Dimensions Flashcards
(304 cards)
1
Q
LVDd normal values
A
42-58mm men
38-52mm women
Moderately dilated
64-68mm men
57-61mm women
2
Q
Moderately dilated LVDd
A
64-68mm men
57-61mm women
3
Q
Wall thickness normal and moderate
A
6-10mm men
6-9mm women
Moderately thickened
14-16mm men
13-15 mm women
4
Q
Grading of LV mass /BSA
A
Normal
49-115 g/m^2 men
43-95g/m ^2 women
Moderate hypertrophy
132-148 men
109-121 women
5
Q
Relative wall thickness
A
= (2 x post wall thickness)/ LVDd
6
Q
LV 2D derived volumes
A
Indexed
Normal 34-74ml/m^2 men
29-61 ml/m^2 women
Moderately dilated
90-100 men
71-80 women
7
Q
Define wall motion
A
Hypokinesia = <50% of normal movement
Akinesis - absent movement
Dyskinesis - movement out of phase
Aneurysmal - paradoxical movement
8
Q
Normal mitral TDI S’ by age
A
20-40 >/=6.4
40-60 >/= 5.7
>60 >/=4.9
9
Q
Normal LVOT VTI
A
17-23cm if HR 55-95
>18cm with HR <55bpm
<22cm with HR >95
10
Q
Global longitudinal strain
For cardio oncology patients
A
Normal <-18%
Borderline -16% to -18%
Abnormal >-16%
11
Q
dp/dt for mitral
A
dt = time between MR jet 1->3m/s which represents pressure change of. 32mmHg
Normal =>1200
Abnormal 800-1200
Severely abnormal <800
12
Q
Diastolic filling patterns
Normal
A
MV E/A >0.8
MV E >50cm/s
E/E’ <10
13
Q
Diastolic filling patterns
Grade 1
A
“Slow filling”
MV E/A </=0.8 MV
E </=50cm/s
E/E’ <10
14
Q
Diastolic filling patterns
Grade 2
A
“ pseudonormal”
MV E/A ration >0.8 but >/=2
MV E >50cm/s
E/E’ >14
15
Q
Diastolic filling patterns
Grade 3
A
“Restrictive”
MV E/A ratio
>/=2
MV E >50cm/s
E/E’ >14
Raised filling pressures
16
Q
Features of takotsubo cardiomyopathy
A
- Transient hypokinesis, akinesis, or dyskinesis of the left ventricular mid-segments with or without apical involvement.
- The regional wall motion abnormalities extend beyond a single epicardial vascular distribution.
- Absence of significant obstructive coronary disease* or angiographic evidence of acute plaque rupture.
- New electrocardiographic abnormalities (either ST-segment elevation and/or T wave inversion) or modest elevation in cardiac troponin.
-Absence of phaeochromocytoma or myocarditis.
17
Q
What is the threshold for abnormal TV Tissue Doppler systolic velocity?
A
<10 cm/s
Indicates impaired right ventricular function when below this threshold.
18
Q
What is the threshold for abnormal TAPSE?
A
<17 mm
TAPSE stands for Tricuspid Annular Plane Systolic Excursion.
19
Q
What is the threshold for abnormal RV FAC?
A
<35%
RV FAC refers to Right Ventricular Fractional Area Change.
20
Q
What is the threshold for abnormal RV 3D EF?
A
<45%
RV 3D EF stands for Right Ventricular 3D Ejection Fraction.
21
Q
What is the threshold for abnormal RV free wall strain in research use?
A
> -19% (absolute value <19%)
This measure is used to assess right ventricular function.
22
Q
Calculate PAP
A
4 x (TR Vmax)^2 + RAP
23
Q
Secondary indices of raised RA / pulmonary pressure if normal IVC
A
- Restrictive right-sided filling pattern (tricuspid E/A >2.1, deceleration time <120 ms)
- Tricuspid E/E’ >6
- Diastolic flow dominance in the hepatic vein
- RA dilatation with no other cause (e.g. tricuspid regurgitation or atrial fibrillation)
- Displacement of atrial septum to the left throughout the cycle
24
Q
TR Vmax in valve pathology
A
• In mitral stenosis, a PA systolic pressure >50 mmHg at rest is an indication for balloon valvotomy, even in the absence of symptoms.
• In severe aortic stenosis (AS), a PA systolic pressure > 60 mmHg indicates a high risk of dying, unless surgery or a TAVI is performed.
• This identifies the patient as having critical AS, meaning, that intervention is needed as soon as possible.
• Inform the clinician in charge of the case.
• A rise in TR Vmax is a secondary sign of deterioration in any type of valve disease and may aid the cardiologist to recommend intervention in otherwise-equivocal cases.
