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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

A

PW

23
Q

What is a normal PW E/A ratio?

A

1.1-1.5

24
Q

What does IVRT stand for?

A

Isovolumetric relaxation time

25
Q

What is diastisis?

A

When LA passively fills LV and then stops

26
Q

What are the 4 grades of diastolic dysfunction ?

A

1 = impaired relaxation
2= pseudonormal
3= restrictive (reversible)
4= restrictive (non reversible)

27
Q

In grade 1 of diastolic dysfunction, what happens to the E wave velocity?
- ratio?
- deceleration time?

A

Reduced resulting in E/A reversal
- <1.0
- >200 milliseconds

28
Q

In grade 2 of diastolic dysfunction,
- what happens?
- signs and symptoms
- function status
- left atrium
- filling pressures
- excel time

A
  • slow early LV with decreased LV compliance
  • dyspnea
  • moderate impairment
  • enlarged and hypocontractile
  • increased
  • 160-200ms
29
Q

What is a common clue to the presence of grade 2 as compared to normal diastolic function is …

A

LA enlargement
LV hypertrophy
Dyspnea

30
Q

In grade 2 what process is done first distinguish pseudonormal from normal as well as e to e prime ratio ?

A

Valsalva maneuver

31
Q

In grade 3 of diastolic dysfunction
- what happens?
- signs and symptoms
- functional status
- left atrium
- filling pressures
- decel time

A
  • severe decrease in LV compliance and slow early LV relaxation
  • dyspnea
  • impairment
  • enlarged and hypocontractile
  • increased
  • <160ms
32
Q

What happens in grade 4 ?
- e/a ratio
-

A

Indicates a poor prognosis and very elevated left atrial canal pressures
- >2.0

33
Q

What does the valsalva maneuver do?
- what does it permit?

A

Increased intrathoracic pressure and this reduces venous return to the atrium
- the unmasking (hidden) elevated filling pressures

34
Q

Valsalva maneuver unmasks diastolic dysfunction and alters pseudonormal filling into______

A

Impaired relaxation

35
Q

To perform valsalva have the patient __________

A

Bear down

36
Q

The valsalva maneuver if effective once you see a rise in _____

A

Heart rate

37
Q

What does tissue Doppler measure ?

A

Slow speeds of muscle and tissue movements

38
Q

What does PW Doppler measure?

A

Faster speeds of blood

39
Q

A stiff heart will have a _____ speed of muscle relaxation

A

Slower

40
Q

In diastolic dysfunction we use TDI to specifically measure the speed of the left ventricular muscle relaxation during _____

A

Diastole

41
Q

In TDI the motions of the MV annulus mirrors ____ and _____ events

A

Systolic and diastolic

42
Q

In TDI of MV the annulus moves towards _____ during ____

A

Apex
Systole

43
Q

In TDI of the MV , the annulus moves ______ the atrium during _____

A

Towards
diastole

44
Q

In TDI the E’ and A’ waves are ______ the baseline

A

Below

45
Q

What is the main limitation for performing echo for diastolic dysfunction?

A

Technical difficulties getting the images and getting them at the correct angle

46
Q

Normal diastolic function
- E/A ratio
- Decel time (DT)

A
  • 1.0 - 1.5
  • > 160 ms
47
Q

Impaired relaxation grade 1
-E/A ratio
- DT

A
  • <1.0
  • > 200 ms
48
Q

Pseudonormal grade 2
- E/A ratio
- DT

A
  • 0.8-1.5
  • 160-200 ms
49
Q

Reversible restricted grade 3
- EA ratio
-DT

A
  • > = 2.0
  • <160 ms
50
Q

Fixed restricted grade 4
- EA ratio
- DT

A
  • > = 2.0
  • <160 ms

CCI book Review (7 decks)

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