pHTN, RV, PE

Question 1

RVSP

Answer 1

4 * Vtr^2 + RA pressure

Question 2

Overestimating RVSP

Answer 2

Overgained signal

Question 3

PA diastolic pressure

Answer 3

4 * Vend PR^2 + RAP

Question 4

Mean PAP by TR

Answer 4

PAPm = TR mean gradient + RAP

Question 5

Mean PAP by PR

Answer 5

4 (Peak PR^2) + RAP

Question 6

Mean PA by AT

Answer 6

Simple: 80 - 0.5 AT
79 - (0.45 x AT)
90 - (0.62 x AT) if < 120 ms

Question 7

PVR

Answer 7

mPAP - LAP / CO

Question 8

ULN RV area women

Answer 8

11.5

Question 9

ULN RV area men

Answer 9

12.6

Question 10

ULN RV volume women

Answer 10

74

Question 11

ULN RV volume men

Answer 11

87

Question 12

RV FAC

Answer 12

(RV end diastolic area - RV end systolic area) / RV end diastolic area * 100

Question 13

RV FAC dysfunction

Answer 13

<35%

Question 14

TAPSE

Answer 14

Distance tricuspid annulus travels towards apex in systole

Question 15

Peak systolic velocity (S’)

Answer 15

Peak velocity of longitudinal excursion of RV

Question 16

RV systolic strain abnormal

Answer 16

Greater than -25%

Question 17

RV index myocardial performance (RIMP)

Answer 17

(IVCT + IVRT) / RV ET
Underestimates severity, don’t use by itself
Falsely low if RAP high

Question 18

RV resistance

Answer 18

PVR = Peak TR pressure gradient / RVOT VTI * 10

Question 19

RV compliance / capacitance

Answer 19

RVCAP = SV / PA pulse pressure

= (LVOT area * VTI) / 4 * (TRvmax^2 - PRendV^2)

Question 20

W sign

Answer 20

High RV afterload

Mid systolic notching in RVOT velocity

Question 21

Cardiac surgery and RV

Answer 21

TAPSE / S’ low

FAC or EF preserved

Question 22

McConnell’s sign

Answer 22

Akinesis of RV free wall
Preservation of RV apex
Acute PE / right heart failure

Question 23

HV systolic flow reversal

Answer 23

Severe TR

RV dysfunction

Question 24

TV stenosis parameters

Answer 24

PHT >= 230 in mechanical valve
MG >= 6 mmHg
Vel >1.7m/s

Question 25

RV restrictive filling parameters

Answer 25

Tricuspid E/A >2.1 DT <120 ms Late diastolic antegrade flow in PA

Question 26

ARVD characteristics

Answer 26

Regional dysfunction in RVOT, apex, basal RV free wall | RV dilatation and depressed function may occur

Question 27

MV doppler in pHTN

Answer 27

Septal velocity reduced | Lateral velocity normal

Question 28

Hepatic vein physiology

Answer 28

Reflects RA pressure Antegrade flow from HV to RA in systole (S) and diastole (D) RA contraction -> brief retrograde late-diastolic flow (Ar) and late systolic flow (Vr)

Question 29

HV S > D RAP

Answer 29

0-5

Question 30

HV S = D RAP

Answer 30

5-10

Question 31

HV S < D RAP

Answer 31

10-15

Question 32

HV only D RAP

Answer 32

>=20

Question 33

Limitations of HV for predicting RAP

Answer 33

TV stenosis or regurgitation Pericardial compression syndromes High-grade AVB Heart transplant

Question 34

Parameters for advanced RV disease in amyloid

Answer 34

RV wall thickness > 7 mm Restrictive TV filling HV reduced systolic forward flow, increased forward diastolic flow, inspiratory diastolic atrial flow reversal

Question 35

mPAP from PASP/PADP

Answer 35

``` mPAP = PADP + 1/3 * pulse pressure mPAP = (PASP + 2*PADP)/3 ```

Question 36

High AR

Answer 36

Increased RVEDP