25
Estimating the probability of PH from the PA systolic signal
• A PA acceleration time > 105 ms excludes pulmonary hypertension and <80 ms makes pulmonary hypertension highly likely. This method is not accurate enough to give an estimate of absolute pressure
26
Probability of pulmonary hypertension from end diastolic PR signal
• Measure the end-diastolic velocity of the pulmonary regurgitant signal and estimate the pressure difference (4v^2).
• An end-diastolic pressure difference >5 mmHg suggests PH
• To estimate PA end-diastolic pressure:
• Estimate the RA pressure via IVC
• End-diastolic PA pressure = PR end-diastolic pressure difference +
RA pressure.
• This technique is not reliable if there is severe PR
27
Cardiac causes of pulmonary hypertension detectable on TTE
Valve disease
- Mitral valve disease (stenosis > regurgitation)
- Severe aortic stenosis (pulmonary hypertension in at least 25%)
- Severe left ventricular impairment
Cardiomyopathy
- LV failure of any cause
Congenital heart disease without shunts
- Coarctation
- Subaortic or supravalvar stenosis
Pericardial constriction
Left atrial obstruction
- Myxoma
- Cor triatriatum
Pulmonary vein obstruction
• Congenital vein stenosis
• Mediastinal pathology (fibrosis, tumour)
Chronic left-to-right shunts
- ASD, VSD, patent ductus arteriosus, ruptured aortic sinus, aorto-pulmonary window
28
What is the normal range for LV End-Diastolic Diameter (LVEDD) in men?
42–58 mm
29
What is the normal range for LV End-Diastolic Diameter (LVEDD) in women?
38–52 mm
30
What is the normal range for LV End-Systolic Diameter (LVESD) in men?
25–40 mm
31
What is the normal range for LV End-Systolic Diameter (LVESD) in women?
22–35 mm
32
What is the normal range for LV Wall Thickness in men?
6–10 mm
33
What is the normal range for LV Wall Thickness in women?
6–9 mm
34
What is the normal range for LV Mass Index in men?
49–115 g/m²
35
What is the normal range for LV Mass Index in women?
43–95 g/m²
36
What is the normal Ejection Fraction (EF) percentage?
≥ 55%
37
What Ejection Fraction (EF) percentage indicates borderline dysfunction?
50–54%
38
What Ejection Fraction (EF) percentage indicates moderate dysfunction?
36–49%
39
What Ejection Fraction (EF) percentage indicates severe dysfunction?
≤ 35%
40
What is the normal diameter of the Left Atrium (LA)?
≤ 40 mm
41
What is the normal volume index for the Left Atrium (LA)?
≤ 34 mL/m²
42
What volume index indicates moderate enlargement of the Left Atrium (LA)?
> 34 mL/m²
43
What is the basal diameter of the Right Ventricle (RV) considered normal?
≤ 41 mm
44
What is the mid cavity diameter of the Right Ventricle (RV) considered normal?
≤ 35 mm
45
What is the normal wall thickness for the Right Ventricle (RV)?
≤ 5 mm
46
What is the normal TAPSE (Tricuspid Annular Plane Systolic Excursion) measurement?
≥ 17 mm
47
What is the major dimension of the Right Atrium (RA) considered normal?
≤ 53 mm
48
What is the normal volume index for the Right Atrium (RA)?
≤ 27 mL/m²
49
What is the normal Aortic Root Diameter range for men?
29–39 mm
50
What is the normal Aortic Root Diameter range for women?
26–36 mm
51
What is the normal range for Sinotubular Junction diameter in men?
21–35 mm
52
What is the normal range for Sinotubular Junction diameter in women?
19–32 mm
53
What is the normal diameter of the Ascending Aorta for men?
23–37 mm
54
What is the normal diameter of the Ascending Aorta for women?
21–35 mm
55
What is the normal diameter of the Pulmonary Artery?
< 25–27 mm
56
What is the normal Pulmonary Artery Systolic Pressure?
< 35 mmHg
57
What Pulmonary Artery Systolic Pressure range indicates moderate condition?
36–50 mmHg
58
What is the normal Pulmonary Acceleration Time?
> 120 ms
59
What is the normal Aortic Valve Area (AVA)?
≥ 2.0 cm²
60
What Aortic Valve Area indicates moderate stenosis?
1.0–1.5 cm²
61
What is the normal peak velocity for the Aortic Valve?
< 2.0 m/s
62
What peak velocity indicates moderate stenosis of the Aortic Valve?
3.0–4.0 m/s
63
What is the normal mean gradient for the Aortic Valve?
