Regional And Global Lv Sys Fxn

Question 1

What condition are associated with region and global systolic dysfunction

Answer 1

• Cardiomyopathies
• Pressure/volume overload

Question 2

What types of cardiomyopathy are associated with systolic dysfunction

Answer 2

• dilated
• ischemic/nonischemic
• hypertrophic
• Restrictive

Question 3

What are the 3 types of short axis segments of the LV and their numbers

Answer 3

• Base 1-6
• mid 7-12
• Apex 13-16

Question 4

Name short axis segments 1-6

Answer 4

1) basal anterior wall
2) basal anteroseptal wall
3) basal inferoseptal wall
4) basal inferior wall
5) basal inferolateral wall
6) basal anterolateral wall

Question 5

Name short axis segments mid 7-12

Answer 5

7) mid anterior wall
8) mid anteroseptal wall
9) mid inferoseptal wall
10) mid inferior wall
11) mid inferolateral wall
12) mid anterolateral wall

Question 6

Name short axis segments of Lv apex 13-16

Answer 6

13) apical anterior wall
14) apical septal wall
15) apical inferior wall
16) apical lateral wall

Question 7

How many LV segments are in short axis vs apical

Answer 7

Short axis has 16 segments
Apical has 18 segments

Question 8

Name the 4ch apical segments from left to right

Answer 8

• basal anterolateral
• mid anterolateral
• apical lateral
• apical cap
• apical septum
• mid inferoseptum
• basal inferoseptum

Question 9

Name the 2ch segments from left to right

Answer 9

• Basal anterior
• mid anterior
• apical anterior
• apical cap
  -apical inferior
• mid inferior
• basal inferior

Question 10

Name apical 3ch segments from left to right

Answer 10

• basal anteroseptal
• mid anteroseptal
• apical septum
• apical cap
• apical lateral
• mid inferolateral
• basal inferolateral

Question 11

How to asses regional myocardial function

Answer 11

Observing wall thickness and endocardial motion

Question 12

Define hyperkinetic

Answer 12

Hyperkinetic is excessive movement of the myocardium

Question 13

Define hypokinetic

Answer 13

Reduced systolic thickening of the ventricles

Question 14

Define hypokinetic

Answer 14

Reduced systolic thickening of the ventricles

Question 15

Define akinesis

Answer 15

No systolic thickening

Question 16

What arrhythmia may mimic wall motion abnormalities

Answer 16

Left bundle branch block

Question 17

Define dyssynergia

Answer 17

A disturbance in muscular coordination, abrupt movements

Question 18

What is normal kinesis of the left ventricles

Answer 18

All segments move towards the center of the cavity in a coordinated fashion

Question 19

What is the quantitative approach when assessing for wall abnormalities

Answer 19

• a 2D biplane simpsons
• 3D volumetric LV EF% (if available)
• Global Longitudinal Strain (GLS)

Question 20

Why is 3D better for assessing EF than 2D

Answer 20

3D accounts for all walls of the ventricle

Question 21

EF equation

Answer 21

[(LVEDV-LVESV) / LVEDV] x 100

Question 22

Stroke volume equation

Answer 22

LVEDV-LVESV = SV

Question 23

Why do we use UEA

Answer 23

• LVO (colors in the ventricle)
• EBD (to visualize myocardium)
• visualize intracardiac masses including thrombus in the apex

Question 24

Normal values for GLS (men and women)

Answer 24

Men: -18% - -26%
Female: -17% - -25%
(High GLS value reflect good fxn(-25%))

Question 25

What is GLS

Answer 25

• Global Longitudinal Strain
• expressed as a negative value due to change in length from original segment