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valvular pathology > Mitral Valve Pathology > Flashcards

Mitral Valve Pathology Flashcards

1
Q

normal mitral inflow

A

during diastole

normal flow pattern is biphasic w/ E and A peaks

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2
Q

how is the spectral doppler labeled

A

D-E-F-A-C

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3
Q

what does the E wave represent

A

early diastole

passive filling

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4
Q

what does the A wave represent

A

atrial contraction

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5
Q

diastasis

A

when the pressures are practically equal, happens in mid diastole

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6
Q

in what views is MV flow evaluated

A

PLAX/PSAX

apical 4,3,2

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7
Q

what is deceleration time

A

the rate of deceleration of the pressure gradient between the LA and the LV, measured as the E-F slope

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8
Q

MV. peak velocity should not be greater than

A

1.5 m/s

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9
Q

what is cw for MV used to calculate

A

the mean gradient by performing a VTI trace of the spectral waveform above the baseline

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10
Q

what is pressure half time?

A

the time needed for the initial pressure gradient to fall to half of its value
-measure another e-f slope
also used for MV area in MS

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11
Q

normal PHT for MV

A

30-60 msec

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12
Q

when is the LV pressure much higher than the LA

A

during systole

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13
Q

what do we use to measure MR

A

CW doppler

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14
Q

color doppler for MR

A

turbulent with possible aliasing

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15
Q

mild mr

A

Mr jet just beyond the MV Leaflets

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16
Q

moderate MR

A

will fill up LA 1/3

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17
Q

severe MR

A

will fill up LA mid to back wall of LA
3/3

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18
Q

PISA

A

Blood converging on the regurgitant orifice can be seen as an isovelocity hemisphere of color. The area of this hemisphere is directly related to the volume of blood flow entering the regurgitant orifice.

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19
Q

how to calculate the PISA

A
  • VTI trace
  • radius of MR jet with color
  • aliasing velocity
20
Q

PISA for MIld MR

A

less than .5m

21
Q

Vena contracta for moderate MR

A

.5 to .7cm

22
Q

pisa for severe MR

A

greater than .8cm

23
Q

pisa volumetric method

A
  • only used when multiple MR jets are present
    1. flow across the mitral valve calculated by the product of the area of the MV annulus and VTI of the MV PW
    2. lvot calculated
    3. regurgitant fraction calculated
24
Q

2 major consequences of MS

A
  1. the LA does not empty completely, LV maintains higher pressure than normal
  2. pressure in the LA falls very slowly during diastole, E-F slope is diminised
25
Q

what is the planimetry

A

manual tracing of the MV area in PSAX

26
Q

mild MS mean gradient

A

less than 5 mmHg

27
Q

mild MS mean gradient

A

<5 mmHG

28
Q

severe MS mean pressure gradient

A

greater than 10 mmHg

29
Q

MS pressure half time equation

A

220/pht

30
Q

normal MVA

A

4-6 cm squared

31
Q

mitral stenosis on M MODE

A

Anterior motion of PMVL due to stenosis

32
Q

causes of MS

A

rheumatic fever
MAC
MV atresia
prosthetic valve
lupus etc

33
Q

Equation for calculating MVA

A

MVA=220/PHT (pressure half time)

34
Q

The greater the pressure half time in a stenosis…

A

The more severe

35
Q

how do you adjust the color flow doppler for PISA

A

shift the baseline down to approx. 20-40 cm/s

36
Q

EROA EQUATION

A

effective regurgitant orifice area= 2pie(PISAr)2 x Va (aliasing velocity) / MRVmax

37
Q

MR volume equation

A

MR volume= EROA x MR vti

38
Q

mild MR EROA

A

<.20

39
Q

severe MR EROA

A

> .40

40
Q

severe MR pulomary vein assesment

A

S wave reversal
D wave increased

41
Q

MVP causes

A

connective tissue disorder
hereditary
assoc. heart abnormalities

42
Q

in who is MVP more prevalent

A

women under 40

43
Q

complications of MVP

A

MR
infective endocarditis
embolic events
ruptured chordae

44
Q

severe ms PHT

A

> 220

45
Q

mild ms pht

A

90-150

46
Q

severe MR volume

A

> 60

47
Q

mild MR volume

A

<30

valvular pathology (3 decks)

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