< 10 mmHg
64
What mean gradient indicates moderate stenosis of the Aortic Valve?
20–40 mmHg
65
What is the normal Mitral Valve Area (MVA)?
4–6 cm²
66
What Mitral Valve Area indicates moderate stenosis?
1.0–1.5 cm²
67
What EROA (Effective Regurgitant Orifice Area) indicates moderate Mitral Regurgitation (MR)?
0.20–0.39 cm²
68
What regurgitant volume indicates moderate Mitral Regurgitation (MR)?
30–59 mL
69
What Vena Contracta Width indicates moderate Mitral Regurgitation (MR)?
0.3–0.69 cm
70
What is the normal pressure gradient for the Tricuspid Valve (mean)?
< 2 mmHg
71
What pressure gradient indicates moderate stenosis of the Tricuspid Valve?
2–6 mmHg
72
What is the normal TR Vmax (Tricuspid Regurgitation)?
< 2.8 m/s
73
What TR Vmax indicates moderate Tricuspid Regurgitation?
2.9–3.4 m/s
74
What is the normal Pulmonary valve Peak Gradient?
< 25 mmHg
75
What Pulmonary Stenosis Peak Gradient indicates moderate condition?
36–64 mmHg
76
What is the moderate Pulmonary Regurgitation Pressure Half Time (PHT)?
100–200 ms
77
What is Ar-a?
Definitions:
• Ar (Atrial Reversal): A retrograde flow wave in the pulmonary vein that occurs during atrial contraction.
• A wave: The late diastolic filling wave seen in the mitral inflow Doppler, also due to atrial contraction.
Ar-a:
• It is calculated as the difference in duration between the pulmonary vein Ar wave and the mitral A wave (i.e., Ar duration − A duration).
• Normal: Ar-a is <30 ms.
• Elevated (>30 ms): Suggests increased left ventricular end-diastolic pressure (LVEDP) or impaired relaxation (diastolic dysfunction).
78
What is the Tei Index and how is it measured?
Tei Index (Myocardial Performance Index) =
(IVCT + IVRT) / ET
= (a − b) / b
• a = time from end to start of mitral inflow (IVCT + ET + IVRT)
• b = LV ejection time (from LVOT Doppler)
👉 Assesses global heart function (systolic + diastolic)
✅ Normal LV Tei Index < 0.40
79
What is the normal LVEF by Simpson’s biplane method?
>55% (Normal range: 55–70%)
80
What is the Tei Index formula?
(IVCT + IVRT) / ET or (MV inflow time - AV ejection TIME) / LV EJECTION TIME
81
Normal left atrial volume index (LAVI)?
≤34 mL/m²
82
Normal LV mass index (men/women)?
Men: ≤115 g/m²
Women: ≤95 g/m²
83
What is a normal E/e’ ratio?
<8 suggests normal filling pressures
84
Grade II diastolic dysfunction criteria?
E/A 0.8–2, E/e’ >14, LAVI >34, TR velocity >2.8 m/s
(≥2 criteria positive = Grade II)
85
What is GLS (Global Longitudinal Strain) normal value?
≤−18% (more negative is better)
86
What causes 'apical sparing' in strain imaging?
Cardiac amyloidosis
87
RV systolic pressure (RVSP) is estimated from?
TR velocity + RA pressure estimate
(RVSP = 4V² + RAP)
88
Normal RVSP?
≤35 mmHg
89
What is the continuity equation for AVA (Aortic Valve Area)?
AVA = (LVOT Area × LVOT VTI) / AV VTI
90
Normal AVA (Aortic Valve Area)?
3–4 cm²
91
Severe aortic stenosis criteria?
AVA <1.0 cm²
Mean gradient ≥40 mmHg
Peak velocity ≥4.0 m/s
92
What is PISA used for?
Quantifying valvular regurgitation (mainly mitral)
93
What is the effective regurgitant orifice area (EROA) for severe MR?
≥0.4 cm² (primary MR); ≥0.2 cm² (secondary MR)
94
What defines severe tricuspid regurgitation?
VC width >7 mm
Dense CW signal
Hepatic vein systolic flow reversal
95
TAPSE normal value?
≥17 mm
96
S′ (RV TDI) normal value?
≥9.5 cm/s
97
LVOT diameter is measured where and when?
Parasternal long axis, mid-systole, inner edge to inner edge
98
What is the preferred view for RV assessment?
Apical 4-chamber with RV-focused modification
99
What is the cutoff for normal pericardial effusion?
<10 mm
100
What Doppler finding suggests tamponade?
>25% respiratory variation in mitral inflow
101
What does a D-shaped LV in systole suggest?
