the rise of LV ____

A

Rate
Pressure

44
Q

Where is the Dp/dt measurement is taken from?

A

MR Doppler jet

45
Q

What is the normal LV DP/dt measurement?

A

> 1200 mmhg/sec

46
Q

When Cardiac output is low the dp/dt is?

A

Abnormally low

47
Q

What kind of valve regurgitation is used in echo to measure DP/dt?

A

MR

48
Q

Dp/dt measurement of MR assess what?

A

Directional LV systolic contractility

49
Q

A systolic MR velocity of 4-5 to ___ is a high gradient between LV & LA during systole.

A

5 m/sec

50
Q

LA pressure can be calculated from?

A

MR jet velocity

51
Q

What’s the LAP formula?

A

Systolic BP - MR pressure gradient

52
Q

What is Myxomatous mitral valve degeneration?

A

It’s non-inflammatory progressive alteration of the mitral valve structure associated with mitral valve prolapse and mitral insufficiency.

53
Q

Myxomatous mitral valve degeneration is associated with that 2 disease process?

A

mitral valve prolapse and mitral insufficiency

54
Q

pap muscle dysfunction is associated with?

A

Ischemic Mr

55
Q

Ischemic MR is associated with what disease?

A

Pap muscle dysfunction

56
Q

The worst the pulmonary vein systolic flow reversal is the lower or nonexistent the ____ wave is.

A

S

57
Q

What are the steps before you measure PISA?

A
  1. Zoom in on valve
  2. Lower color baseline down to 30-40 nyquist limit
  3. Color compare images
  4. Acquire over multiple beats
58
Q

Where do you measure DP/dt ?

A

You measure the time on the MR regur jet below the baseline. And you get the pressure gradient before that.

59
Q

What’s the formula for DP/dt?

A

Pressure/time of MR jet

60
Q

Patient had a BP of 120/80. And a systolic MR velocity of 3.5-4m/sec. How do you calculate LAP?

A

Systolic BP - MR jet pressure gradient

  1. First you must convert the velocity and of the MR by using the modified bernouli equation.
  2. Then you use the equation

56 is the answer

61
Q

What equation do you use to convert numbers to pressures?

A

Modified Bernoulli P4v2

Reguritation ESP Book (4 decks)

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