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Personal CV > TEE 2 > Flashcards

TEE 2 Flashcards

1
Q

What is the equation for obtaining Fractional area change?

A

FAC = (EDA-ESA)/EDA

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2
Q

Name the ways EEF are estimated?

A
  • Normal = >55
  • Mild 45-54
  • Moderately 35-44
  • Moderate Severe 25-34
  • Severe <25
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3
Q

The LV is divided into 17 segments, how is each one qualitativley rated for thickening during systole?

A
  • 1 = Normal = 30% thickening
  • 2 = Mild hypokinesis = 10 - 30%
  • 3 = Severe hypokinesis = < 10%
  • 4 = Akinesis = no thickening
  • 5 = Dyskinesis = Thinning w/ paradoxical motion
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4
Q

What is a suggestive of myocardia ischemia?

A

-An increase in the scale of 2 or more regions

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5
Q

In assessment of diastolic function what does he PWD E wave correspond with?

A

Early passive diastolic flling

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6
Q

In assessment of diastolic function what does he PWD A wave correspond with?

A

Atrial contraction filling

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7
Q

A mild form of diastolic dysfunction results in what?

A

-impaired relaxation pattern

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8
Q

What causes an impaired relaxation pattern?

A
  • Decreased peak E-A velocity

- Prolonged E wave decelartion

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9
Q

Advanced diastolic dysfunction causes what?

A

-restrictive pattern

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10
Q

What causes a restrictive pattern?

A
  • Increased peak E-A velocity

- Decreased E wave deceleration

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11
Q

What is pseudonormal pattern?

A

-As diastolic dysfunction progresses from mild to severe there are periods when pattern appears normal

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12
Q

How is normal diastolic function identified?

A
  • Positive waves during systole and diastole

- Negative wave during atrial contraction

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13
Q

Mitral valve prolapse is present when a portion of the leaflet moves to the _______ side during ________

A
  • Atrium

- Systole

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14
Q

When is flail present?

A
  • choradae tendenae is ruptured

- Leaflet is oscillating in LA during systole

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15
Q

How is mitral regurge severity rated?

A

1-4 scale with 1 being mild and 4 severe

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16
Q

What are the 2 causes of functional Mitral Regurge?

A
  • Dilation of Annulus

- Papillary muscle displacement

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17
Q

What causes the annulus dilation and papillary displacement in functional MR?

A

-Wall motion abnormalities from CAD and LV dilation

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18
Q

What type of MR is common and requires surgery?

A

Myxomatous degeneration

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19
Q

Myxomatous degeneration is caused by what?

A

-Elongated, redundant leaflets that prolapse into LA during systole

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20
Q

What is the most common form and easiest to fix of Myxomatous degeneration?

A

-Prolapse of middle scallop of posterior leaflet

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21
Q

What type of MR is causes thickening and shortening MV leaflets?

A

Rheumatic

22
Q

Rheumatic MR is ________ to repair and usually requires ________ valve

A

Difficult, Prosthetic

23
Q

What does promixal isovelocity surface area do?

A

-Quantify MR with echo, using CFD, CWD

24
Q

Proximal isovelocity surface area is commonly applied to _______ MR and not accurate for _________ MR

A
  • Central

- Eccentric

25
Q

ROA of less than 0.2 cm² is considered _______ while ROA of 0.4 cm² is considered ________.

A

Mild

Severe

26
Q

Mitral stenosis is almost always caused by what?

A

Rheumatic heart disease

27
Q

What is considered severe and moderate Mitral stenosis?

A
  • Severe <1 cm²

- Moderate 1-1.5 cm²

28
Q

In what 2 ways con Mitral Stenosis be measures

A
  • Planimetry

- Pressure half time

29
Q

Rate at which pressure gradient decreases across stenotic valve is directly related to what? and is called what?

A
  • severity of stenosis

- Pressure half time

30
Q

The severity of aortic regurge is measured how?

A
  • Size of regurgitant jet on CFD

- Depth it extends into LV

31
Q

Evaluation of Aortic Stenosis is based on what?

A
  • 2D valve appearance

- Doppler velocity measurement of flow through valve

32
Q

Severity of aortic stenosis can be made by what 3 ways?

A
  • Trasaortic gradients
  • Planimetry
  • Aortic valve area (AVA) by continuity equation
33
Q

Transaortic gradients be calculated using what by what?

A
  • Simplified bernouli equation

- CWD

34
Q

During aortic valve planimetry, what finding is considered significant?

A

-Aortic valve area of less than 1 cm²

35
Q

What is the continuity equation?

A

Same amount of flow passes through the AV and LVOT w/ each stroke

36
Q

How is TR graded and what is it based on?

A
  • Semiquantitative 1-4 scale

- Size or reguritant jet

37
Q

Significant TR is caused by what?

A

annular dilation secondary to right heart failure

38
Q

Tricuspid stenosis is _________ seen and is due to ________.

A

Rarely

rheumatic heart disease

39
Q

Pulmonic stenosis is usually ________ and rare in adult

A

Congenital

40
Q

When looking at the left atrium what is being looked for?

A
  • Size (normal less than 5 cm)

- Masses (Afib)

41
Q

A variable sized fold of tissue at the junction of the IVC and the RA is called what?

A

-Eustachian valve

42
Q

What is a chiari network?

A

-Fine filamentous mobile strands in the RA

43
Q

What parts of the aorta can be blocked by the trachea?

A
  • Distal ascending

- Proximal arch

44
Q

Normal inside diameter of ascending aorta? Aortic arch? Descending aorta?

A
  • 3.5 cm
  • 3.0 cm
  • 3.0 cm
45
Q

3 common abnormalities of the aorta detected by TEE

A
  • Atherosclerosis
  • Aneurysm
  • Dissection
46
Q

Normal thickness of aorta intima layer

A
  • < 2mm
47
Q

How are aortic aneurysms classified?

A
  • Location

- shape (diffuse or saccular)

48
Q

How are aortic dissections classified?

A
  • Type A = Ascending (surgical emergency)

- Type B = Non-Ascending (treated medically)

49
Q

Measuring stroke volume w/ TEE requires what 2 measurements? Taken when and where?

A
  • Velocity profile
  • Area which flow occurs
  • both Must be measured at same location at same time in cardiac cycle
50
Q

What view is used to monitor for ischemia?

A

TG mid SAX

51
Q

Beside ischemia, what other problem may cause wall motion abnormalities?

A

-Hypovolemia

52
Q

Air in the heart is easily seen in TEE as what?

A

-Hyperdense or white

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