RV pressure overload (e.g. pulmonary hypertension)
102
What is the normal aortic root diameter (indexed)?
<21 mm/m²
103
What is a sinus of Valsalva aneurysm?
A dilation >4.0 cm of the aortic root sinus
104
How is prosthetic valve function assessed?
With Doppler for gradients, velocity ratios, and visual motion
105
What is the normal mitral valve area?
4–6 cm²
106
What is the pressure half-time (PHT) cutoff for severe mitral stenosis?
>220 ms (MVA = 220 / PHT)
107
What are signs of constrictive pericarditis on echo?
Septal bounce
Respiratory variation in mitral/tricuspid inflow
Dilated IVC with reduced collapse
108
What is the normal peak gradient across a normal prosthetic aortic valve (mechanical or bioprosthetic)?
Usually <20 mmHg (but depends on valve type and size)
109
What is a pathological prosthetic valve regurgitation finding?
Holodiastolic (aortic) or holosystolic (mitral) regurgitation with dense CW signal and/or paravalvular leak
110
What is the myocardial viability indicator on stress echo?
Improvement in wall motion with low-dose dobutamine
111
What does biphasic response on dobutamine stress echo suggest?
Viable but ischemic myocardium
112
What is an abnormal response in wall motion during stress echo?
New or worsening regional wall motion abnormality (RWMA)
113
Indications for contrast echocardiography?
• Endocardial border definition
• Apical thrombus evaluation
• LV opacification
• Stress echo when image quality is poor
114
What is the most specific echo sign of tamponade?
Diastolic RV collapse
115
What contrast agent is used for right-to-left shunt detection?
Agitated saline (bubble study)
116
How do you detect a PFO on bubble study?
Bubbles in the left atrium within 3 cardiac cycles of RA opacification, especially with Valsalva
117
What echo view is best to assess coarctation of the aorta?
Suprasternal long-axis view
118
What are signs of pulmonary hypertension on echo?
• TR velocity >2.8 m/s
• Dilated RA/RV
• Flattened septum
• RVSP >35 mmHg
119
What is McConnell’s sign?
RV free wall hypokinesia with apical sparing (suggestive of PE)
120
What is the role of 3D echo in valve disease?
Precise valve anatomy assessment, regurgitant orifice quantification, surgical planning
121
What causes mirror image artifact in echo?
Reflection from strong acoustic interface (often the diaphragm)
122
What is reverberation artifact?
Multiple linear echoes caused by repeated reflection between two strong interfaces (e.g., mechanical valve)
123
What is “aliasing” in Doppler echocardiography?
When velocity exceeds Nyquist limit, color reverses (red ↔ blue)
124
Which echocardiographic view is best for assessing ASD?
Subcostal 4-chamber view with color Doppler
125
What does an eccentric MR jet suggest?
Mitral valve prolapse or flail leaflet
126
When is TDI (Tissue Doppler Imaging) used?
Assessing diastolic function, annular motion, dyssynchrony
127
What is the E/e’ ratio used for?
Estimating LV filling pressures
128
What is strain imaging best for?
Early detection of subclinical LV dysfunction (e.g., cardio-oncology, amyloidosis)
129
What is the “bull’s eye” or “polar plot” in echo?
Visual summary of regional longitudinal strain from all LV segments
130
What is the main advantage of speckle tracking over TDI?
Angle independence and better regional deformation analysis
131
What does paradoxical septal motion indicate?
Post-op (e.g., CABG), RV pressure overload, LBBB, or constriction
132
What is the main TTE view to assess LVOT?
Parasternal long-axis and apical 5-chamber for Doppler
133
What gradient defines dynamic LVOT obstruction?
≥30 mmHg at rest or with provocation (e.g., HCM)
134
What is SAM (systolic anterior motion) of the mitral valve?
Abnormal motion of MV leaflet into LVOT during systole, often in HCM
135
What is the normal mitral valve area (MVA)?
4–6 cm²
136
What MVA defines severe mitral stenosis?
≤1.5 cm²
137
How is mitral valve area calculated using pressure half-time (PHT)?
MVA = 220 / PHT
138
What is the normal aortic valve velocity?
<2.0 m/s
139
What is the mean gradient in severe aortic stenosis?
≥40 mmHg
140
What is the dimensionless index (DI) for aortic stenosis?
DI = LVOT VTI / AV VTI
## Footnote
Severe AS if DI < 0.25
141
What are the main signs of severe MR on color Doppler?
• Central jet >50% of LA
• VC width ≥7 mm
• Dense, triangular CW signal
142
What EROA defines severe primary mitral regurgitation?
