Week 7 Left Heart Flashcards
What is M mode
- 1d imaging
- structures in the line of the cursor will be sampled
- superior temporal resolution compared to 2D
What is the FPS in M mode compared to B Mode
M mode: > 1200 FPS
B mode: 50 FPs
Advantages of M mode
- high temporal resolution
- allows for precise measurements
- High FPS
Disadvantages of M mode
- linear measurements does not represent true volume
- does not show true lateral distance between structures
- cannot estimate EF%
What is the cursor placement for M mode imaging
1) Ao root, Av cusps, and LA
2) MV leaflets
3) LV at the level of the MV tips (between pap and valve)
M Mode NL values
- Ao root: 2.0-3.7 cm
- LA: 1.9-4.0 cm
What is normal MV E point separation in M mode
EPSS: 0.7 cm
What are the 4 major regions/structures of the RV
1) RVIT
2) RVOT
3) Apex
4) membranous septum
What is the NL value for RVOT proximal diameter
<3.3 cm
What is plax rv inflow view good for
- assessing TV morphology
- measuring peak TR velocity
- assessing stenosis
What is plax RVOT view good for
- assessing PV morphology
- Visualing PR
- measuring PR velocity
- assessing stenosis
Normal value for RVOT distal diameter
<2.7
What is modified RV good for
- Assessing TV morphology
- Visualizing RV free wall
- Visualizing TR
- measuring Peak TR velocity
What is apical 4 chamber view good for?
- assessing TV morphology
- visualizing Lv-RV comparison
- visualizing TR
- Measuring peak TR velocity
What size should the RV be compared to the LV?
The RV should be 2/3 the size of the LV
Normal size of RA area
<18cm^2
What is TAPSE
- Tricuspid annular plane systolic excursion
- the annular movement of the rvs lateral annulus reflects systolic function
Normal value for tapse
> 1.6
What is the normal value for pw tdi velocity of annulus
< 10 cm/s
What are technical factors affecting peak tdi velocity measurements
1) suboptimal image quality
2) US beam alignment (non parallel can underestimate peak velocity)
3) sample box not aligned on the annulus
What is RV fractional area change
- reflects overall RV systolic fxn
- ## same EF% but for the RV
Equation for RVFAC
(EDA-ESA)/EDA x 100
Normal value for RVFAC
> 35%
Technical factors affecting RVFAC
1) suboptimal image quality
2) not in a RV focused view
3) measuring at wrong time in cardiac cycle
What view is rv wall thickness measured and what is NL value
- Measured in subcostal 4 chamber
- NL value is <5 mm
- used for determining hypertrophy of RV
