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Echocardiography I > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q

Normal flow for Mitral Valve

A

.6 - 1.3 m/s

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2
Q

Normal flow for tricuspid valve

A

.3 - .7 m/s

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3
Q

Normal flow for pulmonary artery

A

.6 - .9 m/s

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4
Q

Normal flow for LVOT

A

.7 - 1.1 m/s

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5
Q

Normal flow for aortic valve

A

1.0 - 1.7 m/s

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6
Q

Where is MV flow obtained from?

A

Apical 4 chamber

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7
Q

What type of flow does the mitral valve display?

A

biphasic flow

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8
Q

Where is the TV flow obtained from?

A

Apical 4 chamber, RV inflow, Parasternal short at AO valve

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9
Q

What type of flow does the tricuspid valve display?

A

biphasic flow

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10
Q

Where is aortic valve flow taken from?

A

apical 5 chamber, subcostal

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11
Q

Where is the pulmonic valve flow taken from?

A

parasternal short at AO valve, pulmonary artery outflow tract, subcostal

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12
Q

What is different in the LA and the LV in mitral stenosis?

A

There is an increased gradient. LA pressure is increased causing pulmonary hypertension.

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13
Q

What must you check if a patient has mitral stenosis?

A

RVSP

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14
Q

What physical symptoms might someone have with mitral stenosis?

A

Sleeping on two pillows at night because their heart rate drops and blood backs up into the pulmonary system causing a dry cough in the morning. (PHTN)

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15
Q

When might you see hockey stick leaflets of the mitral valve?

A

Rheumatic mitral stenosis

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16
Q

What are the four things noted in m-mode if someone has mitral stenosis? Which is most important?

A
  1. Thickened leaflets
  2. Decreased E-F slope
  3. Anterior movement of the PMVL
  4. LA enlargement
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17
Q

What is planimetry of the MV orifice?

A

Measuring the orifice

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18
Q

In Doppler, the MV normally looks like an M. What does an abnormal (stenotic) MV look like/ what characteristics does it have?

A

Looks like a trapezoid. It has spectral broadening and a persistent gradient

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19
Q

What is pressure half time?

A

The amount of time it takes the initial peak pressure gradient to fall to one half its original pressure

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20
Q

If a patient’s MV mean gradient is between 5-10 they have what type of stenosis?

A

Moderate

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21
Q

What is the pulmonary artery pressure for someone with moderate MS?

A

30-50

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22
Q

What is the valve area for someone with moderate MS?

A

1.0 - 1.5

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23
Q

What does color flow Doppler look like for someone with mitral stenosis?

A

Candle flow, aliased flow

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24
Q

Why would a stress Doppler be used for MS?

A

Exercise increased volume of the heart. This will increase the mean gradient and the RVSP

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25
Q

What does mitral stenosis with smoke in the left atrium indicate?

A

precursor for clot formation with an organized clot in the LAA

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26
Q

What is a bicuspid aortic valve?

A

2 cusps

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27
Q

What might someone with a bicuspid aortic valve experience in the first 5-7 decades of their life?

A

Early calcification of their leaflets

28
Q

50% of people with bicuspid aortic valves have what condition as well?

A

coarctation of the descending aorta

29
Q

How might the leaflets of the aorta look with someone who has aortic stenosis?

A

Doming

30
Q

What is the hemodynamics of aortic stenosis?

A

Rise in LV pressure, LVP overload, LVH, rise in LVEDP, rise in LA pressure, eventually it will lead to LV systolic dysfunction

31
Q

What are some 2-D findings for someone with aortic stenosis?

A

Thickened leaflets, systolic/diastolic doming, how many cusps, dilated AO root, LV systolic and diastolic function, concentric LVH, co-existing lesions

32
Q

Normal pressure gradient flow for the aortic valve?

A

.7 - 1.9 m/sec

33
Q

What level of AS does a patient have if their pressure gradient is 3 - 4 m/sec

A

Moderate

34
Q

When do we use the Bernoulli equation?

A

To convert velocity to a pressure gradient

35
Q

What is the Bernoulli equation?

A

4(V2)squared - 4(V1)squared

36
Q

What is different with Echo and Cath gradients?

A

Echo measures peak instantaneous and Cath measure peak to peak. Echo will be higher so we compare the MEAN gradient from both

37
Q

What do V1 and V2 represent?

A

V1 is pre-aorta (outflow tract) and V2 is in the aorta

38
Q

What is the formula for A2 or the AVA?

A

(Area1 x velocity 1) divided by velocity 2

39
Q

Tricuspid flow and Mitral flow are seen in what cardiac phase? (same as stenosis)

A

Diastole

40
Q

Tricuspid flow and Mitral flow are seen above or below the baseline? (same as stenosis)

A

Above

41
Q

Tricuspid/mitral regurgitation are seen in what cardiac phase?

A

Systole

42
Q

Tricuspid/mitral regurgitation are seen above or below the baseline?

A

Below

43
Q

The pulmonic and aortic valve, normal flow, is seen in what cardiac phase?

A

systole

44
Q

The pulmonic and aortic valve, normal flow, is seen above or below the baseline?

A

Below

45
Q

The pulmonic and aortic valve, regurgitation, is seen in what cardiac phase?

A

diastole

46
Q

The pulmonic and aortic valve, regurgitation, is seen above or below the baseline?

A

above

47
Q

Higher frequencies mean _________ wavelengths

A

Smaller

48
Q

Lower frequencies mean ___________ wavelengths

A

higher

49
Q

Doppler tracings must be ____________ to flow

A

parallel

50
Q

What is the Doppler shift? (Doppler equation)

A

Cos0 is 0 degrees = 1
90 degrees = 0 (as the denominator)

51
Q

Mild mitral stenosis will have __________ gradient during ____________

A

persistent gradient
diastasis

52
Q

Severe mitral stenosis will have ___________ gradient

A

high

53
Q

The higher the _____________ in the LA the lower the ___________

A

pressure, velocity

54
Q

respirations do not play a role in _____ or ______ but do with _________

A

MS or MR, Tricuspid regurgitation

55
Q

Pressure 1/2 time in the MVA is under what number?

A

220

56
Q

Pressure 1/2 time in the TVA is under what number?

A

190

57
Q

Pulmonic stenosis has a _______ velocity with a _______________________

A

low, diastolic shelf

58
Q

How can you tell the difference in AI and MS?

A

AI peaks early and reaches higher velocities. Peaks during the IV times. MS not as high as 3.0 and only occurs when the MV is open.

59
Q

In stenosis, the chamber ________ the valve will be ______ and have a ____________

A

behind
dilated
pressure overload

60
Q

Echo uses ________ gradients but Cath uses _____________. Use the __________ for both.

A

peak instantaneous
peak to peak
mean gradient

61
Q

AOV uses ____________.
MV uses ______________.

A

Peak
Mean

62
Q

What kind of murmur is heard with AS?

A

systolic crescendo decrescendo murmur

63
Q

What kind of murmur is heard with MS?

A

diastolic rumble. not loud. decrescendo-crescendo

64
Q

What is the continuity equation?

A

LVOTD^2 x .785 x LVOTTVI

65
Q

What is the AVA equation?

A

LVOTD^2 x .785 x LVOTTVI/ AOVTVI (V2)

Echocardiography I (3 decks)

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