≥0.4 cm²
143
What EROA defines severe secondary mitral regurgitation?
≥0.2 cm²
144
What is a flail mitral leaflet?
Chordal rupture with leaflet tip pointing into LA
145
What findings suggest severe aortic regurgitation?
• Pressure half-time <200 ms
• Holodiastolic flow reversal in descending aorta
• Wide pulse pressure
146
What gradient suggests severe tricuspid stenosis?
Mean gradient ≥5 mmHg
147
What are signs of severe TR?
• VC >7 mm
• Dense CW signal
• Systolic reversal in hepatic veins
• Large RA/RV
148
What is the role of 3D echo in valve disease?
Accurate quantification of regurgitant orifice, better leaflet visualization
149
What is the most specific sign of tamponade?
Diastolic collapse of the right atrium or ventricle
150
What respiratory change in mitral inflow supports tamponade?
>25% decrease with inspiration
151
How does constrictive pericarditis appear on echo?
• Septal bounce
• Dilated IVC
• Exaggerated respiratory mitral/tricuspid inflow variation
• Annulus reversus/paradoxus
152
What is annulus reversus?
Lateral e’ < septal e’ (seen in constriction)
153
What is the best view for atrial septal defect (ASD) detection?
Subcostal 4-chamber view with color Doppler
154
How is a patent foramen ovale (PFO) diagnosed?
Contrast bubbles appear in LA within 3 cardiac cycles after RA opacification
155
What is the Qp/Qs ratio and how is it used?
Pulmonary to systemic flow ratio; Qp/Qs >1.5 suggests significant shunt
156
What is a common echo finding in Ebstein’s anomaly?
Apical displacement of septal tricuspid leaflet
157
What is Tetralogy of Fallot?
1. VSD
2. Overriding aorta
3. Pulmonary stenosis
4. RV hypertrophy
158
What is the main indication for stress echo?
Detect inducible myocardial ischemia or viability
159
What is a biphasic response in dobutamine stress?
Improvement at low dose, worsening at high dose — suggests viability with ischemia
160
What is the target HR for stress echo?
85% of age-predicted max HR
## Footnote
(= 220 − age × 0.85)
161
What is a positive stress echo result?
New or worsening wall motion abnormality
162
What is reverberation artifact?
Repetitive reflections between two strong reflectors (e.g., valve, wire)
163
What is mirror image artifact?
Duplicate structure seen due to strong reflector (e.g., diaphragm)
164
What causes side lobe artifact?
Off-axis beam reflections appearing as false echoes
165
What is color Doppler aliasing?
Color reversal (red ↔ blue) when velocity exceeds Nyquist limit
166
What is Nyquist limit in echo?
Half of the pulse repetition frequency; sets aliasing threshold
167
What is drop-out artifact?
False absence of tissue due to poor signal (e.g., in thin septum)
168
What is the Aortic Valve Area (AVA) formula?
AVA = (CSA_LVOT × VTI_LVOT) / VTI_AV
## Footnote
CSA_LVOT: Cross-sectional area of the left ventricular outflow tract (LVOT), calculated as π × (D/2)², where D is the LVOT diameter. VTI_LVOT: Velocity Time Integral of LVOT flow. VTI_AV: VTI across the aortic valve.
169
What is the Mitral Valve Area (MVA) formula?
MVA = 220 / PHT
## Footnote
PHT: Time for the peak transmitral gradient to reduce by half.
170
What is the Simplified Bernoulli Equation?
ΔP = 4V²
## Footnote
ΔP: Pressure gradient across a valve or orifice (mmHg). V: Peak velocity through the valve (m/s).
171
What is the formula for Pulmonary Artery Systolic Pressure (PASP)?
PASP = 4(V_TR)² + RAP
## Footnote
V_TR: Peak velocity of tricuspid regurgitation jet. RAP: Right atrial pressure, estimated from IVC size and collapsibility.
172
What is the Mean Pulmonary Artery Pressure (mPAP) formula?
mPAP = 79 - (0.45 × PAcT)
## Footnote
PAcT: Time from onset to peak flow in the pulmonary artery (ms).
173
What is the formula for Pulmonary Vascular Resistance (PVR)?
PVR = (TRV / VTI_RVOT) × 10 + 0.16
## Footnote
TRV: Tricuspid regurgitation velocity. VTI_RVOT: Velocity Time Integral of right ventricular outflow tract.
174
What are the formulas for Stroke Volume (SV) and Cardiac Output (CO)?
SV = CSA_LVOT × VTI_LVOT
CO = SV × Heart Rate
## Footnote
Accurate measurement of LVOT diameter and VTI is essential for precise calculation.
