Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Echo Registry Review > Wk 2 Terry Reynolds *AR/AS evaluation > Flashcards

Wk 2 Terry Reynolds *AR/AS evaluation Flashcards

1
Q

Continuity Equation?

*figuring out effective orifice area (EOA)

A

https://www.cardioserv.net/echo-aortic-stenosis-continuity-equation/

AVA = (0.785) x (LVOT d)2 x (LVOT PSV peak systolic velocity) / (AV PSV peak systolic velocity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

!!!

Classic symptoms associated with severe valvular aortic stenosis include all the following EXCEPT:

A. Angina pectoris
B. Atypical chest pain
C. Congestive heart failure
D. Syncope

A

B. Atypical chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pathologies that may result in a left ventricular pressure overload include all the following EXCEPT:

A. Discrete subaortic stenosis
B. Mitral valve stenosis
C. Systemic hypertension
D. Valvular aortic stenosis

A

B. Mitral valve stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Secondary echocardiographic findings associated with severe valvular aortic stenosis include all the following EXCEPT:

A. Decreased left ventricular systolic function (late in course)
B. Left ventricular hypertrophy
C. Post-stenotic dilatation of the ascending aorta
D. Right ventricular hypertrophy

A

D. Right ventricular hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

!!!

The pulse that is characteristic of significant valvular aortic stenosis is:

A. Pulsus alternans
B. Pulsus bisferiens
C. Pulsus paradoxus
D. Pulsus parvus et tardus

A

D. Pulsus parvus et tardus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

!!!

The cardinal symptoms of valvular aortic stenosis include all the following EXCEPT:

A. Angina pectoris
B. Congestive heart failure
C. Palpitations
D. Syncope

A

B. Congestive heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

!!!

Heart sounds associated with significant valvular aortic stenosis include:
A. Loud S1
B. Fixed split S2
C. S3
D. S4

A

D. S4

A S4 heart sound can be an important sign of diastolic heart failure or active ischemia and is rarely a normal finding. Diastolic heart failure frequently results from severe left ventricular hypertrophy, or LVH, resulting in impaired relaxation (compliance) of the LV. In this setting, a S4 is often heard.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The principle electrocardiographic finding in severe valvular aortic stenosis is:

A. Atrial fibrillation
B. Left atrial enlargement
C. Left ventricular hypertrophy
D. Right ventricular hypertrophy

A

C. Left ventricular hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cardiac Doppler parameters used to assess the severity of valvular aortic stenosis include all the following EXCEPT:

A. Aortic pressure half-time
B. Aortic velocity ratio
C. Mean pressure gradient
D. Peak aortic valve velocity

A

A. Aortic pressure half-time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The intracardiac pressure that will most likely be increased in patients with severe valvular aortic stenosis is:

A. Left ventricular pressure at end-diastole
B. Pulmonary artery pressure
C. Right atrial pressure
D. Right ventricular pressure at end-diastole

A

A. Left ventricular pressure at end-diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

!!!

The onset of flow to peak aortic velocity Doppler tracing in severe valvular aortic stenosis is:

A. Increased
B. Decreased
C. Decreased with expiration
D. Increased with inspiration

A

A. Increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

!!!

A Doppler mean pressure gradient of 18 mmHg is calculated in a patient with valvular aortic stenosis. The severity of the stenosis is:

A. Mild
B. Moderate
C. Moderately severe
D. Severe

A

A. Mild

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
  1. A more appropriate name for idiopathic hypertrophic subaortic stenosis (IHSS) is:

A. Aortic tunnel disease (ATD)
B. Discrete subaortic valve stenosis (DSS) C. Hypertrophic Cardiomyopathy (HCM) D. Subaortic hourglass deformity (SHD)

A

C. Hypertrophic Cardiomyopathy (HCM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  1. Types of supravalvular aortic stenosis include:

A. Discrete fibromuscular stenosis
B. Hourglass deformity
C. Hypertrophic obstructive cardiomyopathy
D. Tunnel aortic valve stenosis

A

B. Hourglass deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

!!!

