Apical, SubC, SSN- Anatomy, Measurements And Doppler

Question 1

Which view in apicals can you see the anteroseptal wall?

Answer 1

A3C

Question 2

Which apical view can you see the inferior wall?

Answer 2

A2C

Question 3

Which view in apical can you see the anterior wall?

Answer 3

A2C

Question 4

Which view in apical can you see the inferolateral wall?

Answer 4

A3C

Question 5

Which view in apical can you see the anterolateral wall?

Answer 5

A4C

Question 6

Which view in apical can you see the inferoseptal wall?

Answer 6

A4C

Question 7

Which cusps of the AV are visible in A3C?

Answer 7

RCC and NCC, just like in PLAX

Question 8

Which chamber is closest to the probe in the subcostal view?

Answer 8

RV

Question 9

Which chamber is furthest from the probe in the subcostal view?

Answer 9

LA

Question 10

What are the order of the aortic branches on the ascending AO?

Answer 10

1. Brachiocephalic/innominate artery
2. Left common carotid
3. Left subclavian artery

Question 11

Averages the A4C and A2C end-diastole/systole tracings to get what?

Answer 11

Simpson’s biplane- EF

Question 12

What are normal ranges for males and females for biplane EF?

Answer 12

Male: 52-72%
Female: 54-74%

Question 13

What is a normal measurement for the RVIDd?

Answer 13

<41mm

Question 14

What are normal RA and LA volume indexes?

Answer 14

RA: <32 mL/m2
LA: <34 mL/m2

Question 15

What do the waveforms mean over the MV inflow?

Answer 15

E wave- early filling
Diastasis- gap between E and A wave where the flow starts to slow into the LV
A wave- atrial kick

Question 16

True or false. The A wave should be larger than the E

Answer 16

False

Question 17

What is normal E wave deceleration time?

Answer 17

160-220 ms

Question 18

What is a normal E/A ratio?

Answer 18

0.8-2.0

Question 19

True or false: E/A reversal can be normal in older patients

Answer 19

True

Question 20

The time between AV closure and MV opening

Answer 20

IVRT

Question 21

What is normal duration for IVRT?

Answer 21

50-100ms

Question 22

When is IVRT seen on MV trace?

Answer 22

Between the aortic outflow (below the baseline) and mitral inflow (E/A waves)

Question 23

When we do MV TDI, we are looking at what changes of the LV?

Answer 23

Longitudinal

Question 24

What is the PW measuring when doing TDI?

Answer 24

The velocity of the contraction and expansion of the tissues

Question 25

Normal TDI values?

Answer 25

Medial >/=7 cm/s Lateral >/=10 cm/s

Question 26

What happens to velocity as the valve gets smaller?

Answer 26

It increases

Question 27

When taking a CW through MR, how long does it last?

Answer 27

Throughout systole and IVRT

Question 28

What information do when get when doing a tracing of the LVOT PW Doppler waveform from A5C?

Answer 28

LVOT V max LVOT VTI

Question 29

What information do we get when doing a trace of the CW through the AV in A5C?

Answer 29

AV VMax AV VTI AV peak and mean gradient

Question 30

What is considered an abnormal AV velocity?

Answer 30

>2.0 m/s

Question 31

What are normal AV peak and mean gradients?

Answer 31

Peak: <10mmHg Mean: <5mmHg

Question 32

What info can you calculate from a peak velocity CW through TR?

Answer 32

RVSP

Question 33

What is measured when doing TDI over the RV?

Answer 33

S prime, should be >9.5 cm/s

Question 34

Which heart chamber is most anterior and most posterior in subcostal view?

Answer 34

Anterior- RV Posterior- LA

Question 35

What is the best view for assessing inter atrial shunts?

Answer 35

Subcostal 4 chamber

Question 36

When can subcostal SAX be used?

Answer 36

When there’s no good parasternal windows

Question 37

What is considered a dilated IVC?

Answer 37

>21mm

Question 38

What are the 3 branches of the aorta in the suprasternal view?

Answer 38

Brachiocephalic (innominate) Left common carotid Left subclavian