Random Facts

Question 1

4 measures of systolic functions that are load independent?

Answer 1

End systolic elastance
Preload recruitable stroke work
Tissue Doppler peak systolic velocity
Strain rate

Question 2

Measures of systolic function? (11)

Answer 2

Qualitative assessment
Fractional shortening
Fractional area change
Ejection fraction
Stroke volume and cardiac output
Dp/dt
Velocity id circumferential shortening (Vcf)
End systolic elastance
Preload recruitable stroke work
Tissue Doppler peak systolic velocity
Strain rate

Question 3

how do you measure strain rate?

Answer 3

[(L2-L1)/L1]/deltat
normal if more negative than -20

Question 4

Characteristics of Fibroelastomas

Answer 4

• arises on valvular tissue
• mimics appearance of vegetation
• often seen on downstream side of valve (LV side of MV; Ao side of AV)

Question 5

Low independent measurement of LV function?

Answer 5

End systolic elastance
Preload recruitable stroke work
Preload adjusted max power
Strain rate

Question 6

What value of peak TR jet would be expected with high LA pressures?

Answer 6

More than 2.8 m/s

Question 7

E/a’ inidicating high LA pressure?

Answer 7

Greater than 14

Question 8

Finding consistent with prosthetic aortic valve stenosis?

Answer 8

• peak velocity greater than 4 m/s
• mean gradient greater than 35 mmHg
• DVI = vel ration less than 0.25
• effective orifice area less than 0.8 cm2
• rounded symmetrical cwd jet with acceleration time greater than 100 ms
• Accel time/ejection time = AT/ET greater than 0.4

Question 9

8 risk factors for SAM after MV repair?

Answer 9

EDD less than 45 mm
C-sept distance less than 2.5 cm
Narrow LVOT (less than 2 cm)
Mitral-aortic angle less than 129 degrees
AP/PL ratio less than 1.3 (measured at the beginning of systole with valve closed)
Basal septal hypertrophy greater than 1.5 cm
Anterior mitral leaflet length greater than 2 cm (end diastole un me5ch)
Posterior mitral leaflet length greater than 1.5 cm (end diastole)

Question 10

MPI

Answer 10

Normal MPI <0.35
LV dysfunction>0.5
Measure of systolic and diastolic FX
Not load independent

Question 11

Av canals

Answer 11

Partial = ostium primum.ASD (no VSD)
Transitional = Primum + restrictive inlet VSD
Complete = Primum + non restrictive inlet VSD

Question 12

L-TGA is AKA?

Answer 12

Double discordance
Ventricular inversion
Congenitally corrected TGA

Question 13

List 5 associated cardiac lesions with L-TGA?

Answer 13

TV 90%
MV 55%
VSD 70-80%
LVoT obstruction (30-60%)
Complete heart block (most common arrhythmia)

Question 14

LV non compaction?

Answer 14

• thickened LV wall consisting of two layers:thin compacted epicardial layer and markedly thickened endocardial layer with numerous prominent trabeculations and deep recesses with a max ratio of non compacted myocardium if grater than 2:1 at end systole in a tte parasternal short axis view
• color Doppler highlighted flow within the recesses creates by the deep trabeculations
• involvement of the mid to apical inferior and lateral wall segments

Question 15

Lvad goal BP?

Answer 15

60-85 mmHg

Question 16

Advancing age and tissue Doppler?

Answer 16

Increase a’, decrease s’ and e’

Question 17

Tdi dependent on preload?

Answer 17

S’ and e’

Question 18

Afterloas and tdi?

Answer 18

Acute increase –> decrease e’
Chronic increase –> decrease s’ and e’

Question 19

Increase HR and tdi?

Answer 19

Increase s’

Question 20

Dp/dt

Answer 20

W mmHg/delta t nr100-300
Time required d for a mitral regurg jet to go from Vel 100 to 300 cm/s during isovolum contraction

Question 21

Pfo can be associated with?

Answer 21

Prominent eustachian valve
Chiari network
Aneurysmal Interatrial septum

Question 22

Mean pulm artery pressure?

Answer 22

PAMP -CVP= 4(Vpiearly)^2

Question 23

Lvad velocities of inflow cannula?

Answer 23

<230 for pulsatile
<200 for non pulsatile

Question 24

Finding consistent with prosthetic aortic valve stenosis?

Answer 24

Peak Vel >4
Mean PG >35
Doppler vel index (DVI) less 0.25
EOA less 0.8
Rounded symmetrical cwd jet
AT >100
AT/ET more than 0.4