175
What is the E/e′ Ratio formula?
E/e′ = Peak E-wave velocity / Mean e′-wave velocity
## Footnote
E: Early diastolic transmitral flow velocity. e′: Early diastolic mitral annular velocity (average of septal and lateral).
176
What is the Left Ventricular Mass (LVM) formula?
LVM = 0.8 × [1.04 × ((IVSd + LVIDd + PWd)³ - (LVIDd)³)] + 0.6
## Footnote
IVSd: Interventricular septal thickness in diastole. LVIDd: Left ventricular internal diameter in diastole. PWd: Posterior wall thickness in diastole.
177
What is the formula for Right Ventricular Systolic Pressure (RVSP)?
RVSP = PASP (in absence of pulmonary stenosis)
## Footnote
Assuming no RV outflow obstruction, RVSP equals PASP.
178
What is the relationship between frequency and resolution in ultrasound?
Higher frequencies provide better resolution but less penetration; lower frequencies penetrate deeper but with lower resolution.
179
What is attenuation in ultrasound?
Attenuation is the reduction in amplitude and intensity of the ultrasound beam as it travels through tissue.
180
What is the Doppler Effect?
The Doppler Effect is the change in frequency of the reflected ultrasound wave due to motion of the source or observer.
181
What is aliasing in ultrasound?
Aliasing occurs when the Doppler shift exceeds the Nyquist limit, causing incorrect velocity representation.
182
What is beam steering in ultrasound?
Beam Steering is the electronic manipulation of the ultrasound beam direction, essential for imaging structures at various angles.
183
What are common ultrasound artifacts?
Common artifacts include reverberation, shadowing, and enhancement.
184
Aortic valve peak velocity is ≥ 4.0 m/s — what is the severity of AS?
Severe Aortic Stenosis
185
Mean transaortic gradient is ≥ 40 mmHg — what is the severity of AS?
Severe Aortic Stenosis
186
Aortic valve area is ≤ 1.0 cm² — what is the severity?
Severe Aortic Stenosis
187
Indexed AVA is ≤ 0.6 cm²/m² — what does this indicate?
Severe Aortic Stenosis
188
Dimensionless index is ≤ 0.25 — what is the severity of AS?
Severe Aortic Stenosis
189
Pressure half-time is < 200 ms — what is the severity of AR?
Severe Aortic Regurgitation
190
Vena contracta width is ≥ 6 mm — how severe is the AR?
Severe Aortic Regurgitation
191
Regurgitant volume is ≥ 60 mL/beat — what severity of AR does this indicate?
Severe Aortic Regurgitation
192
Regurgitant fraction is ≥ 50% — what is the severity of AR?
Severe Aortic Regurgitation
193
Effective regurgitant orifice area (EROA) is ≥ 0.3 cm² — what is the severity?
Severe Aortic Regurgitation
194
Mean transmitral gradient is ≥ 10 mmHg — what is the severity of MS?
Severe Mitral Stenosis
195
Mitral valve area is ≤ 1.0 cm² — what severity of MS does this indicate?
Severe Mitral Stenosis
196
Pressure half-time gives MVA = 0.8 cm² — how severe is the MS?
Severe Mitral Stenosis
197
Vena contracta width is ≥ 7 mm — what is the severity of MR?
Severe Mitral Regurgitation
198
Regurgitant volume is ≥ 60 mL/beat — what does this indicate?
Severe Mitral Regurgitation
199
Regurgitant fraction is ≥ 50% — what severity of MR does this suggest?
Severe Mitral Regurgitation
200
EROA is ≥ 0.40 cm² — what is the severity of MR?
Severe Mitral Regurgitation
201
Pulmonary vein Doppler shows systolic flow reversal — what does this indicate?
Severe Mitral Regurgitation
202
Vena contracta width is ≥ 7 mm — what is the severity of TR?
