Tricuspid and pulmonic valves

Question 1

Primary TR

Answer 1

Only about 10% of TR
iatrogenic
endocarditis
ebsteins - associated with SVT and ASD
rheumatic
carcinoid - serotonin is cause
myxomatous
drug related

Question 2

secondary TR

Answer 2

RV dysfunction and annular dilation - 90% of TR

Leads to TR which causes vol overload , leaflet tethering and more TR

Question 3

TV annulus

Answer 3

greater than 4 cm in diastole is dilated

Question 4

RV E and A wave

Answer 4

If E<A then TR is not severe

Question 5

Color flow doppler limitations

Answer 5

Physics principles unrelated to hydraulic flow (momentum = mass x velocity). Nyquist limit too high/low as well as gain too high/low can alter how significant a jet looks

Question 6

ASE guidelines for TR

Answer 6

VC 0.3-0.69 moderate (assumes jet is round, and can be large compared to actual hydraulic vena contracta)
EROA 0.2-0.4 moderate (as EROA gets larger, shells of PISA get flat and that it is round, PISA radius changes over time)
Rvol 30-44 moderate

massive and torrential have been proposed