The severity of aortic valve stenosis may be underestimated if only the maximum velocity measurement is used in the following condition:

A. Anemia
B. Doppler intercept angle of 0°
C. Low cardiac output
D. Significant aortic insufficiency

A

C. Low cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The most common etiology for chronic aortic insufficiency is:

A. Idiopathic dilatation of the aortic root and aortic annulus
B. Infective endocarditis
C. Marfan’s syndrome
D. Trauma

A

A. Idiopathic dilatation of the aortic root and aortic annulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

!!!

The characteristic feature of the murmur of aortic insufficiency is a:

A. Diastolic decrescendo blowing murmur heard best along the left sterna border
B. Diastolic crescendo-decrescendo murmur heard best along the left upper sterna border
C. Diastolic rumble following an opening snap
D. Harsh systolic ejection murmur heard best at the right upper sterna border

A

A. Diastolic decrescendo blowing murmur heard best along the left sterna border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The murmur associated with severe aortic insufficiency is:

A. Austin Flint murmur
B. Carvallo’s murmur
C. Graham Steell murmur
D. Still’s murmur

A

A. Austin Flint murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

!!!

A technique used in the cardiac catheterization laboratory that determines the severity of aortic insufficiency is:

A. Austin Flint technique
B. Judkin’s technique
C. Left ventriculography
D. Supravalvular aortography

A

D. Supravalvular aortography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

!!!

Echocardiographic evidence of severe, acute aortic insufficiency includes all the following EXCEPT:

A. Premature closure of the mitral valve
B. Premature opening of the aortic valve
C. Premature opening of the mitral valve
D. Reverse doming of the anterior mitral valve leaflet

A

C. Premature opening of the mitral valve

21
Q

!!!

The M-mode measurements that have been proposed as an indicator for aortic valve replacement in patients with chronic severe aortic insufficiency are left ventricular:

A. End-diastolic dimension ≥ 55 mm and fractional shortening of ≤25%
B. End-diastolic dimension ≤ 55 mm and fractional shortening of ≥ 25%
C. End-diastolic dimension ≥70 mm and left atrial dimension ≥ 55 mm
D. End-systolic dimension ≥ 55 mm and fractional shortening of ≤ 25%

A

D. End-systolic dimension ≥ 55 mm and fractional shortening of ≤ 25%

22
Q

!!!

Reverse diastolic doming of the anterior mitral valve leaflet is associated with:

A. Flail mitral valve
B. Papillary muscle dysfunction
C. Rheumatic mitral valve stenosis
D. Severe aortic insufficiency

A

D. Severe aortic insufficiency

23
Q

!!!

The hallmark M-mode finding for aortic insufficiency is:

A. Coarse diastolic flutter of the anterior mitral valve leaflet
B. Fine diastolic flutter of the anterior mitral valve leaflet

C. Chaotic diastolic flutter of the mitral valve
D. Systolic flutter of the aortic valve

A

B. Fine diastolic flutter of the anterior mitral valve leaflet

24
Q

!!!

A pulsed-wave Doppler blood flow velocity profile of aortic insufficiency obtained from the apical five-chamber view will demonstrate a diastolic:

A. Laminar high-velocity flow signal
B. Laminar low-velocity flow signal
C. Turbulent high-velocity flow signal
D. Turbulent low-velocity flow signal

A

C. Turbulent high-velocity flow signal

25
Q

!!!

The simplest semiquantitative technique for determining the severity of aortic insufficiency using pulsed-wave Doppler is:

A. Comparing the detected jet height to the left ventricular outflow tract height
B. Detecting a laminar diastolic flow pattern, which indicates severe aortic insufficiency
C. Examining the spectral strength of the regurgitant jet
D. Flow mapping of the left ventricle

A

D. Flow mapping of the left ventricle

26
Q

!!!

