MR Quiz Flashcards
Which vessels perfuse the posteromedial papillary muscle?
RCA
Which vessels perfuse the anterolateral papillary muscle?
LCX and LAD
this makes this pap muscle less susceptible to ischemia and rupture.
what are the cell layers of the mitral leaflet?
Arterialis- composed of elastin
Spongiosa- composed of elastin and collogen
Fibrosa- the ventricular side.
collogen and elastin provide the support and strength and shape to the valve structures during dynamic forces.
what is the normal mitral valve area?
4-6 cm2
what is the mitral valve annulus diameter?
2.3 cm (+/- 0.5)
What is the normal valve thickness?
no greater than 3mm
what is the normal anterior mitral leaflet length?
no greater than 2 cm
what is the normal posterior mitral leaflet length?
1.4 - 2 cm
what is the annulaortic fibrosa?
the Aortic Mitral curtain.
draw the surgical, transthoracic and TEE views of the mitral valve and their scallops
thoracic: A3,A2,A1 > Trigone
TEE: P3, P2, P1 > Trigone
Surgical: Trigone > A1, A2, A3
what does a mitral regurge murmer sound like?
holosystolic, decrescendo, heard at the apex, may radiate out toward the axilla.
What are the grades of murmur?
1/6 faint and difficult to hear 2/6 faint but heard immediately 3/6 moderately loud 4/6 loud 5/6 very loud 6/6 heard with bell off the chest
What is class I mild heart failure?
No limitation of physical activity. ordinary physical activity does not cause undue, fatigue, competition or dyspnea (shortness of breath).
What is class II mild heart failure?
Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity resulting fatigue, palpitation or dyspnea.
What is class III moderate heart failure?
Marked limitation of physical activity. Comfortable at rest, but less then ordinary activity causes fatigue, palpitation or dyspnea.
What is class IV severe heart failure?
Unable to carry out any physical activity without discomfort. Symptoms of cardiac insufficiency at rest. If any physical activity is undertaken discomfort is increased.
What are the grades of a PISA radius?
less than 4mm = mild 5-7 mm = mild to moderate 7-10mm = moderate to severe 1 cm (10mm) = Severe
In color flow what are the grades of mitral regurgitation?
1+ = Mild 2+ = Mild to Moderate 3+ = Moderate to Severe 4+ = Severe
When measuring the vena contracta, what are the grades of severity?
Less than 3 mm = mild MR
4 to 6 mm = Moderate MR
Greater than 6 mm = Severe MR
What are the steps to perform a PISA?
Zoom the mitral Valve
Decrease color baseline to identify hemesphere shell
Note aliasing velocity
Measure PISA radius
Calculate Regurgitant flow rate = 2(pie) r2 X Va
what are the grades of severity in the RJA/LAA calculation?
Less than 10% = Trace
Less than 20% = Mild
21 to 39% = Moderate
Greater than 40% = Severe
how do you calculate Regurgitant Volume? ( RV )
MVSV - LVSV
What do you calculate by CSA x VTI?
SV = CSA x VTI
What is the equation for CSA?
CSA= 0.785 x d2
What are the grades of severity for RV & RF%
Grade 1 + Mild < 30cc ( < 30% )
Grade 2+ Moderate 30-44cc ( 30 - 44% )
Grade 3+ Mod/Severe 44-59cc ( 44 - 59% )
Grade 4+ Severe > 60cc ( > 60% )
What are the grades of severity for ERO?
Grade 1 = < 10
Grade 2 = 10 - 25
Grade 3 = 25 - 35
Grade 4 = > 35
What are the three calculations for ERO?
6.28 x r2 x aliasing velocity/ MR Jet Velocity
RV /MR VTI
r2/2
What is normal MVA?
Normal = 4-6cm2
What is the normal MV Annulus dimension?
MV annulus 2.3cm (+/- 0.5)
