Pulmonary Regurg

Question 1

Pulmonary Regurg: Etiology

Answer 1

1. Primary valve disease
2. Pulmonary hypertension
3. Carcinoid heart disease
4. Trivial/mild regurg is common

Question 2

Pulmonary Regurg: Etiology–> Primary valve disease

Answer 2

1. Stenosis

2. Endocarditis

Question 3

Pulmonary Regurg: Pathophysiology

Answer 3

1. RV volume overload
2. Severe regurg may cause right heart failure
3. Even moderate regurg will be well tolerated for years
4. Increased risk for endocarditis

Question 4

Pulmonary Regurg: Pathophysiology–> RV volume overload may lead to?

Answer 4

RV dilation

Question 5

Pulmonary Regurg: Pathophysiology–> Severe regurg may cause?

Answer 5

Right heart failure

Question 6

Pulmonary Regurg: Murmur

Answer 6

Low pitched diastolic murmur (LSB) may increase with inspiration

Question 7

Pulmonary Regurg: Physical signs–> With pulmonary hypertension murmur

Answer 7

A high pitched blowing diastolic murmur (Graham-Steele) may be heard (LSB)

Question 8

Pulmonary Regurg: Echo

Answer 8

1. RV dilation with displacement of LV septum posteriorly

2. TRicuspid valve fluttering is rare

Question 9

Pulmonary Regurg: Doppler RVOT

Answer 9

Diastolic turbulence in the RVOT

Question 10

Pulmonary Regurg: Doppler–> Map the regurg area with?

Answer 10

Pulsed or color flow doppler

Question 11

Pulmonary Regurg: Doppler–> Severe PI spectral trace is

Answer 11

NOT holodiastolic

Question 12

How would you calculate pulmonary artery end diastolic pressure?

Answer 12

Pulmonic insufficiency velocity

Question 13

PAEDP equation

Answer 13

PAEDP= RAP+ EDP(converted from the EDV)