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Utlrasound > Cardio > Flashcards

Cardio Flashcards

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1
Q

What is a good view for looking at the velocites in the mitral and tricuspid valve?

A

Left apical view (LAp)

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2
Q

What is the difference between pulsed-wave Doppler and Continuous Doppler?

A

Pulsed-wave shows you velocity at a specific point but has a velocity limit

Continuous wave shows you velocity throughout your line of sight (no specific point) but does not have a velocity limit.

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3
Q

When is the normal aortic ejection signal? What does it look like?

A

Early systole - Dagger-like

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4
Q

When is the normal pulmonic ejection?

A

Later in systole and is a long ejection

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5
Q

What artifact is this?

A

Pulse wave aliasing

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6
Q

Aliasing is a consequence of what?

A

Nyquist limit or undersampling

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7
Q

Normal LA/Ao ratio for dogs and cats?

A
  1. 6 is the upper limits for dogs
  2. 2 - 1.7 upper limit for cats
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8
Q

What is the equation for Fractional shortening (LV)?

A

(LVend diastolic - LVend systolic)/LV end diastolic

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9
Q

What is the modified Bernoulli equation?

A

Pressure = 4v2

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10
Q

Velocity in the modified bernoulli equation is measured how?

A

m/s

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11
Q

What is acceleration time (AT)?

A

The interval between the beginning of the ejection to the peak flow velocity

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12
Q

In normal animals what is the difference in movement of the LV free wall and the intervetricular septum?

A

They are dyssynchronous with the septum moving first

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13
Q

There are three subtypes of aortic stenosis.. what are they and what is the most common?

A
  1. Valvular
  2. Subvalvular (subaortic) - Most common
  3. Supravalvular
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14
Q

Aortic stenosis is normal seen in what type of dog?

A

Large breed and is congenital

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15
Q

On the RPS LAx image where will the subaortic stenotic area extend from; the septum or the mitral apparatus?

A

Both

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16
Q

What type of tissue is the subaortic stenotic tissue?

A

fibrocartilainous

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17
Q

Echo signs for subaortic stenosis?

A
  1. Concentric thicken of the LV walls including the papillary muscles
  2. Increase echogencity of the papillary muscles and sub-endocardial myocardium
  3. Possible calification or fibrosis
  4. Pre-mature closure of the aortic valve
  5. Increased distal velocity (>2.5m/s)
  6. Dilation of the aortic root
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18
Q

What is this dog affected with?

A

SAS

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19
Q

Is pulmonary stenosis common in cats or dogs?

A

Dogs - 3rd most common heart defect in dogs

Cats it is rare.

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20
Q

What are the three times of pulmonary stenosis? What is the most common?

A
  1. Subvalvular
  2. Supravalvular
  3. Valvular - Most common
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21
Q

Most common echocardio signs of pulmonic stenosis?

A
  1. Concentric hypertrophy of the RV
  2. Post - stenotic dilation of the pulmonary trunk
  3. Right atrial enlargement
  4. The papillary muscles and trabeculae carnae become prominent and thus the RV has an irregular surface.
  5. Increased echogenicity of the myocardium
  6. Flattening of the intervetricular septum
    1. Also seen in pulmonary hypertension
  7. Pseudohypertrophy of the LV due to underloading
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22
Q

Arbitrary prognostic categories for aortic stenosis based on pressure gradients include?

A
  1. <50mmHg = mild
  2. 50-75mmHg = moderate
  3. 75-100mmHg = severe
  4. >100mmHg = Out of control
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23
Q

What is a concern for Boxers/Bulldogs with pulmonic stenosis?

A

R2A anomaly with the coronary artiery wrapping around the pulmonary trunk.

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24
Q

What is the double chambered right ventricle?

A

An unusal subvalvular PS that is caused by a discrete fibromuscular partition separating the RV outflow from the RV

