LV Systolic and Diastolic Function

Question 1

Grades of Diastolic Dysfunction

Answer 1

Grade I Impared Relaxation
Grade II Pseudo-Normal Filling
Grade III Restrictive Filling

Question 2

Causes of Diastolic Dysfunction

Answer 2

Primary Myocardial disease
Secondary LV hypertrophy
Coronary Artery disease
Extrinsic Constraint

Question 3

In which cases we can not mesuare th E’?

Answer 3

Prostetic#
Valve
Annuloplasty or Mitral Annular Calcifiaction

Question 4

How to get me Maximun HR:

Answer 4

(220 - age) x 0.8

Question 5

what is the best Stress test to evaluate Myocardial viability?

Answer 5

Dobutamine test
Increases HR and Contractility

Question 6

Strain and Strain Rate Characterize?

Answer 6

Wall Deformation

Question 7

E-point Septal Separation more than 10mm, Indicated:

Answer 7

Decreases on Ejection Fraction ( sytolic Dysfunction)

Question 8

is the speckle tracing angel independent or angel dependent?

Answer 8

angel independent

It/s just speckel

Question 9

Phases of Diastole

Answer 9

IVR
Early Rapid Filling
Diastasis
Late diatolic filling caused by atrial contraction

Question 10

Is the Stress Test Indicated to evalued Diastolic Dysfunction? WHY?

Answer 10

Yes, To evaluate E’

In patient with Diastolic Dysfunction the E’ will not increases
In patient with normal Diastolic Function the E’ will Increase

Question 11

Most common cause of walll motion?

Answer 11

CAD (isquemic heart disease)

Question 12

Septal Flash:

Answer 12

Is an inward and then outward motion of the septum during systolic.

Indicates LBBB

Question 13

Name of the finding and diagnosis?

Answer 13

Septal beaking in M-Mode or septal flash in 2D
LBBB

Question 14

What does represent S1, S2 and AR in pulmonary vein signal?

Answer 14

S1: Atrial relaxation (systole Ventricular)
S2: Atrial Relaxation and Beginning of Diastole
AR: Atrial contraction

Question 15

Premature closer of the Aortic valve, Indicates:

Answer 15

Reduced of Stroke Volume (systolic Dy
sfuntion)

Question 16

Ventricular Syatolic Function and pump performance depends on:

Answer 16

Preload
Afterload
Contratility
ventricular Geometric

Question 17

Stroke Volumen
(concept and Equation)

Answer 17

The amount of blood pumped by the heart on a single beat.

SV= EDV -ESV

Question 18

Primary Tricuspid regurgitation, is called?

Answer 18

Low pressure TR

Question 19

L Wave is suggestive of:

Answer 19

Elevated LV Preload
Pseudo-normal Filling. Grade II
Could be normal in patient with Bradycardia

Question 20

what is the best stress test to evaluate Diastolic Function?

Answer 20

Bicycle
Increases Stroke Volume

Question 21

what is considered Hypertensive responde to exercise?

Answer 21

During exercises:
SBP > 220mmg for men
> 190 for women

Diastolic BP > 90

for Dobutamin ST >182 / >96mmhg

Question 22

Finding in Super natural filling

Answer 22

E/A radio > 2
IVR <
High E wave
Healthy patient

Question 23

How do we calculated Maximun Workload?

Answer 23

HR x Systolic Blood Pressure

Question 24

Normal Fractional Shortenning
LVEDD
LVESD
RWT

Answer 24

FS <28,5
LVEDD= M <59 W<53
LVESD= M<40 W<35
RWT <0,42

Question 25

What is the cut point to define Hypertensive Response during Dobutamin Stress Echo?

Answer 25

SBP> 182mmhg and DBP < 96mmhg

Question 26

Velocity and Displacement Characterize:

Answer 26

Wall Motion

Question 27

What is the most common type of Dilated Cardiomyopathy?

Answer 27

Ischemic Cardiomyopathy

Question 28

How many signal should you get during Atrial Fibrilation?

Answer 28

5 to 10 signal

Question 29

Reduced of Anteroposterior motion of the aortic root, indicates:

Answer 29

Reduced Cardiac Output (systolic Dysfunction)

Question 30

For wall motion Score Index, above which numer will be a bad outcome?