Severe aortic insufficiency can be diagnosed by continuous-wave Doppler by all the following criteria EXCEPT:

A. A maximum velocity of > 3 m/sec
B. A pressure half-time of ≤ 300 msec
C. Aortic insufficiency deceleration slope ≥ 3 m/sec
D. Darkened spectrum of the regurgitant jet

A

A. A maximum velocity of > 3 m/sec

*slope of the AR spectral display 3 m/s2 may indicate significant AR

27
Q

!!!

The severity of aortic insufficiency may best be determined with color flow Doppler by the following method:

A. Measuring the aortic insufficiency jet aliasing area in the parasternal longaxis view
B. Comparing the aortic insufficiency jet height with the left ventricular outflow tract height
C. Measuring the aortic insufficiency jet maximal height
D. Noting the temporal pattern of color variance

A

B. Comparing the aortic insufficiency jet height with the left ventricular outflow tract height

28
Q

!!!

A color flow Doppler technique that permits detection of 3+ to 4+ aortic insufficiency is:

A. Early diastolic flow reversal in the abdominal aorta
B. Early diastolic flow reversal in the descending thoracic aorta
C. Holodiastolic flow reversal in the descending thoracic aorta
D. Holosystolic flow reversal in the abdominal aorta

A

C. Holodiastolic flow reversal in the descending thoracic aorta

29
Q

!!!

Proximal flow convergence of an aortic insufficiency jet as seen on color flow Doppler may represent:

A. Physiologic insufficiency
B. Mild (1+) aortic insufficiency
C. Moderate (2+) aortic insufficiency
D. Moderately severe (3+ 4+) aortic insufficiency

A

D. Moderately severe (3+ 4+) aortic insufficiency

30
Q

The mitral valve inflow pattern often associated with severe acute aortic insufficiency is stage:

A. I
B. II
C. III
D. IV

A

C. III

31
Q

!!!

The Doppler signal of aortic insufficiency may be differentiated from the Doppler signal of mitral stenosis by the following guideline:

A. If the diastolic flow pattern commences before mitral valve opening, then the signal is due to aortic insufficiency

B. If the diastolic flow pattern commences after mitral valve opening, then the signal is due to aortic insufficiency

C. The Doppler flow velocity pattern of mitral valve stenosis is laminar, while the Doppler flow velocity pattern of aortic insufficiency is turbulent

D. Since both mitral valve stenosis and aortic insufficiency are diastolic, it is not possible to differentiate the Doppler flow velocity patterns.

A

A. If the diastolic flow pattern commences (begins) before mitral valve opening, then the signal is due to aortic insufficiency

32
Q

!!!

The M-mode finding that indicates severe acute aortic insufficiency is premature aortic valve:

A. Closure
B. Diastolic flutter
C. Mid-systolic closure
D. Opening

A

D. Opening

*too much blood backing up as regurgitant flow leading to premature opening (due to higher LV pressure)

33
Q

A two-dimensional echocardiographic finding in a patient with pure aortic insufficiency is:

A. Left atrial enlargement
B. Left ventricular enlargement
C. Right atrial enlargement
D. Right ventricular hypertrophy

A

B. Left ventricular enlargement

34
Q

!!!

The most common etiology of acute aortic insufficiency is:

A. Aortic ballon valvuloplasty
B. Hypertension
C. Infective endocarditis
D. Rheumatic fever

A

C. Infective endocarditis

35
Q

!!!

A pulse that is associated with significant aortic insufficiency is:

A. Pulsus alternas
B. Pulsus bisferiens
C. Pulsus paradoxus
D. Pulsus parvus et tardus

A

B. Pulsus bisferiens

36
Q

!!!

M-mode reveals diastolic flutter of the anterior mitral valve and a left ventricular end-systolic dimension of 58 mm. Two-dimensional echocardiography demonstrates an aortic root that is 4.5 cm in diameter with aortic valve sclerosis.

