Unit 1 Flashcards
Dyskinesis
squeezes in the wrong direction
hypokinesis
slow or limited movement
akinesis
with scarring, not moving with bright reflector.
aneurysmal
dilated with an outward movement during systole with systolic thinning
Normal measurements for AO root
2.2 - 3.7 cm
When is the AO root measured?
Diastole
Normal measurements for the LA
2.5 - 4.0 cm
When is the LA measured?
systole
Normal measurements for IVS
.7 - 1.1 cm
When is the IVS measured?
diastole
Normal measurements for the LVIDd
4.0 - 5.6 cm
When is the LVID measured?
diastole and systole
Normal measurements for LVIDs
2.0 - 3.8 cm
Normal measurements for PLVW?
.7 - 1.1 cm
When is the PLVW measured?
diastole
Normal measurement for fractional shortening?
greater than 25%
normal measurement for ejection fraction?
greater than 55%
Stress echo can be used at what point of the ischemic cascade?
diastolic disfunction followed by systolic dysfunction. Can be seen before ECG and chest pain
What is the importance of the stress echo
it can differentiate between viable myocardium from the scarred myocardium
What are the reasons to stop and not complete a stress echo?
- unstable angina, 2. severe base line hypertension, 3. uncontrolled rhythms, 4. mobile LV thrombus, 5. severe aortic stenosis, 6. HOCM, 7. decompensated HF
How quickly do the images need to be taken after target heart rate is reached?
60 seconds
What drug is used for a medical stress echo?
Dobutamine
How much dobutamine is give and over how much time in stress echo?
10mg and then 10 more every 3 min.
What are some false negatives for stress echo?
inadequate stress, antianginal treatment, mild stenosis, poor image quality, delayed images
What are some false positives for stress echo?
abnormal septal motion (LBB), cardiomyopathies, hypertensive response to stress
Which M-mode view to we just acquire, no measurements
the mitral valve
In M-mode at the aortic root, what structures are also seen?
RVOT, ascending aorta, RCC and NCC, LA
When is the aortic root measured?
end-diastole
When is the LA measured?
end-systole
What would indicate aortic stenosis during m-mode?
calcified, bright, multiple lines during systole and diastole
Which leaflet of the MV moves in a mirror image?
the posterior leaflet
What does the D-E point reflect on the mitral valve?
the excursion of the MV leaflet - rapid filling of the LV
What does the E-F point reflect on the mitral valve?
the rate of LV filling or LA emptying
What does the A point correspond with on the mitral valve?
the p wave of the ECG and reflects filling during atrial systole
What does C and D reflect on the mitral valve?
systole when the valve is closed
When looking at m-mode, how do we know there is MV prolapse?
bowing of the leaflet (not-mirror image)
What are the two biggest indicators of mitral stenosis in m-mode
thickened leaflets and PMVL moves anteriorly
Where does MV stenosis occur?
at the commissural edges
What is the mitral valve B notch?
When the MV doesn’t close. Indicates elevated LV end diastolic pressure. LV dilated
What indicates HOCM
Asymmetric septal hypertrophy (ASH), Mid systolic closure of the aortic valve, and systolic anterior motion of the MV (SAM)
What is HOCM?
Hypertrophic obstructive cardiomyopathy. When the LA pressure is lower than the LV pressure. Pulls the AMVL into the outflow tract