Severe Tricuspid Regurgitation
203
Aortic valve peak velocity is < 2.6 m/s
Mild Aortic Stenosis
204
Aortic valve peak velocity is 2.6–2.9 m/s
Mild Aortic Stenosis
205
Aortic valve peak velocity is 3.0–3.9 m/s
Moderate Aortic Stenosis
206
Aortic valve peak velocity is ≥ 4.0 m/s
Severe Aortic Stenosis
207
Mean aortic gradient is < 20 mmHg
Mild Aortic Stenosis
208
Mean aortic gradient is 20–39 mmHg
Moderate Aortic Stenosis
209
Mean aortic gradient is ≥ 40 mmHg
Severe Aortic Stenosis
210
Aortic valve area (AVA) > 1.5 cm²
Mild Aortic Stenosis
211
AVA 1.0–1.5 cm²
Moderate Aortic Stenosis
212
AVA ≤ 1.0 cm²
Severe Aortic Stenosis
213
Dimensionless index > 0.5
Mild Aortic Stenosis
214
Dimensionless index 0.25–0.5
Moderate Aortic Stenosis
215
Dimensionless index ≤ 0.25
Severe Aortic Stenosis
216
Vena contracta width < 3 mm
Mild Aortic Regurgitation
217
Vena contracta width 3–5.9 mm
Moderate Aortic Regurgitation
218
Vena contracta width ≥ 6 mm
Severe Aortic Regurgitation
219
Regurgitant volume < 30 mL/beat
Mild Aortic Regurgitation
220
Regurgitant volume 30–59 mL/beat
Moderate Aortic Regurgitation
221
Regurgitant volume ≥ 60 mL/beat
Severe Aortic Regurgitation
222
Regurgitant fraction < 30%
Mild Aortic Regurgitation
223
Regurgitant fraction 30–49%
Moderate Aortic Regurgitation
224
Regurgitant fraction ≥ 50%
Severe Aortic Regurgitation
225
EROA < 0.1 cm²
Mild Aortic Regurgitation
226
EROA 0.1–0.29 cm²
Moderate Aortic Regurgitation
227
AR EROA ≥ 0.3 cm²
Severe Aortic Regurgitation
228
Mitral valve area > 1.5 cm²
Mild Mitral Stenosis
229
Mitral valve area 1.0–1.5 cm²
Moderate Mitral Stenosis
230
Mitral valve area ≤ 1.0 cm²
Severe Mitral Stenosis
231
Mean transmitral gradient < 5 mmHg
Mild Mitral Stenosis
232
Mean transmitral gradient 5–9 mmHg
Moderate Mitral Stenosis
233
Mean transmitral gradient ≥ 10 mmHg
Severe Mitral Stenosis
234
Vena contracta width < 3 mm
Mild Mitral Regurgitation
235
Vena contracta width 3–6.9 mm
Moderate Mitral Regurgitation
236
Vena contracta width ≥ 7 mm
Severe Mitral Regurgitation
237
Regurgitant volume < 30 mL/beat
Mild Mitral Regurgitation
238
Regurgitant volume 30–59 mL/beat
Moderate Mitral Regurgitation
239
Regurgitant volume ≥ 60 mL/beat
Severe Mitral Regurgitation
240
Regurgitant fraction < 30%
Mild Mitral Regurgitation
241
Regurgitant fraction 30–49%
Moderate Mitral Regurgitation
242
Regurgitant fraction ≥ 50%
Severe Mitral Regurgitation
243
EROA < 0.2 cm²
Mild Mitral Regurgitation
244
EROA 0.2–0.39 cm²
Moderate Mitral Regurgitation
245
EROA ≥ 0.4 cm²
Severe Mitral Regurgitation
246
Vena contracta width < 3 mm
Mild Tricuspid Regurgitation
247
Vena contracta width 3–6.9 mm
Moderate Tricuspid Regurgitation
248
Vena contracta width ≥ 7 mm
Severe Tricuspid Regurgitation
249
Regurgitant volume < 30 mL/beat
Mild Tricuspid Regurgitation
250
Regurgitant volume 30–44 mL/beat
Moderate Tricuspid Regurgitation
251
Regurgitant volume ≥ 45 mL/beat
Severe Tricuspid Regurgitation
252
What indicates Mild Mitral Regurgitation regarding pulmonary vein systolic flow?
Pulmonary vein systolic flow is normal or predominant
253
What indicates Moderate Mitral Regurgitation regarding pulmonary vein systolic flow?
Pulmonary vein systolic flow is blunted
254
What indicates Severe Mitral Regurgitation regarding pulmonary vein systolic flow?
Pulmonary vein systolic flow shows reversal
255
What mitral inflow E velocity indicates Mild Mitral Regurgitation?
Mitral inflow E velocity is < 1.2 m/s
256
What mitral inflow E velocity indicates Moderate Mitral Regurgitation?
Mitral inflow E velocity is 1.2–1.5 m/s
257
What mitral inflow E velocity indicates Severe Mitral Regurgitation?
Mitral inflow E velocity is > 1.5 m/s
258
What PISA radius indicates Mild Mitral Regurgitation?
PISA radius < 0.4 cm (at Nyquist 30–40 cm/s)
259
What PISA radius indicates Moderate Mitral Regurgitation?
PISA radius 0.5–0.8 cm
260
What PISA radius indicates Severe Mitral Regurgitation?
