Pulmonic/Tricuspid Pathology

Question 1

TV flow varies with?

Answer 1

respiration and increasing during inspiration

Question 2

pressures on the right are

Answer 2

lower than pressures on the left

Question 3

color doppler eval of TV

Answer 3

1. RV inflow view
2. PSAX
3. apical 4

Question 4

what is TS

Answer 4

narrowing or obstruction of the LV that impedes flow from the Ra to the RV during diastole

Question 5

How to measure TS mean pressure gradient

Answer 5

CW VTI trace

Question 6

moderate TS measurement

Answer 6

2-6

Question 7

mild TS mean pressure gradient

Answer 7

less than 2 mmHg

Question 8

TS mean pressure gradient severe

Answer 8

greater than 6 mmHg

Question 9

obtaining the pressure half time for TS

Answer 9

PHT deceleration slope CW waveform

Question 10

normal TV

Answer 10

7-9cm squared

Question 11

severe TS PHT

Answer 11

greater than 190 msec

Question 12

is TR holosystolic

Answer 12

yes

Question 13

most common cause of secondary or functional TR

Answer 13

annular dilation from RV or RV enlargement

Question 14

most common cause of primary TR

Answer 14

myxomatous degeneration of TV

Question 15

what is peak TR velocity used to calculate what?

Answer 15

the RV systolic pressure and the systolic pulmonary artery pressure

Question 16

right atrial pressure is estimated by the…

Answer 16

IVC diameter and percentage of collapse as seen in the subcostal view

Question 17

high SPAP will give patients…

Answer 17

SOB

Question 18

equation to measure RVSP

Answer 18

Question 19

what is RAP when the ivc collapse more than 50%

Answer 19

3 mmhg

Question 20

what is the RAP when the ivc collapse 30-40%

Answer 20

8 mmhg

Question 21

what is the RAP when the ivc collapse less than 50%

Answer 21

15 mmhg

Question 22

eisenmengers syndrome

Answer 22

the process which a long standing left to right shunt cause by a congenital heart disease by a VSD or ASD causes pulmonary hypertension

Question 23

normal SPAP

Answer 23

18-25 mmhg

Question 24

pulmonary hypertension is defined by

Answer 24

1. elevated SPAP greater than 25 mmhg at rest, greater than 30 mmhg with exercise
2. elevated pulmonary vascular resistance: the resistance the Rv must overcome to pump blood into the PA

Question 25

normal pulmonic flow peaking during

Answer 25

mid systole

Question 26

normal PV outflow

Answer 26

blue

Question 27

PI flow

Answer 27

red in diastole

Question 28

the PV is evaluated in what views

Answer 28

RVOT tilt view PSAX subcostal short axis

Question 29

PV cw vti will give you

Answer 29

mean pressure gradient

Question 30

how do you obtain the pulmonic valve area

Answer 30

1. PV PW vti 2. PV CW VTI 3. RVOT diameter

Question 31

severe PS peak pressure gradient

Answer 31

greater than 64 mmhg

Question 32

how else can you asses pulmonic stenosis

Answer 32

running m mode though the right posterior PV leaflet | look for a dip in mid systole and a more prominent rising slope

Question 33

pulmonary hypertension m mode

Answer 33

look for mid systolic closure notch, creates the flying W pattern

Question 34

how is PI evaluated

Answer 34

with CW in the RVOT and PSAX view

Question 35

the end diastolic velocity of the PR jet can be used to calculate the...

Answer 35

pulmonary artery end diastolic pressure

Question 36

normal pulmonary artery end diastolic pressure

Answer 36

4-12 mmHg

Question 37

Tricuspid stenosis symptoms

Answer 37

ascites abdominal swelling edema

Question 38

TV area equation

Answer 38

TVA=190/PHT

Question 39

back up of blood flow due to TS

Answer 39

diastolic doming due to TS RA enlargement due to volume overload and pressure overload dilated IVC

Question 40

what is enlarged on echo due to TR

Answer 40

1. RA 2.RV 3. IVC 4. hepatic veins

Question 41

RV volume overload cause the septal to

Answer 41

become paradoxical septal motion

Question 42

in absence of pulmonary vascular disease an elevated RVSP/SPAP indicates

Answer 42

elevated LAP and can identify increased LV filling pressure

Question 43

most common cause of PS

Answer 43

congenital

Question 44

most common form of acquired PS

Answer 44

carcinoid heart disease

Question 45

m mode of the Right posterior pv cusp with PS

Answer 45

increased A wave depth

Question 46

the end diastolic pulmonic regurg gradient helps identify...

Answer 46

the pulmonary artery pressure and cardiac dysfunction

Question 47

TV area equation w/ pht

Answer 47

190/pht

Question 48

TS signs and symptoms

Answer 48

jaundice LE swelling ascites

Question 49

most common cause of TS

Answer 49

rheumatic heart disease

Question 50

TS mean pg severe

Answer 50

>5

Question 51

carcinoid hard disease affects which side of the heart

Answer 51

the right side