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Know It Pt5! Flashcards

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1
Q

What are 3 primary valve diseases that cause MR?

A

-MVP
-Rheumatic Stenosis
-endocarditis

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2
Q

Papillary muscle dysfunction can be due to _____ MR

A

Ischemic

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3
Q

A ____chordae tendineae can cause ____

A

Ruptured ; MR

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4
Q

Congenital valve abnormalities can cause ____

A

MR

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5
Q

Annulus ____ or ___ can cause MR

A

Dilation or calcification

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6
Q

With MR the first thing to occur is ____ in the LA then that leads to ___ of the LA

A

Volume overload; dilation

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7
Q

With MR what 2 chambers become dilated due to volume overload?

A

LA & LV

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8
Q

MR is what kind of murmur?

A

Holosystolic murmur that radiates to the axilla

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9
Q

Long standing MR leads to symptoms of ____ & ____ complicated by LV dysfunction

A

CHF & PHTN

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10
Q

_____ prolapse causes MR

A

MVP

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11
Q

What are some mitral valve abnormalities that you may see on echo with MR?

A
  • MVP
    -MAC
    -Rheumatic stenosis
  • Myxomatous leaflets
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12
Q

What are - Myxomatous leaflets?

A

A valve disease associated with other diseases.

Causes thick MV leaflets and chorade creating a loss of mechanical leaflet integrity

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13
Q

____ dilation & ____ may be present with MR

A

LV; hyper contractility

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14
Q

What is the MV scallop view from the sonographers prospective?

A

A3,A2,A1 on top AMVL
P3, P2, P1 on bottom PMVL

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15
Q

What is the MV scallop view from the surgeon prospective?

A

A1,A2,A3 on top AMVL
P1,P2,P3 on bottom PMVL

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16
Q

A vena contracta of a MR jet may be seen with which cardiomyopathy?

A) Restrictive
B) infiltrative
C) Dilated
D)HOCM

A

C

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17
Q

What are the 4 parts of a MR jet?

A
  1. Flow of convergence ( dome of flow)
  2. Vena contracta
  3. Jet size
  4. Down stream affect of pulm veins
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18
Q

If the vena contracts of a MR jet is > or equal to ____ cm it’s severe MR

A

> or equal to 0.7cm

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19
Q

What is meant by the downstream affect of the MR Jet?

A

How it affects the pulmonary veins & if there’s pulmonary vein flow reversal

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20
Q

What does PISA stand for?

A

Proximal isovelocity surface area

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21
Q

What is PISA used to estimate?

A

EROA ( effective regur office area)

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22
Q

PISA assumes the radius (r) of the ____ occurs at the same time as the peak regurgitant MRvelocity.

A

Flow of convergence dome

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23
Q

PISA method is able to provide us with what 3 valves?

A

-EROA
-Regurgitant flow
-Regurgitant volume

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24
Q

What are the l steps of PISA?

Study These Flashcards
A
  1. Zoom in on MR
  2. Take images with and without color
  3. LOWER baseline aliasing velocity to -30 to -40cm/s
  4. Measure r - radius of vena contracta
  5. Take CW Doppler of MR and VTI trace it
25
With PISA what should do with your baseline aliasing velocity?
Lower it to -30 to -40
26
To calculate PISA & EROA what 3 things did you need to measure?
1. CW VTI of MR jet ( VTI) 2. Peak revue velocity (V-max) given when you do VTI anyway 3. R-radius of vena contracta
27
What does r mean in the PISA math?
Radius of vena contracta
28
What does Va in the PISA math mean?
Aliasing velocity ( baseline / VTI)
29
What does PkVreg in the PISA math mean?
Regurgitant amount of volume ( VMAX)
30
What is the regurgitation volume formula?
EROA X VTI of MR
31
What is the mild, mod & severe vena contracta for MR?
Mild= <0.3cm Mod=0.3-0.69 cm Severe= > or equal to 0.7cm
32
What is the mild, mod & severe EROA?
Mild = <0.2cm Mod = 0.2-0.39cm Severe = > or equal to 0.4cm
33
What is the mild, mod & severe Regurgitation volume ?
Mild= <30ml Mod= 30-59ml Severe= > of equal to 60ml
34
What is the Conda effect?
When regur jets hug the walls and causes us to underestimate the jet size
35
What’s another name for the Conda effect?
Eccentric jets
36
If you suspect severe MR where else should you take a look?
Pulmonary veins
37
What does JA/LAA ratio stand for?
Jet area / left atrial area
38
You obtain the JA/LAA in what 2 views?
AP4 & AP2
39
What is the mild, mod & severe JA/LAA ratio?
Mild= <20% Mod= 20-39% Severe= > or equal to 40%
40
Pulmonary vein ____ reversal indicates severe MR
Systolic reversal or decreased S wave in pulm veins
41
The greatest source of error in measuring in PISA with? A) length of regur jet B) vena contracts measurement C)radius of flow convergence D) peak velocity measurement
C)
42
What is dp/dt a measurement of?
LV myocardial directional contractility
43
Which is a measurement of LV myocardial directional contractility ? A) EDV-ESV B) P=4v2 C) EROA x VTI D) DP/dt
D
44
Dp/dt describes the rate in ___rise in the LV during ____
Pressure ; systole
45
In a patient with normal LV systolic function the Dp/dt there’s ___ raise in ____ pressure in systole
Rapid ; systolic
46
In a pt. That has impaired LV systolic function the rate in squeezing systolic pressure is _____ therefore dp/dt starts to ___
Lower ; falll
47
Dp/dt is measured in which? A) mmhg B) Cm C) % D) mm
A
48
Dp/dt is ____ to measure even in the cath lab
Difficult
49
In the echo lab where is our dp/dt measurement taken from?
CW MR Doppler jet
50
What is a normal LV dp/dt?
>1200mmhg/sec
51
What is the formula for dp/dt?
32 / MR jet going from 1-3m/sec
52
When measuring the dp/dt MR jet ensure your sweep speed is?
High as possible to “spread out the trace”
53
How do you measure the dp/dt?
32/ MR get from 1-3m/sec Measure slope of MR from 1-3msec
54
Dp/dt is not reliable if the MR is ___ or if there is significant increased _____
Acute ; afterload
55
A systolic MR velocity of ____ to ____ m/sec indicates high gradient between LA & LA in systole
4.5 to 5 m/sec
56
Left atrial pressure can be calculated from the ____ peak velocity
MR
57
What is the formula for LAP calculation with MR?
Systolic BP - MR gradient
58
Calculate LAP from a MR Doppler SBP = 120mmhg MR= 5m/sec
1. Convert the 5m/sec with the bernloui equation 2. Then you have your MR and put into the equation Answer = 20mmhg

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