Diastolic Dysfunction Flashcards
(25 cards)
Mitral valve PW Doppler should be measured over how many cycles and at what point in respiration?
Over 3 cycles at end expiration.
An E/A ratio of what indicates Grade I, Normal, Grade II and Grade III diastolic dysfunction?
Grade I; E/A <1 | Normal & Grade II; E/A 1-2 | Grade III; E/A >2.
A deceleration time of what indicates Grade I, Normal, Grade II and Grade III diastolic dysfunction?
Grade I; >230ms | Normal & Grade II; 130-230ms | Grade III; <130ms.
What is useful when distinguishing Grade II from normal diastolic function?
A Valsalva.
What indicates a good Valsalva technique?
A decrease in 20cm/s in E wave velocity.
A decrease in mitral E/A ratio of what upon Valsalva is highly specific of raised LV filling pressures?
≥50%
When obtaining pulmonary vein flow patterns, PW Doppler sample volume should be placed how far into the pulmonary vein?
> 0.5cm.
Pulmonary vein PW Doppler should be measured over how many cycles and at what point in respiration?
Over 3 cycles at end expiration.
If there are two systolic peaks (S1 and S2), which should be used to compute the S/D ratio?
S2.
An S/D>1 could indicate what?
Normal or mild diastolic dysfunction.
An S/D<1 could indicate what?
Grade II or Grade III diastolic dysfunction.
An a dur - A dur of what indicates raised LV filling pressure?
> 30ms.
In the calculation a dur - A dur, which is taken away from which (with regards to mitral or pulmonary).
Pulmonary - mitral.
When are e’ measurements unreliable?
In the presence of mitral annular calcification, mitral prosthetic valves and annuloplasty rings and severe mitral valve disease.
e’ velocities should be measured over how many cycles and at what point in respiration?
Over 3 cycles at end expiration.
True or false; e’ will be reduced in all grades of diastolic dysfunction.
True.
Mitral E/VP ratio can be used to predict LA pressure. E/VP of greater than what indicates elevated LA pressures?
> 2.5
Raised PA pressure may indicate diastolic dysfunction in the absence of what?
Any lung or mitral valve disease.
True or false; LA size can be normal in Grade I diastolic dysfunction.
True.
In the setting of E/A fusion, what is still considered useful when assessing diastolic dysfunction?
E/e’
In the setting of Atrial Fibrillation, what is still considered useful when assessing diastolic dysfunction?
DT and E/e’ (averaged over 5-10 cardiac cycles; recorded from cycle lengths equivalent to a heart rate between 60-80 beats/minute).
What can present with heart failure symptoms and restrictive filling pattern (Grade III) in the absence of diastolic dysfunction?
Constrictive pericarditis.
What can distinguish constrictive pericarditis from true Grade III diastolic dysfunction?
Normal or increased e’ velocities.
Mitral E Vmax and PVs are affected by what?
Significant mitral regurgitation.
