Know It Pt &

Question 1

What are the five phases of diastole?

Answer 1

1.IVRT
2. E wave - early filling
3. Diastasis
4. A wave- atrial contraction
5. IVCT

Question 2

During IVRT which valves are open and closed?

Answer 2

AV closed
MV opens

Question 3

The majority of ventricular filling occurs during?

A) IVRT
B) IVCT
C) first third of diastole
D) atrial contraction

Answer 3

C

Question 4

What valves are open during IVCT?

Answer 4

-AV open
-MV closed

Question 5

What are the three abnormal filling patterns?

Answer 5

• abnormal relaxation -grade 1
  -pseudo normal - grade 2
  -Restrictive - grade 3

Question 6

Which abnormal filling pattern represents grade 1 diastolic dysfunction

Answer 6

Abnormal relaxation

Question 7

Which abnormal filling pattern represents grade 2 diastolic dysfunction

Answer 7

Pseudo normal

Question 8

Which abnormal filling pattern represents grade 3 diastolic dysfunction

Answer 8

Restrictive

Question 9

Which abnormal filling pattern represents grade 4 diastolic dysfunction

Answer 9

Grade 4 - is dependent on whether or not a restrictive grade 3 inflow pattern normalizes with Valsalva or persists

If the restrictive flow pattern persists even with Valsalva, this is known as great 4 and is irreversible

Question 10

A patient comes into the Ecolab with grade 3 diastolic dysfunction. what maneuver do you perform to determine if it is irreversible?

Answer 10

Valsalva maneuver

Question 11

A patient comes into the Ecolab with grade 3 diastolic dysfunction. You ask the patient to Valsalva and the restrictive flow pattern persists what is this classified as?

Answer 11

Grade 4 - irreversible

Question 12

If a patient has a normal mitral valve inflow, but their pulmonary veins show a decreased S wave and D wave what might you consider they have??

Answer 12

Pseudo normal pattern

Question 13

In elderly patients > ___ the a-wave is normally ___ to or ____ than the E -wave

Answer 13

60; Equal ; higher

Question 14

What’s does an abnormal relaxation grade 1 diastolic dysfunction pattern look like?

Answer 14

Blunted E , normal A

Question 15

What’s does an pseudo normal grade 2 diastolic dysfunction pattern look like?

Answer 15

Normal looking E & A

Question 16

What’s does a restrictive grade 3 diastolic dysfunction pattern look like?

Answer 16

Narrow, tall E, long diastasis, small A

Question 17

what is a normal E/e’?

Answer 17

<14 cm/sec

Question 18

What should a normal lateral e’ be?

Answer 18

> or equal to 10cm/s

Question 19

What should a normal septal e’ be?

Answer 19

> or equal to 7cm/s

Question 20

What’s a normal LA volume?

Answer 20

<34ml

Question 21

What should your e/a ratio be?

Answer 21

> 1

Question 22

What’s a normal Decel time?

Answer 22

<220m/sec

Question 23

How long should your IVRT be?

Answer 23

<100m/s

Question 24

What is the ratio of your S& D wave on your pulmonary veins?

Answer 24

> 1

Question 25

What should your A duration be for your pulmonary vein a wave?

Answer 25

<20ms

Question 26

If you have a patient that has a normal septal and lateral e’ but a slightly enlarged LA what would be classify this in terms of diastolic dysfunction?

Answer 26

Athletes heart or constriction

Question 27

A E/A ratio of 0.8-1.5 means?

Answer 27

Grade 2 -pseudonormal diastolic dysfunction

Question 28

A E/A ratio of > 2 means?

Answer 28

Grade 3- restrictive diastolic dysfunction

Question 29

A decel time of >200 means?

Answer 29

Grade 1 -abnormal relaxation

Question 30

A decel time of 160-200ms is a sign of?

Answer 30

Grade 2- pseudo normal diastolic dysfunction

Question 31

A decel time of <160ms is a sign of?

Answer 31

Grade 3- restrictive diastolic dysfunction

Question 32

If 2 out of 3 diastolic dysfunction criteria are negative we consider it?

Answer 32

Normal or grade 1

Question 33

Out of the 3 diastolic dysfunction criteria if 1 is positive and 1 is negative. We consider this?

Answer 33

Unable to determine

Question 34

Out of the diastolic dysfunction criteria if 2 are positive or 3 are positive we consider this?

Answer 34

Grade 2

Question 35

If the E/A ratio of > or equal to 2 we consider this?

Answer 35

Grade 3

Question 36

When dopplering your MV inflow. You should do it in your __ view. Use ____ wave. Ensure you sample volume is at _____mm and place it at the ____tips.

Answer 36

Ap4; PW; <2mm; leaflet

Question 37

When dopplering your MV inflow. Your frequency and gain should be?

Answer 37

Low

Question 38

What should the sample size be for mitral inflow Doppler?

Answer 38

<2mm

Question 39

When dopplering your pulmonary veins. You should use ____ wave. Make sure your sample volume is at ____mm

Answer 39

PW, 3-4mm

Question 40

What should your sample size be for pulmonary vein Doppler?

Answer 40

3-4mm

Question 41

When using Doppler at the pulmonary veins, you should be ___ to ___cm into the pulm veins

Answer 41

1-2cm

Question 42

What is the difference with the mitral valve info pattern between construction and restriction disease?

Answer 42

MV inflow changes with respiration with constrictive disease

Question 43

How would you determine if a patient has constrictive versus restrictive disease? A) strain Imaging B) pulmonary venous flow C) mitral valve flow with respiratory variation D) tricuspid valve inflow with respiratory variation

Answer 43

C

Question 44

With constrictive pericarditis does the E wave in a mitral valve flow pattern increase or decrease with inspiration?

Answer 44

Decrease

Question 45

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