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CCI book Review > Ventricular Function Systolic / Diastolic > Flashcards

Ventricular Function Systolic / Diastolic Flashcards

1
Q

Flow velocity integral normal aortic valve

A

18-22cm

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2
Q

Flow velocity integral of normal mitral valve

A

10-13cm

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3
Q

What does Dp/dt mean

A

Changes in pressure over time

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4
Q

LV DP/dt
Normal
Borderline
Abnormal

A
  • 1200 mmHg/sec
    -1000-1200 mmHg/sec
  • <1000 mmHg/sec
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5
Q

What does hypokinetic mean for wall motion ?

A

Heart walk movements have a decreased amplitude or reduced low wall function

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6
Q

What does akinetic mean?

A

Absence of systolic wall thickening

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7
Q

What does dyskinetic wall motion mean ?

A

Systolic expansion of segment which is thin and moves PARADOXICALLY relative to surrounding myocardium

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8
Q

What does aneurysmal mean?

A

Weakening or thinning of the wall

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9
Q

How many wall segments does the LV have?

A

17

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10
Q

What are the 6 segments of the basal portion of the LV in short axis?

A

Anterior
Anterolateral
Inferolateral
Inferior
Inferoseptal
Anteroseptal

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11
Q

What are the 6 segments of the mid cavity portion of the LV in short axis?

A

Mid anterior
Mid anterolateral
Mid inferolateral
Mid inferior
Mid inferoseptal
Midabteroseptal

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12
Q

What are the 4 segments of the apex portion of the LV in short axis

A

Apical anterior
Apical lateral
Apical inferior
Apical septal

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13
Q

To obtain functional values of the 16 cardiac segments they are arranged as a _________. (Circle chart)

A

Polar plot

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14
Q

In a polar plot where is the apex?

A

At the center (#17)

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15
Q

In polar plot, what is in the first ring?

A

4 apical segments

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16
Q

For polar plot what’s after the 4 apical segments (going inner to outer)

A

Mid cavity segments

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17
Q

In polar plot what is the outermost ring?

A

Basal

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18
Q

In pillar plot what segments are involved with the left anterior descending coronary artery?

A

1-2-7-8-13-14-17

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19
Q

In polar plot what segments are in the right coronary artery ?

A

3-4-9-10-15

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20
Q

In Polar point what segments are with the left circumflex coronary artery ?

A

5-6-11-12-16

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21
Q

What is diastolic dysfunction ?

A

When LV myocardium does NOT listen and does not accept normal blood return from the LA
( the LV is not filling properly bc myocardium is not properly moving!)

22
Q

To evaluate LV diastolic dysfunction, a ______ Doppler is placed at the MV leaflets

23
Q

What is a normal PW E/A ratio?

24
Q

What does IVRT stand for?

A

Isovolumetric relaxation time

25
What is diastisis?
When LA passively fills LV and then stops
26
What are the 4 grades of diastolic dysfunction ?
1 = impaired relaxation 2= pseudonormal 3= restrictive (reversible) 4= restrictive (non reversible)
27
In grade 1 of diastolic dysfunction, what happens to the E wave velocity? - ratio? - deceleration time?
Reduced resulting in E/A reversal - <1.0 - >200 milliseconds
28
In grade 2 of diastolic dysfunction, - what happens? - signs and symptoms - function status - left atrium - filling pressures - excel time
- slow early LV with decreased LV compliance - dyspnea - moderate impairment - enlarged and hypocontractile - increased - 160-200ms
29
What is a common clue to the presence of grade 2 as compared to normal diastolic function is …
LA enlargement LV hypertrophy Dyspnea
30
In grade 2 what process is done first distinguish pseudonormal from normal as well as e to e prime ratio ?
Valsalva maneuver
31
In grade 3 of diastolic dysfunction - what happens? - signs and symptoms - functional status - left atrium - filling pressures - decel time
- severe decrease in LV compliance and slow early LV relaxation - dyspnea - impairment - enlarged and hypocontractile - increased - <160ms
32
What happens in grade 4 ? - e/a ratio -
Indicates a poor prognosis and very elevated left atrial canal pressures - >2.0
33
What does the valsalva maneuver do? - what does it permit?
Increased intrathoracic pressure and this reduces venous return to the atrium - the unmasking (hidden) elevated filling pressures
34
Valsalva maneuver unmasks diastolic dysfunction and alters pseudonormal filling into______
Impaired relaxation
35
To perform valsalva have the patient __________
Bear down
36
The valsalva maneuver if effective once you see a rise in _____
Heart rate
37
What does tissue Doppler measure ?
Slow speeds of muscle and tissue movements
38
What does PW Doppler measure?
Faster speeds of blood
39
A stiff heart will have a _____ speed of muscle relaxation
Slower
40
In diastolic dysfunction we use TDI to specifically measure the speed of the left ventricular muscle relaxation during _____
Diastole
41
In TDI the motions of the MV annulus mirrors ____ and _____ events
Systolic and diastolic
42
In TDI of MV the annulus moves towards _____ during ____
Apex Systole
43
In TDI of the MV , the annulus moves ______ the atrium during _____
Towards diastole
44
In TDI the E’ and A’ waves are ______ the baseline
Below
45
What is the main limitation for performing echo for diastolic dysfunction?
Technical difficulties getting the images and getting them at the correct angle
46
Normal diastolic function - E/A ratio - Decel time (DT)
- 1.0 - 1.5 - >160 ms
47
Impaired relaxation grade 1 -E/A ratio - DT
- <1.0 - >200 ms
48
Pseudonormal grade 2 - E/A ratio - DT
- 0.8-1.5 - 160-200 ms
49
Reversible restricted grade 3 - EA ratio -DT
- >= 2.0 - <160 ms
50
Fixed restricted grade 4 - EA ratio - DT
- >= 2.0 - <160 ms

CCI book Review (7 decks)

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