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DMST 367 Echo 3 > Dilated And Hypertrophic CMO > Flashcards

Dilated And Hypertrophic CMO Flashcards

(59 cards)

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1
Q

Label

A

Everything here is right except for hypertension and CAD

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2
Q

What does this image represent?

A

LV chamber enlargement which leads to rounder, spherical shape

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3
Q

What does this image represent?

A

Spherical shape vs bullet shaped LV from DCM

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4
Q

What does this image represent?

A

LIV size and function in four chamber for DCM

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5
Q

What does this image represent?

A

Grade 3 DD

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6
Q

What does this image represent?

A

M-mode findings for DCM.

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7
Q

What does this image represent?

A

B-bump and EPSS

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8
Q

What does this image represent?

A

AV - M mode

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9
Q

What does this image represent?

A

M-mode in DCM (Look at the EPSS) specifically, LV global or multi segmental hypokinesis

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10
Q

What is Dilated cardiomyopathy?

A

Disease of the myocardium characterized by the dilation and decreased systolic function of the LV or both ventricles

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11
Q

What is the etiology of DCM? 3

A
  1. Idiopathic
  2. Genetic/ familial (20-50%)
  3. Stress induced
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12
Q

What is S/S of DCM? 3

A
  1. Related to CHF
  2. Dyspnea/ SOB
  3. Sudden death
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13
Q

What are some S/S of DCM that are related to CHF? 4

A
  1. Low BP
  2. Fatigue
  3. Weakness
  4. Peripheral cyanosis
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14
Q

What are things that result in Dyspnea/ SOB? (In terms of DCM)3

A
  1. Orthopnea
  2. Tachypena
  3. Paroxysmal Nocturnal dyspnea (PND)
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15
Q

What does ECGs look like with DCM? 6

A
  1. Tachycardia
  2. Atrial Arrythmias
  3. LBBB
  4. LVH (large QRS complexes)
  5. LAE
  6. Ventricular arrhythmias
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16
Q

What does DCM look like on X-ray?2

A
  1. Cardiomegaly
  2. Pulmonary congestion
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17
Q

In terms of Echo findings with DCM, it is important to rule out what?

A

Other causes of LV/RV dysfunctions such as Valvular disease and IHD

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18
Q

What do we assess with echo in 2D? 3

A
  1. Chamber size
  2. Systolic function
  3. Potential thrombus
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19
Q

Why would we use M-mode for DCM?

A

To confirm findings

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20
Q

Why do we use doppler in echo for in terms of DCM assessment?3 (what do we look for)

A

To look for
1. Diastolic function
2. Valvular regurgitation
3. Potential PHTN

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21
Q

What do we see in terms of LV chamber enlargement with DCM? 8

A
  1. LV takes a rounder, spherical shape
  2. Mitral annular dilatation
  3. LV thrombus/ aneurysm
  4. Increase LV mass index
  5. Increase EPSS on m-mode
  6. Decrease LV function
  7. Decrease in EF/FS/CO
  8. Spontaneous contrast in LA and LV
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22
Q

What is the abnormal spherical index of DCM?

A

> 0.76

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23
Q

What is found during the 2D echo assessment of DCM?3

A
  1. 4 chamber dilation
  2. CHF/Pulmonary HTN
  3. Decrease in global LV/RV S+D fxn
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24
Q

What is seen in the 4 chambers dilation for DCM?

