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Echo Semester Final > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

1
Q

Has valvular heart disease incidence increased or decreased over time?

A

decreased

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2
Q

When a normal valve is open, the pressure on either side of the valve is effectively equal so there is not a significant pressure gradient across the open valve. T or F?

A

true

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3
Q

What is normal flow through a valve called?

A

laminar or parabolic flow

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4
Q

The circulatory system is made up of independent “hoses”, therefore a kink in one hose will not effect the workings of another. T or F?

A

false

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5
Q

Stenotic valves can cause what in the circulatory system?

A

loss of laminar flow, areas of turbulent flow, pressure/volume overload

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6
Q

Stenotic valve leads to:

A

pressure overload, turbulent flow, and hypertrophy

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7
Q

Regurgitant valve leads to:

A

volume overload, turbulent flow, and dilation

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8
Q

Doppler above the baseline represents flow (away from, towards) transducer?

A

towards

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9
Q

What is a narrowing, thickening, fusion, or blockage of a valve that impedes or obstructs blood flow through the valve?

A

Valvular stenosis

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10
Q

What are the three levels of impact of valvular stenosis?

A

proximal, at the level of the stenosis, and distal

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11
Q

(Proximal, distal, at the level of) the stenotic valve, blood backs up and pressure increases.

A

proximal

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12
Q

Pressure overload pattern is present in what chamber to the stenotic valve?

A

proximal chamber

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13
Q

Pressure overload pattern is also known as what?

A

increased afterload

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14
Q

(Hypertrophy, dilation) in the proximal chamber is a result of a stenotic valve.

A

hypertrophy

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15
Q

When atrioventricular valves are stenotic, atria cannot compensate for increased pressure and volume, therefore they enlarge. T or F?

A

true

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16
Q

At the level of the stenotic valve, the stenotic leaflets experience what during the open phase?

A

doming

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17
Q

Valvular area (increases, decreases) within the valve orifice in a stenotic valve.

A

decreases

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18
Q

What causes doming in a stenotic valve?

A

increase in pressure in the proximal chamber pushes on the undersurface of the leaflets

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19
Q

If a valve’s orifice area decreases, what happens to velocity?

A

increases in attempt to maintain cardiac output

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20
Q

Distal to the stenotic valve, flow is ________ and pressure ________.

A

turbulent, decreases

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21
Q

What is the first imaging technique to locate and evaluate a stenotic valve?

A

TTE with doppler

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22
Q

What is pressure half time?

A

the time required for the peak gradient across the valve to reduce to one-half

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23
Q

What is calculated via the P1/2T equation?

A

MVA and TVA

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24
Q

What is a mean pressure gradient?

A

averages the instantaneous gradients across the open valve

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25
Q

What is calculated via the continuity equation?

A

AVA and PVA

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26
Q

What is the maximum pressure gradient?

A

peak instantaneous gradients across an open valve

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27
Q

What is another name for valvular regurgitation?

A

insufficiency

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28
Q

What is classified as primary (organic) regurgitation?

A

structural changes to the valve itself causes regurgitation

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29
Q

What is classified as functional (secondary) regurgitation?

A

regurgitation caused by chamber remodeling (changes to the atria/ventricles)

30
Q

What is the vena contracta?

A

high velocity laminar flow within the narrowest portion of the regurgitant jet

31
Q

What does a MS murmur sound like?

A

low-pitched, diastolic rumble with opening snap

32
Q

2 main causes of mitral stenosis are:

A

rheumatic fever, severe mitral annular calcification

33
Q

Follow the chain reaction of mitral stenosis:

A

MS—increased in LAP—MV leaflet doming—LAE—backup and enlargement of Pul.Veins—increased PAP—PHTN—increased RA and RV pressure—etc.