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25
Suggested prognostic categories for pulmonic stenosis based on pressure gradients?
1. \<50mmHg - Mild 2. 50-100mmHg - Moderate 3. \>100mmHg - Severe
26
Breed for tricuspid dysplasia?
Labs
27
What velocity of regurgitation through the tricuspid valve should prompt you to think of pulmonary hypertension, pulmonary stenosis of artrial septal defect?
\>3.0m/s
28
What are the first chambers to enlarge from a PDA?
LV and LA due to volume overload
29
If the velocity of the pulmonary outflow tract is less than what value will make you think of pulmonary hypertension?
\<4.5-5.0m/s
30
What is a good way to determine if which way a shunt is going?
Inject aggitated saline.
31
Normal EPSS in dog? Cat?
Dog: \<6mm Cat: \<2mm
32
What is the normal LA:Ao ratio in a dog? Cat?
Dog: \<1.3 Cats do not use a ratio
33
What is the normal size of the LA in a cat?
1.5cm
34
What is the normal fractional shortening in small dogs? Large dogs? Cats?
35-45% small dogs \>25% large dogs 45-55% cats
35
How do you calculate fractional shortening?
(LV in diastole - LV in systole)/LV in diastole
36
For fractional shortening what mode is most accurate?
M-mode
37
Normally the left ventricle should be bigger than the right... but how much bigger?
3x
38
When should the Aorta be measured and the LA should be mesured for the LA:Ao ratio?
Aorta: end of diastole LA: end of systole Peak to peak... valley to valley
39
What is one sign of RV enlargement?
Septal flattening
40
What blood work abnoramlity can be seen with a R-L PDA?
Polycythemia - due to hypoxia of the blood missing the lungs
41
What is the most common acquire heart disease in dogs?
Mitral valve insufficiency
42
Pulmonary hypertension should be considered if tricuspid regurg is over what velocity?
2.3m/s
43
Pulmonic valve insufficiency should be considered if pulmonic valve regurg is greater than what?
\>1.9m/s
44
What will happen to the fractional shortening of dog with DCM?
Reduced
45
What will happen to the fraction shortening of a cat with HCM?
Goes up
46
What is the common echo finding with ARVC?
Right side enlargement
47
Feline echo parameters?
FS = 45-55% EPSS = \<0.2cm LA size = \<1.5cm IVS and LVFW thickness in diastole = \<0.6cm LV in diastole = 1.5cm LV in systole = 0.9cm
48
What is the sign for Obstructive HCM (Sam HCM)?
Flow velocity in the LVOT \> aorta
49
Signs of Canine DCM?
LV and LA are enlarged Fractional shortening in small EPSS is increased Asynchronous motion of the septum and Free wall
50
What is the normal echocardiographic sign for normal mitral valve regurg?
Blue jet \<1cm
51
What is the most challenging congential heart disease to diagnoseon radiographs?
Aortic stenosis
52
What are common breeds with aortic stenosis?
GSD Newfies Boxers
53
Aortic velocity that is suspect for aortic stenosis?
1.7-2.2 m/s ... anything above 2.2 is diagnostic \>2.5 in boxer breeds
54
Pulmonic stenosis is common in what breeds of dogs?
Brachycephalic (bulldogs, chihauhaus, fox terriers)
55
What do you have to look for in bull dogs and boxers after diagnosinig pulmonic stenosis?
R2A - left coronary artery encircling the RVOT
56
Mitral Valve dysplasia is commonly seen in what breeds?
GSD, bull terrier and Great Danes
57
What are the four components of the tetrology of fallot?
VSD Overriding aorta Pulmonic stenosis RV enlargement
58
What breeds are associated with Tetrology of fallot?
English bulldogs keenhond
59
An ASD is commonly clinical T/F
False
60
Pulmonic stenosis most commonly involves which portion of the pulmonic region?
Valvular - thickening of leaftlets or fusion of leaflets Sub and supra are rare
61
What other valvular abnormality can be seen with pulmonic stenosis and what type of dogs is this seen in?
Tricuspid dysplasia - seen in large breed dogs.
62
When does vascular resistence of the lungs complete resolve after birth?
Can be \>2 months This is important because the pulmonary arteries and heart could be big at this age and be normal.
63
What is the severity scale for the pulmonic stenosis based off of doppler velocity pressures?
1. Mild (Doppler gradient up to 49 mmHg) 2. Moderate (Doppler gradient of 50 to 100 mmHg) 3. Severe (Doppler gradient greater than 100 mmHg
64
What is the diagnosis for A and for B?
A = Pulmonary dysplasia B = Pulmonary stenosis
65
What is this? Young dog.
Pulmonary insufficiency Contrast is injected in the pulmonary outflow tract but then opacifies the right ventricle.
66
DDX and description:
Loss of cardiac waist with prominece of the ascending aorta noted. Left artial enlargement Widening of the cranial DDX: **Aortic stenosis,** Mediastinal mass with mitral valve disease.
67
A and B ddx?
A: SAS with PDA B: SAS

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