Study These Flashcards
A
  1. Increase chamber volumes
  2. Increased LV mass index
  3. Increased EPSS on M-mode
  4. Functional MR
25
Why is there CHF/ pulmonary HTN with DCM?
Response from increased LAP
26
Why is there a decrease in global LV/RV S+D fxn? 4
1. Reduced EF 2. Reduced LVOT/AV velocity 3. Abnormal Dp/DT 4. Increased filling pressures
27
How can we measure LV size and function with DCM? 5
1. LV global assessment 2. Systolic function (Dp/Dt) 3. Simpsons 4. LV size 5. LV mass index
28
How do we measure RV size and function?3
1. RV free wall thickness 2. Dimension 3. Systolic function
29
What are some doppler findings in DCM? 4
1. Color doppler fill is reduced at a normal scale 2. Decreased Pulmonary V acceleration time (PAT) 3. Decreased LVOT velocity 4. Increased RVSP
30
What do we need to do to better see the color fill in DCM?
Decrease the color scale to see lower velocity flow
31
What is the decreased LVOT velocity for DCM? (actual speed)
<60cm/sec
32
What increases RVSP in DCM?
PHTN due to pressure back up
33
What is the regurg percentage with DCM? 4 (each valve)
1. MR (100%) 2. TR (90%) 3. PR (50%) 4. AR (20%)
34
What does doppler measurements of DCM do?
Quantify the severity of any regurgitation
35
How do we calculate pulmonary pressures? 2
1. Use TR jet max (RVSP) 2. PAT
36
What is the CO formula?
SV X HR or (CSA x VTI) x HR
37
How do we calculate LV systolic function?
LV dp/dt
38
100% of DCM has what type of regurg?
MR
39
What does significant MR do with DCM? Why is this beneficial?
1. Reduces the LV preload which may make LVEF seem better than it really is 2. Makes dp/dt especially useful for estimating global LV systolic function in DCM patients
40
What is abn dp/dt < what? (for DCM)
abd dp/dt < 1200 mmHg/sec
41
What kind of diastolic dysfunction is usually seen with DCM?
Grade 3 is typical
42
All patients with DCM have some degree of what?
Diastolic dysfunction
43
What are things that we see with Grade 3 DD again? 7
1. Increase in LVEDP 2. Increase in LAP 3. E/A >2.0 4. E/e' >14 5. Peak TR velocity >2.8 m/s 6. IVRT <60ms 7. DT <160 m/s
44
What are some M-mode findings with DCM? 3
1. Reduced CO due to decreased systolic function 2. Increased EPSS 3. B-bump 4. Decreased AV cusp excursion or opening 5. May also see early AV closure due to reduced CO
45
Why would we see reduced CO due to decreased systolic function with M-mode for DCM? 2
1. Reduced wall excursion 2. Both IVS and PW not moving inwards
46
In terms of M-mode and DCM, why would we see increased EPSS? What is abnormal?
1. Due to larger chamber space 2. >7mm is abnormal 3. >20mm = EF <30%
47
Why would we see a B-bump with DCM on M-mode?
MV tries to close early due to high LVEDP
48
Why would we see decreased AV cusp excursion or opening with DCM on m-mode?
Due to low output from reduced CO
49
What are some DCM complications? 4
1. Thrombus/ emboli 2. Dyssynchrony of contraction 3. Sudden cardiac death 4. Consequences of underlying disease
50
Why would there be thrombus/emboli in terms of DCM? What would mask it?
1. Due to stasis of blood 2. Poor image quality
51
What are some consequences of underlying diseases that are complications of DCM? 2
1. Infective endocarditis 2. Nonbacterial thrombotic endocarditis
52
What are 7 tips for detecting LV thrombus?
1. Use highest frequency possible 2. Use harmonic imaging 3. Reduce depth- most thrombi are near the LV apex 4. Utilize the focal zone 5. Slowly pan through the LV 6. Confirm a thrombus in 2 or more imaging planes 7. Use color doppler as a contrast with reduced scale to confirm thrombus
53
How would we generally treat DCM?
Treat etiology if known, clinical Hx is very important to discovering the etiology
54
If we don't know the etiology, how would we treat DCM? 4
1. Lifestyle modifications 2. Medications 3. Interventional 4. Surgical
55
What are some lifestyle modifications for DCM? 2
1. Restrict salt 2. Alcohol cessation
56
What are some medications that can be used for treatment of DCM?
1. Diuretics, ace inhibitors, beta blockers 2. Anticoagulants 3. Anti-arrhythmic
57
What are some interventional methods to treat DCM? 2
1. Biventricular pacing 2. Cardioveter/ defibrillator
58
What are some surgical methods to treat DCM? 4
1. MV repair/ replacement 2. Batista procedure 3. LV assist device 4. Transplant
59
What is batista procedure?
Removing part of LV

DMST 367 Echo 3 (27 decks)

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