Valvular Heart D Flashcards
After Balloonig surgery for mMitral valve, what is the best way to calculated MVA?
Planimetry
Stages of Valvular Heart Disease?
Stage A= at risk
Stage B= Progressive
Stage C= Asymptomatic Severe
Stage D= Symptomatic Severe
what is this? wnad where we see it?
Late systolic MR.
Hammocking Sign
Antegrade Flow
Back Flow jet
Antegrade flow: Two normal flow seen in patient with Prostetic bileafelt valve
Back Flow jet: Two normal Regurgitation flow back
DX
Bioprosthetic Valve.
There’s not reverberation or shadowing
Atrial Dilatation will lead to?
Trumbus and Atrial Fibrillation
Image compatible with?
TR.
Systolic flow reversal (s wave is retrograde means above base line and it should be bellow baseline anterograde)
DX
Cut of sign in Acute mitral regurgitation
It’s the opposited to dagger signal from Dinamic obstruction
Differeces Between Pannus and Thrombus?
Pannus is groing tissue (chronic), surgically removed
Trambus is acute and can be treated with Fibrinolysis
Minor criteria for I endocarditis (duke critireas)
-Fevere> 38
-Vacular phenomena
-Inmunologic phenomena
-Evidence of active infection
-Predisposing heart condition or inejction od grugs
most commun Bioprosthetiv Valve?
Stented xenograph
What can we see in patient with Mitral Stenosis, 2D and Color?
L shape or Hockey Stick
Fish mouth
Domming in Diastole
La enlargment
Color
Candle Flame
M- Mode
Thick Mitral Leaflet
Decrease of E - F slope
Pulling of the posterior leaflet up by the anterior leaflet
DX?
Mitral Stenosis
Does the HR affects Mitral valve Area?
YES, good HR <80 (faster HR, Pessure Gradiant increase)]j
MV depends of Preload
Perivalvular complication of endocarditis?
Abscess
fistula
Mycotic Aneurysm
2D and M-mode of Bicuspid Aortic V.
Systolic and Diastolic Duming (charactristic of Bicuspid V)
Eccentric line in diastolic (M-Mode)
what is a systemic Valve
Sistemy Valve is the one that is providing Oxigenited blood for Ejemplo MV
when Calculating the EOR by PISA method from where do you take the alising velocity?
The lowest
Which Orifice area is smaller: FOR or AOR
FOR or Cross-sectional orifice Area
Which Orifice Area is Evaluagted by Echo?
FOA
diagnosis, and explination
Mitral stenosis, Cause by comisural fusion of the two leafles (comun see it in Rehumatic MS)
Maximun gradiant is always higert than Peak to Peak gradiant? True or False
True
Ingroing tissue from the sewing ring in a PHV, that has to be surgical removed.
Pannus
Pannus is chronic
Paradoxical Low Flow, low Gradiant
AVA < 1 or < 0,6cm2
Pressure Gradiant < 40mmhg
EF > 50%
SV <35 ml
The leaflet body displaces into the LA, the leaflet tips stay at annular level or above into LV
Billowing
DX
Bbileaflet prothetic valve. and vegetation
Does the PHV mechanical patient, requires lifelong anticoagulation?
Yes, mechanical valve requires Lifelong antocoagulation
In Prosthetic Valve. more than one closing or openin click, indicates:
Rocking Valve
means, the valve is moving and it’s not totally place correctly
Systolic Flow reversal in pumonary veins, Means?
Severe Mitral Regurg
S reversal
Congenital Disease where the separation between MV and TV is more than 1cm
Ebstein’s Anomaly
Low Flow, High Gradiat
AVA < 1 or < 0,6cm2
Pressure Gradiant > 40mmhg
EF < 50%
Most common cause of MR?
Myxomatous degenerative.
Causes: Valve porlapse and Flail
Local complication of Infected endocarditis?
Local valvular tissue Destruction:
Deformation
Perforation
that will lead to Regurgitation
The valves are named base on the Ventricle
LV= MV
RV=TV
true
the trycuspic Valve Vegetations in most common in:
Drug Abuse patient
DX
Methalic prosthetic valve
You can see the click
most common complication in patient with Stented Bioprothestic valve?