34
Q

2 associations of MS:

A

mitral regurgitation due to LAE and dilated annulus, prohibiting leaflet closure, LA thrombus due to LAE and swirling of blood

35
Q

2 complications of MS:

A

increased risk of infective endocarditis

decreased cardiac output

36
Q

5 Echo findings of MS:

A

diastolic doming of anterior mitral valve leaflet, MV leaflet thickening, decreased MVA (<4cm^2), anterior motion of the posterior mitral valve leaflet, LAE

37
Q

2 M-mode findings of MS:

A

decreased MV excursion, anterior motion of the posterior mitral valve leaflet

38
Q

3 Echo findings of PH resulting from MS:

A

flattened IVS, small, D-shaped LV in diastole and systole

39
Q

MV Pressure Half Time Equation:

A

MVA = 220 / P(1/2)T

40
Q

MS severity:

A

mild: >1.5, severe: <1.0

41
Q

What is the most common primary valve disease?

A

aortic stenosis

42
Q

3 Etiologies of AS:

A

calcific AS

congenital bicuspid AS

rheumatic AS

43
Q

What is the most common etiology of AS in the US?

A

calcific AS

44
Q

What is the most common etiology of AS worldwide?

A

rheumatic AS

45
Q

What does the AS murmur sound like?

A

systolic crescendo decrescendo, heard at sternal border, radiates to carotids

46
Q

Two complications of AS:

A

LV pressure overload leads to LV hypertrophy

increase risk of infective endocarditis

47
Q

Continuity Equation:

A

AVA= (VTI(LVOT)) X (CSA(LVOT)) / VTI(AOV)

48
Q

Aortic stenosis severity:

A

mild: >1.5cm^2

severe:<1.0cm^2

49
Q

What are two causes of acute AR?

A

ascending aortic dissection

infective endocarditis

50
Q

What are two causes of chronic AR?

A

Aortic stenosis

bicuspid AOV

51
Q

What does the AR murmur sound like?

A

high-pitched, blowing, diastolic decrescendo at left sternal border

52
Q

What is an Austin Flint murmur?

A

severe AR murmur, sounds like low-pitched rumble at apex

53
Q

Complications of AR:

A

overtime, LV dilation

decreased LV function

heart failure

54
Q

AR echo findings:

A

diastolic flutter of anterior mitral valve leaflet

left ventricular dilation which may lead to hypertrophy

55
Q

What does the TS murmur sound like?

A

diastolic rumble varies with respiration and has opening snap

56
Q

3 causes of TS:

A

rheumatic heart disease

Ebstein anomaly

RA thrombus/tumor

57
Q

TS echo findings:

A

thickened leaflets

diastolic doming

RA enlargement

58
Q

TVA equation:

A

190 / P(1/2)T

59
Q

What does the TR murmur sound like?

A

holosystolic that increases with inspiration

60
Q

3 causes of TR:

A

secondary TR due to RA/RV enlargement

myxomatous degeneration primary TR

61
Q

Complications of TR:

A

RA/RV enlargement leads to A-fib

enlarged IVC

62
Q

Echo findings of TR:

A

RA enlargement

dilated IVC

diastolic flutter of TV leaflets

63
Q

RVSP equation:

A

RVSP= 4V^2 + RAP

64
Q

PH severity:

A

normal: 10-25 mmHg

severe: >70 mmHg

65
Q

What does the PS murmur sound like?

A

harsh systolic ejection heard at left upper sternal border

66
Q

3 levels of PS:

A

subvalvular/infundibular

valvular

supravalvular

67
Q

Causes of PS:

A

congenital

carcinoid heart disease

68
Q

PS Echo findings:

A

thickening of leaflets

RV hypertrophy

flattened IVS

D-shaped LV

69
Q

What does the PR murmur sound like?

A

low-pitched diastolic murmur increased with inspiration

70
Q

What is a Graham-Steele Murmur?

A

TR murmur heard when PH is present

high-pitched blowing diastolic murmur

71
Q

PR causes:

A

PH causes annular dilation

infective endocarditis/vegetation

Echo Semester Final (8 decks)

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