Pulmonic/Tricuspid Pathology Flashcards
TV flow varies with?
respiration and increasing during inspiration
pressures on the right are
lower than pressures on the left
color doppler eval of TV
- RV inflow view
- PSAX
- apical 4
what is TS
narrowing or obstruction of the LV that impedes flow from the Ra to the RV during diastole
How to measure TS mean pressure gradient
CW VTI trace
moderate TS measurement
2-6
mild TS mean pressure gradient
less than 2 mmHg
TS mean pressure gradient severe
greater than 6 mmHg
obtaining the pressure half time for TS
PHT deceleration slope CW waveform
normal TV
7-9cm squared
severe TS PHT
greater than 190 msec
is TR holosystolic
yes
most common cause of secondary or functional TR
annular dilation from RV or RV enlargement
most common cause of primary TR
myxomatous degeneration of TV
what is peak TR velocity used to calculate what?
the RV systolic pressure and the systolic pulmonary artery pressure
right atrial pressure is estimated by the…
IVC diameter and percentage of collapse as seen in the subcostal view
high SPAP will give patients…
SOB
equation to measure RVSP
what is RAP when the ivc collapse more than 50%
3 mmhg
what is the RAP when the ivc collapse 30-40%
8 mmhg
what is the RAP when the ivc collapse less than 50%
15 mmhg
eisenmengers syndrome
the process which a long standing left to right shunt cause by a congenital heart disease by a VSD or ASD causes pulmonary hypertension
normal SPAP
18-25 mmhg
pulmonary hypertension is defined by
- elevated SPAP greater than 25 mmhg at rest, greater than 30 mmhg with exercise
- elevated pulmonary vascular resistance: the resistance the Rv must overcome to pump blood into the PA
normal pulmonic flow peaking during
mid systole
normal PV outflow
blue
PI flow
red in diastole
the PV is evaluated in what views
RVOT tilt view
PSAX
subcostal short axis
PV cw vti will give you
mean pressure gradient
how do you obtain the pulmonic valve area
- PV PW vti
- PV CW VTI
- RVOT diameter
severe PS peak pressure gradient
greater than 64 mmhg
how else can you asses pulmonic stenosis
running m mode though the right posterior PV leaflet
look for a dip in mid systole and a more prominent rising slope
pulmonary hypertension m mode
look for mid systolic closure notch, creates the flying W pattern
how is PI evaluated
with CW in the RVOT and PSAX view
the end diastolic velocity of the PR jet can be used to calculate the…
pulmonary artery end diastolic pressure
normal pulmonary artery end diastolic pressure
4-12 mmHg
Tricuspid stenosis symptoms
ascites
abdominal swelling
edema
TV area equation
TVA=190/PHT
back up of blood flow due to TS
diastolic doming due to TS
RA enlargement due to volume overload and pressure overload
dilated IVC
what is enlarged on echo due to TR
- RA
2.RV - IVC
- hepatic veins
RV volume overload cause the septal to
become paradoxical septal motion
in absence of pulmonary vascular disease an elevated RVSP/SPAP indicates
elevated LAP and can identify increased LV filling pressure
most common cause of PS
congenital
most common form of acquired PS
carcinoid heart disease
m mode of the Right posterior pv cusp with PS
increased A wave depth
the end diastolic pulmonic regurg gradient helps identify…
the pulmonary artery pressure and cardiac dysfunction
TV area equation w/ pht
190/pht
TS signs and symptoms
jaundice
LE swelling
ascites
most common cause of TS
rheumatic heart disease
TS mean pg severe
> 5
carcinoid hard disease affects which side of the heart
the right side