LVOT obstruction
Whas is Holosystolic MR?
The Regurgitation occurs during the whole Systole
Define eccentric Swarling jet.
indicates severe MR
AVA < 1 or < 0,6cm2
Pressure Gradiant < 40mmhg
EF < 50%
Low Flow Low gradiant AS
Major duke criteria: echocardiography
-Vegetation
-Peri-Valvular abscess
-New or partial; dehiscence
-New regurgitation
-PAravalvular regurgitation
Major Criteria for Infective Endocarditis
Positive culture for IE
Evidence of Endocardial Involvement (echo- Cardiac Ct or Nuclear imaging)
Name of the most Severe Form of Degenerative MV.
BARLOW’S disease
Is caracterized by bileaflet prolapse
DX
MV prolapse. Late systolic Hammoching
Leaflet displacement more than 3 cm bellow the C- D line
The radio of the FOA and the AOR is known as:
Discharge Coefficient
Average course of Valvular Aortic Stenosis
Avarage of 60 years of age:
Angina
Syncope
HF
Symptons Starts in decompasated Phase
What is this and where do we see it?
Holosystolic MR
Tipicaly in Patient with MR due MI or non-isquemic cardiomiopaty
Characterists of Compensated Aortic Stenosis
Increase Afterload
Decrease Stroke Vomune (in decompasated phase)
Preserved Contractility
When does the symptons of Aortic Stenosis will apper?
When the Orifice is reduced to One Quarter its normal size
In which View is MV porlapse evaluated?
PLAX
DX
Subvalvular Aortic Stenosis
Normal Flow High Gradiant AS
AVA < 1 or < 0,6cm2
Pressure Gradiant > 40mmhg
EF > 50%
SV >35 ml
AVA < 1 or < 0,6cm2
Pressure Gradiant > 40mmhg
EF > 50%
SV <35 ml
Paradoxical
High Gradiant
Low Flow AS
What is this
Eccentric diastolic line
Bicuspid AV
DX
Dehiscence of Mechanical Prosthetic Valve (Rocking Valve)
Excessive Bublle Destruction in the near field. (Apex) during contraste study
Swirling
Patology on the image? and Which disease can it causes?
Enstein’s Anomaly
TVR
What can we see in PX with MS?
2D, M mode and color
2D:
Doming in diastoly PLAV, 4C, 2C
L shape or Hockey Stick PLAV
Fish mouth PSAX
Calcification on the tips or on the body of the valve
M-Mode
Increase of the F slope
E and A wave of the Posterios leaflet going up
Color d
Candle Flame
Refers to an increase of Stroke Volumen more than 20% after DST?
Contractile Flow Reverse
Direction of the jet in MV prolapse or flail?
away from the valve afected
Rheumatic Valvular Desiase Affects which valvular first?
give order
1-MV
2-MV + AV
3-AV
4-MV + AV + TV
Name and where do we see it
Picklehaube Sign
bileaflet mitral prolapse in TDI PW Doppler.
S wave > 16cm/sec
what can it be associated to Goose Neck?
AVSD
what is this
Bicuspid AV domming in sistole and diastole
Hos is the E velocity in Mitral stenosis
it’s high
Is peak Velocity Realted to Regurgitation?
Not.
Peake velocity is related to stenosis
DX
Aortic Paravalvular Abscces
How to calculated MVA?
Planemetry
PHT
PISA
Continutiy Equt
Primary Triscuspid Regurgitation is called?
Low pressure TR
Does Biological valve have Click? or created the roching Valve
Not, The click is sseinjg in Prosthetic Valve and more than one closing click can indicated Rocking valve
Above which Velocity, E wave has to be, to be considered. Severe MR
E mitral wave Velocity more than 1,2m/s
DX
Bioprosthetic Valve
There is not reverberation
Pressure Gradiatn Acroos the mitral valve, depends on:
AVA
LV-LA Compliance
HR
Transvalvular Flow
The leaflet tips displaced into the LA from the annular plane and the leaflet tips pointing toward the LV
Prolapse
leaflet displaced more than 2 cm above the annulaus
Secuandary Tricuspid Regurgitation is called?
High Pressure TR
Tricuspid valve vegetation is more commun in:
Drug abuse patient
patology
Ebstein anomality