Answer 30

Anyting above 1 is adnormal, But 1,4 is bad outcome WMSI= Score of 16 segments divided by 16

Question 31

Is the TAPSE and The DTI on the evaluation of RV systolic function, Angel Dependen?

Answer 31

Yes, both are angle depende

Question 32

increases on the E-point will lead to

Answer 32

Decreases in the EF

Question 33

Affection of the filling and emptying of the atrial will cause?

Answer 33

Decreases in the cardiac output

Question 34

Grades of Diastolic Dysfunction

Answer 34

Grade I Impared Relaxation Grade II Pseudo-Normal Filling Grade III Restrictive Filling

Question 35

Quantitive evaluation of Systolic Function?

Answer 35

Fractional S EF Rate of Rise of pressue MPI

Question 36

How much blood passes From LA to LV during E wave, Diastasis and A wave

Answer 36

E wave : 70 - 80% Diastasis: < 5% A Wave: 15 - 25%

Question 37

Which of the view will be the only one qhere we can see the Posterios and Anterior leaflet of the TV?

Answer 37

RV inflow

Question 38

what is the best way to evalue RV ejection Fraction)

Answer 38

3D evaluation

Question 39

How is Atrial Contraction on mitral, pulmonary flow and Mitral Annular movement singal represented:

Answer 39

A wave in mitral Signal A' in annular movement AR in pulmonary vein flow

Question 40

During an ischemic cascade which cardiac cicle is afected first?

Answer 40

Diastolic function: means decrease in E/A radio

Question 41

The Tricuspid Valve apparatus Consists of:

Answer 41

The Tricuspid valve Leaflet Annulus, The chordae Papilary muscle

Question 42

the Hypotension in Dobutamina Stress test could be cause of?

Answer 42

Isquemia Vagal Responde to DOBUTAMINA Vasodilatation

Question 43

Quantities evaluation of Sytolic Function

Answer 43

Race of Rise Of pressure Miocardial Index EF

Question 44

What are the causes of Hypotension respond during Stress Test?

Answer 44

Three Vessels disease Left main Stem Vagal Respond (DST) Vasodilatation (DST)

Question 45

Strain evaluates what type of deformation?

Answer 45

Longitudinal deformation (it is always Negative)p

Question 46

What is the Firts step for evaluation of Diatolic Dysfunction?

Answer 46

LV Systolic Function (Ejection Fraction)

Question 47

Short inward motion starting at the onset of QRS on M-mode:

Answer 47

Septal Beaking, Indicates LBBB

Question 48

How to get the Maximun Workload?

Answer 48

HR x Systolic BP

Question 49

Diastasis Depends on:

Answer 49

Heart Reat. If the HR is slow the diastasis will be longer if the HR is faster the diastasis will be shorter

Question 50

how do we calculated the maximun HR?

Question 51

Cardiac Output (Concept and Equation)

Answer 51

The amount of blood pumped by the heart per min CO= SV x HR

Question 52

If contractility Decreases, Stroke Volume:

Answer 52

Decreases

Question 53

Rate of Rise Of Pressure. Concept and normal Value

Answer 53

Evaluate The contractility EValuate how fast the Pressure increse whitin the left Ventricle Uses MR signal Messuare at 1m/s and 3m/s dP/dT = GP at 3m/s - GP at 1 m/s Time Uses Bernoulli equation for both time 1 and 3 Normal Value >1000mmhg/s The shortest the time the better

Question 54

During Tachycardia, how can the mitral signal can be improve to appretiate the spectral signals

Answer 54

Carotic Sinus massage will lead to separation of the E and A wave

Question 55

How is the pulmonary vein flow signal in Grade III diastolic disfunction?

Answer 55

S wave Decrese because there it lees bloor entering the LA due it's Hight pressure D wave increases, Since all the bllod goes to the LV during rapid filling AR is larger and increases because there is more blood going backwards to PV

Question 56

What effects has the Valvalsa Maneuver in the blood flow on the heart?

Answer 56

It reduces the venous return to the atrium (Decrease Preload) It happens in Fase two (4 phases in total)

Question 57

most common cause of thrombus?

Answer 57

Dilated Cardiomiopaty