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Echocardiography I > Unit 3 > Flashcards

Unit 3 Flashcards

1
Q

What is the first 3 indications of mitral regurgitation?

A

LA dilated, LV dilated, and LVVO pattern

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2
Q

How thick are the mitral valve leaflets?

A

1 mm

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3
Q

Which leaflet of the MV is longer?

A

Anterior. Larger from the base to the center. About 2.0 cm

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4
Q

Which leaflet of the MV is shorter?

A

Posterior. Takes up about 1/3 of the base but is only 1.2 cm in width

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5
Q

About how many chordae tendonae arise from each papillary muscle?

A

12 Primary chordae

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6
Q

What else should you always look for with MR?

A

blood pressure

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7
Q

You should evaluate the MV and the _________ for the cause of MR.

A

left ventricle

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8
Q

What is primary MR?

A

Something is structurally wrong with the valve.

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9
Q

What is secondary MR?

A

Due to enlarged LV or other cause

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10
Q

Where is the jet with primary MR?

A

eccentric, aka the edges of the valve

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11
Q

Where is the jet with secondary MR?

A

central jet

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12
Q

Ischemic MR is caused by?

A

LV remodeling. Coronary artery disease

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13
Q

Non-ischemic MR is caused by?

A

chronic cardiomyopathies

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14
Q

What is symmetric tethering?

A

both leaflets tethered causing global LV systolic dysfunction and remodeling

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15
Q

What type of MR jet is common with symmetric tethering?

A

centrally located jet

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16
Q

What is asymmetric tethering?

A

one leaflet tethers due to localized remodeling and dysfunction of posterior wall

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17
Q

What type of MR jet is common with asymmetric tethering?

A

eccentrically posterior directed MR jet

18
Q

What two things can cause tenting of the MV?

A

inferior MI and non-ischemic cardiomyopathy

19
Q

Mitral stenosis has a ________ gradient for a stronger severity.

A

higher. (5-10mmHg is moderate for MS)

20
Q

Mitral regurgitation has a __________ for a stronger severity

A

lower. (EX on powerpoint was 4.5 m/s is severe MR)

21
Q

LA dilation is one of the first symptoms of MR. Which direction can the LA be dilated?

A

vertically or horizontally. Sometimes PLAX isn’t accurate because it only measures inferior to superior.

22
Q

Vena Contracta represents the effective flow area with MR. What is mild and what is severe?

A

Mild = less than or equal to 0.3 cm
Severe = greater than or equal to 0.7 cm

23
Q

We use color flow to subjectively determine MR severity. What is mild MR?

A

Jet is just beyond the MV leaflets

24
Q

We use color flow to subjectively determine MR severity. What is moderate MR?

A

Jet is 1/3 way into left atrium

25
Q

We use color flow to subjectively determine MR severity. What is severe MR?

A

Jet mid to back wall of left atrium. Goes back towards the pulmonary veins.

26
Q

MR happens in what cardiac cycle?

A

systole

27
Q

What type of murmur is heard with MR?

A

holosystolic that radiates to the armpit. Blowing or high-pitched murmur

28
Q

What side of the baseline is MR seen on with Doppler?

A

below the baseline

29
Q

What type of murmur is heard with AR?

A

high-pitched, blowing, diastolic decrescendo murmur at the left sternal boarder.
Severe AR creates a low-pitched, mid-diastolic, rumble at the apex (Austin-Flint murmur)

30
Q

What cardiac phase does AI occur in?

A

Diastole

31
Q

What are the first three cardiac sequelae for AR?

A

LVVO, dilated LV, and increased LV end-diastolic pressure (lean patient forward)

32
Q

What cardiac phase is a bicuspid aortic valve best seen in?

A

systole

33
Q

What does Phen-fen do to the valves?

A

Adds a gristle-like material

34
Q

What characteristics are seen with Marfan’s syndrome?

A

dilated aortic root with associated MVP connective disease

35
Q

When is surgery indicated for severe AI?

A

Early closure of the MV and early opening of the AOV

36
Q

What is the pressure half time for mild AI?

A

Greater than 400 milliseconds

37
Q

What is the pressure half time for moderate AI?

A

400 - 200 miliseconds

38
Q

What is the pressure half time for severe AI?

A

Less than 200 milliseconds

39
Q

How can you tell the difference in chronic and acute AI in regards to the Doppler velocities?

A

Chronic is wider and flatter. Acute has more of an angle for pressure halftime

40
Q

How can you tell the difference in MS and AI?

A

MS does not reach high velocities like AI. AI occurs in the isovolumic phases. AI has a greater end diastolic velocity

41
Q

The ___________ the jet, the more severe the AI.

A

Wider. Not about distance, it’s about width of jet. Unlike MR.

42
Q

If the eccentric jet of AR hits the AMVL, what does this cause?

A

A smiley sign. Diastolic doming. Reverse doming.

Echocardiography I (3 decks)

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