The aortic insufficiency jet is mapped to the level of the papillary muscles by pulsed-wave Doppler. The pressure half-time of the continuous-wave Doppler tracing of the aortic insufficiency jet is 280 m/sec. The jet height to left ventricular outflow tract height ratio is 53%. The severity of the aortic insufficiency in this case is:

A. Physiologic insufficiency
B. Mild (1+)
C. Moderate (2+)
D. Moderately severe (3+)

A

D. Moderately severe (3+)

37
Q

!!!

  1. The most common regurgitation found in patients with dilated cardiomyopathy is:

A. Aortic insufficiency
B. MR
C. Pulmonary insufficiency
D. Tricuspid regurgitation

A

B. MR

38
Q
  1. An underestimated Doppler peak pressure gradient in aortic coarctation may be caused by:

A. Patent ductus arteriosus
B. Significant aortic insufficiency
C. Significant MR
D. Ventricular septal defect

A

A. Patent ductus arteriosus

39
Q
  1. The formula used to estimate left ventricular end-diastolic pressure (LVEDP) from the continuous-wave Doppler recording of aortic insufficiency is LVEDP is equal to:

A. BPs - Vmax AI
B. BPd - Vmax AI
C. BPd - 4× EDV AI
D. BPd - 4× EDV AI^2

A

D. BPd - 4× EDV AI^2

40
Q

!!!

  1. A possible pitfall in the pressure half-time (PHT) method of assessing the severity of mitral stenosis is concomitant (accompanied):

A. Aortic insufficiency
B. MR
C. Pulmonary insufficiency
D. TR

A

A. Aortic insufficiency

41
Q
  1. With aortic valve stenosis and significant aortic insufficiency, the severity of the aortic valve stenosis by the Doppler pressure gradient may be:

A. Overestimated
B. Unaffected
C. Underestimated
D. Unpredictable

A

A. Overestimated

42
Q

!!!

  1. The continuous-wave Doppler maximum aortic insufficiency velocity reflects the:

A. Maximum instantaneous systolic pressure gradient between the aorta and the left ventricle

B. Maximum peak instantaneous diastolic pressure difference between the aorta and the left ventricle

C. Mean diastolic pressure gradient between the aorta and the left ventricle

D. Mean systolic pressure gradient between the aorta and the left ventricle

A

B. Maximum peak instantaneous diastolic pressure difference between the aorta and the left ventricle

43
Q
  1. The regurgitant fraction (RF%)for aortic insufficiency may be calculated by the following pulsed-wave Doppler formula:

A. Aortic RF%= mitral SV-aortic SV÷mitral SV

B. Aortic RF%=aortic SV-tricuspid SV÷aortic SV

C. Aortic RF%=aortic SV-mitral SV÷aortic SV

D. RF% is solely a cardiac catheterization technique that cannot be duplicated in the echocardiography lab

A

C. Aortic RF%=aortic SV-mitral SV÷aortic SV

44
Q

AS can be overestimated by high cardiac states such as: (3)

A

anemia

pregnancy

3-4+ AR

All increase preload of LV

45
Q

AS can be underestimated by low cardiac output states such as:

A

reduced LV EF, arrhythmia, MR

46
Q

For reduced EF patient, use _______ to assess severity of AS

A

AS velocity ratio = VLVOT / VAOV unitless ratio

mild > 0.5

moderate 0.25 - 0.5

severe < 0.25

47
Q

severe AR causes ____ murmur

A

low-pitched , mid-diastolic rumble at the apex

*Austin Flint murmur

48
Q

mild AR creates a flatter Doppler waveform with a higher pressure half-time

T or F ?

A

T

49
Q

The AR peak velocity is usually 3+ m/s due to the pressure difference between the LV and aorta

T or F ?

A

T

Echo Registry Review (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions