Ventricular Function Flashcards
Hibernating myocardium is:
A. Myocardium that is hyperkinetic post myocardial-infarction
B. Reperfused viable myocardium that is nonfunctional because of chronic ischemia
C. Viable myocardium that is nonfunctional because of chronic ischemia
D. Viable myocardium at rest but not functional with exercise
C. Viable myocardium that is nonfunctional because of chronic ischemia
\_\_\_\_\_ is a direct measure of myocardial contractile function. A. Strain B. E-F Slope C. Deceleration time D. EPSS
A. Strain
The formula used to determine fractional shortening is: A. EDV - ESV B. (EDV - ESV) / EDV X 100 C. CSA X VTI D. (EDD-ESD) / EDD X 100
D. (EDD-ESD) / EDD X 100
The echocardiographic appearance of necrotic myocardium secondary to myocardial infarction includes all of the following EXCEPT: A. Echogenic wall segment B. Akinetic wall segment C. Wall motion score of 1 D. Thin ventricular wall
C. Wall motion score of 1
A systolic wall motion score of 3 is assigned to a certain segment of left ventricular muscle indicates: A. Normal B. Akinetic C. Dyskinetic D. Hypokinetic
B. Akinetic
Stress echocardiography methods that may be used to detect hibernating myocardium include: A. Treadmill B. Handgrip C. Low-does dobutamine D. Cold pressure
C. Low-does dobutamine
Patients with increased diastolic filling pressures post-exercise will demonstrate:
A. Increased mitral deceleration time
B. E/Eprime ratio > 10
C. Normal mitral E/A ratio
D. Normal tricuspid regurgitation peak velocity
B. E/Eprime ratio >10
The most specific echocardiographic finding for ischemic heart muscle is:
A. Alterations in systolic wall thickening
B. Abnormal diastolic wall motion at the ischemic segment
C. Normal diastolic wall motion
D. Normal systolic wall motion
A. Alterations in systolic wall thickening
An ejection fraction of 42% is determined with 2D echocardiography. This indicates \_\_\_\_\_\_ global left ventricular systolic function. A. Mildly abnormal B. Moderately abnormal C. Severely abnormal D. Normal
B. Moderately abnormal
A wall segment of the heart that is without systolic wall thickening is best described as: A. Hypokinetic B. Hyperkinetic C. Dyskinetic D. Akinetic
D. Akinetic
A thrombus shape that is associated with embolization is: A. Spherical B. Flat C. Pedunculated D. Eccentric
C. Pedunculated
Which of the following mitral valve flow patterns provides risk stratification post-myocardial infarction? A. Restrictive (Grade III-IV) B. Normal for age C. Pseudonormal (grade II) D. Impaired relaxation (grade I)
A. Restrictive (grade III-IV)
An increased mitral valve E point to septal-separation (EPSS) may indicate:
A. Reduced ejection fraction
B. Left atrial myxoma
C. Pulmonary hypertension
D. Increased left ventricular end-diastolic pressure
A. Reduced ejection fraction
A pericardial effusion develops in a patient two weeks post-myocardial infraction. This suggests \_\_\_\_\_ syndrome. A. Dressler's B. Williams C. Marfan D. Down
A. Dressler’s
A PW Doppler tracing of the MV inflow at the leaflet tips is obtained with the following information: E/A ratio is 0.7; deceleration time is 320 msec; a tissue doppler at the mitral annulus demonstrated an Eprime peak velocity of 6 cm/s and an E/Eprime ratio is 7. The diastolic grade is: A. III or IV B. II C. I D. Normal diastolic function
C. I
The rate at which the left ventricular pressure rises in ventricular systole is referred to as: A. dP/dt B. dv/dt C. dt/dP D. dd/tP
A. dP/dt
The formula used to determine ejection fraction is: A. (EDV - ESV) / EDV X 100 B. CSA X VTI C. EDV - ESV D. (EDD -ESD) / EDD X 100
A. (EDV - ESV) / EDV X 100
Echocardiographic findings in the post-myocardial infraction patient include: A. Mitral annular calcification B. Mural thrombus C. Valvular stenosis D. Ventricular septal aneurysm
B. Mural thrombus
The infraction most commonly associated with left ventricular aneurysm is: A. Anterior B. Lateral C. True posterior D. Inferior
A. Anterior
The normal response of non-infracted myocardium in a patient with acute myocardial infarction is: A. Dyskinesis B. Hyperkinesis C. Hypokinesis D. Akinesis
B. Hyperkinesis
The four most common 2D views acquired during a stress echocardiogram are the PLAX, PSAV PAP, A4, and the:
A. Apical two-chamber
B. Apical long-axis
C. Subcostal short-axis at the cardiac base
D. Apical five-chamber
A. Apical two-chamber
For exercise echocardiography the images post-exercise need to be acquired within \_\_\_\_ from the time the patient exercise is completed. A. 3 hours B. 5 minutes C. 60 seconds D. 60 minutes
C. 60 seconds
Which of the following methods is recommended to determine left ventricular volumes? A. Biplane Simpson's method of discs B. Teichholtz C. Cubed D. Bipane area-length
A. Biplane Simpson’s method of discs
Which of the following pharmacological agents increases contractility and increases heart rate? A. Verapamil B. Digitalis C. Dobutamine D. Propranolol
C. Dobutamine
The correct term for describing decreased ventricular systolic wall thickening is: A. Dyskinetic B. Hyperkinetic C. Hypokinetic D. Akinetic
C. Hypokinetic
The most common medication used in performing pharmacological stress echocardiography is: A. Adenosine B. Dipyridamole C. Propranolol D. Dobutamine
D. Dobutamine
A possible etiology for pericardial effusion is: A. Pulmonary regurgitation B. Mitral valve prolapse C. Acute myocardial infarction D. Mitral valve stenosis
C. Acute myocardial infarction
The most common etiology for ischemic heart disease is coronary artery: A. Atherosclerosis B. Spasm C. Embolus D. Aneurysm
A. Atherosclerosis
The type of myocardial infarction which most often involves the right ventricle is: A. Anterolateral B. Lateral C. Anterior D. Inferior
D. Inferior
Echocardiography differentiates a pseudoaneurysm from a true ventricular aneurysm by the: A. Width of the neck of the aneurysm B. Length of the aneurysm C. Diastolic motion of the aneurysm D. Width of the border of the aneurysm
A. Width of the neck of the aneurysm
The primary indication for stress echocardiography is:
A. Evaluation for coronary artery disease
B. Evaluation of ejection fraction
C. Assessment of cardiac valve abnormalities
D. Diagnosis of shunt lesions
A. Evaluation for coronary artery disease
A positive stress echocardiogram consists of:
A. Normal left atrial dimension peak exercise
B. Normal wall motion pre and post exercise
C. Normal wall motion to akinesis
D, Improved ejection fraction
C. Normal wall motion to akinesis
The formula used to determine stroke volume by doppler is: A. EDV - ESV B. CSA X VTI C. (EDD - ESD) / EDD X 100 D. (EDV - ESV) / EDV X 100
B. CSA X VTI
In determining the size of myocardial infarction echocardiography generally:
A. Predicts the exact size of infarct
B. Underestimates recent myocardial infarction and overestimates old myocardial infarction
C. Is unpredictable
D. Overestimates recent myocardial infarctions and underestimates only myocardial infarction
D. Overestimates recent myocardial infarctions and underestimates only myocardial infarction
The definition of stunned myocardium is:
A. Myocardium after cardiopulmonary resuscitation
B. Reperfused viable myocardium that is not functioning
C. Myocardium after electrical cardioversion
D. Myocardium that is hyperkinetic post-myocardial infarction
B. Reperfused viable myocardium that is not functioning
A PW Doppler tracing of the MV inflow at the leaflet tips is obtained with the following info: E/A ratio is 1.2, decal time is 200 msec, tissue doppler of the mitral annulus peak Eprime wave velocity is 7 cm/s, Eprime/Aprime ratio is 0.6 and a E/Eprime ratio is 12 is calculated. The diastolic grade is Grade: A. III B. I C. II D. IV
C. II
The principal echocardiographic/Doppler findings of right ventricular infraction include all of the following EXCPET:
A. Right ventricular hypertrophy
B. Abnormal motion of the right ventricular free wall
C. Right ventricular dilatation
D. Tricuspid regurgitation
A. Right ventricular hypertrophy
Which maneuver is most useful to use when trying to determine the presence of Grade II (pseudonormalization) or when determining between Grade III (reversible restrictive) and Grade IV (fixed restrictive): A. Valsalva B. Squatting C. Leg raising D. Mueller
A. Valsalva
In patients with dilated cardiomyopathy, the index of myocardial performance (IMP) will be: A. Normal B. Dependent on blood pressure C. Increased D. Decreased
C. Increased
A pulsed-wave Doppler tracing of the mitral valve inflow at the leaflet tips is obtained with the following information: E/A ratio is 2.3, deceleration time is 123 msec, Valsalva maneuver demonstrated no change in the E/A ratio, tissue Doppler of the mitral valve annulus demonstrates an E' wave peak velocity of 3 cm/s and an E/E' ratio of 33 is calculated. The diastolic grade is grade: A. IV B. III C. II D. I
A. IV
Possible mechanisms in the development of mitral regurgitation following acute myocardial infraction include all of the following EXCPET:
A. Incomplete closure of the mitral valve
B. Fibrosis of the papillary muscle
C. Papillary muscle rupture
D. Mitral valve stenosis
D. Mitral valve stenosis
The expected Doppler finding in a patient with ventricular septal rupture is:
A. Turbulent high-velocity flow in systole on the right side of the interventricular septum
B. Turbulent high-velocity flow in diastole on the right side of the septum
C. Laminar low-velocity flow during diastole on the left side of the interventricular septum
D. Laminar high-velocity flow in diastole on the right side of the septum
A. Turbulent high-velocity flow in systole on the right side of the interventricular septum