PISA radius > 0.9 cm
261
What indicates Mild Aortic Regurgitation regarding descending aortic end-diastolic flow?
Descending aortic end-diastolic flow is antegrade
262
What indicates Moderate Aortic Regurgitation regarding descending aortic flow?
Descending aortic flow shows brief diastolic reversal
263
What indicates Severe Aortic Regurgitation regarding descending aortic flow?
Descending aortic flow shows holodiastolic reversal
264
What indicates Mild Tricuspid Regurgitation regarding hepatic vein systolic flow?
Hepatic vein systolic flow is dominant
265
What indicates Moderate Tricuspid Regurgitation regarding hepatic vein systolic flow?
Hepatic vein systolic flow is blunted
266
What indicates Severe Tricuspid Regurgitation regarding hepatic vein systolic flow?
Hepatic vein systolic flow shows reversal
267
What PISA radius indicates Mild Tricuspid Regurgitation?
PISA radius < 0.6 cm
268
What PISA radius indicates Moderate Tricuspid Regurgitation?
PISA radius 0.6–0.8 cm
269
What PISA radius indicates Severe Tricuspid Regurgitation?
PISA radius > 0.9 cm
270
Prosthetic aortic valve peak velocity is < 3 m/s
Normal or mild obstruction
271
Prosthetic aortic valve peak velocity is 3–4 m/s
Possible moderate obstruction
272
Prosthetic aortic valve peak velocity is > 4 m/s
Suggestive of severe obstruction
273
Mean gradient is < 20 mmHg
Normal or mild prosthetic obstruction
274
Mean gradient is 20–35 mmHg
Moderate obstruction
275
Mean gradient is > 35 mmHg
Severe prosthetic valve obstruction
276
DVI (dimensionless velocity index) > 0.45
Normal function
277
DVI 0.25–0.45
Moderate prosthetic obstruction
278
DVI < 0.25
Severe obstruction of prosthetic aortic valve
279
Peak E velocity is < 1.9 m/s
Normal or mild obstruction
280
Peak E velocity is 1.9–2.5 m/s in prosthetic valve
Moderate prosthetic obstruction
281
Peak E velocity is > 2.5 m/s
Severe obstruction of prosthetic mitral valve
282
Mean gradient is < 5 mmHg
Normal function
283
Mean gradient is 6–10 mmHg
Moderate obstruction
284
Mean gradient is > 10 mmHg
Severe mitral prosthetic obstruction
285
PHT < 130 ms
Normal or mild prosthetic obstruction
286
PHT 130–200 ms
Moderate prosthetic obstruction
287
Prosthetic MV PHT > 200 ms
Severe obstruction of mitral prosthetic valve
288
Small central jet, brief, symmetrical in CW Doppler
Physiological prosthetic regurgitation (normal)
289
Paravalvular jet > 6 mm vena contracta or multiple jets
Suggests significant prosthetic regurgitation
290
Holodiastolic flow reversal in descending aorta in AVR
Severe prosthetic aortic regurgitation
291
Systolic flow reversal in pulmonary veins (MVR)
Severe prosthetic mitral regurgitation
292
EROA ≥ 0.3 cm² in prosthetic AR or MR
Severe prosthetic regurgitation
293
What is reverberation?
Repeated reflection between two strong reflectors.
## Footnote
Multiple equally spaced horizontal lines (e.g., lines in pericardial effusion).
294
What is shadowing?
High attenuation structure blocks sound.
## Footnote
Dark area behind calcification/prosthetic valve.
295
What is enhancement?
Low attenuation structure (e.g., fluid).
## Footnote
Bright area distal to fluid (e.g., pericardial effusion).
296
What is mirror image?
Reflecting structure near strong interface.
## Footnote
Duplicate structure on opposite side of mirror.
297
What is side lobe?
Energy outside main beam reflects.
## Footnote
False echo away from true reflector.
298
What is beam width artefact?
Wide beam picks up structures off-axis.
## Footnote
Smearing or ghost image.
299
What is the formula for Regurgitant Volume?
Regurgitant Volume = (2πr² · Va / VMR) · VTIMR
300
What are the Input Variables for HOCM sudden cardiac death risk?
(all measured at rest):
1. Age (years)
2. Maximal LV wall thickness (mm)
3. Left atrial diameter (mm)
4. Max LVOT gradient (mmHg)
5. Family history of SCD (yes = 1, no = 0)
6. Non-sustained VT on Holter (yes = 1, no = 0)
7. Unexplained syncope (yes = 1, no = 0)
301
Normal Atrial size
302
In HOCM what does wall thickness >29mm mean?
High risk of sudden death
303
304
Normal mid RV diameter
3.3cm
