PW can’t measure high velociraptor but what can it measure up to?
> 2.0-2.5 m\s
PW will aliase if …?
Exceed the nyquist limit,
1/2 PRF
MR flow is about how fast
5-7 m/s
A 20 degree offset from flow direction = —% underestimation of blood flow velocity
6%
When arrhythmias are present how many beats should be measured to be able to average the velocities
3-5 beats
If the velocities exceed —- then the expanded Bernoulli equation should be used
_> 1.2 m/s
If a stenosis is longer then —- then it starts to affect the estimation of pressure gradients
> 10 mm
The baseline should be — from top or bottom
3/4 ways
The useful part of the spectral should occupy how much of the total scale
1/2-3/4
In a stenosis if the area reduces by half, what happens to the speed
Doubles
Aorta systolic pressure
120 mmHg
Aorta diastolic pressure
70 mmHg
Mean aorta pressure
85 mmHg
Mean Right atrial pressure
4 mmHg
Systolic right ventricle pressure
25 mmHg
Diastolic right ventricle pressure
4 mmHg
Systolic left ventricle pressure
120 mmHg
Diastolic left ventricle pressure
10 mmHg
Mean Left atrium pressure
10 mmHg
PA systolic pressure
25 mmHg
PA diastolic pressure
10 mmHg
PA mean pressure
16 mmHg
Normal Parasternal EF
_> 55%
Normal FS
> 25%
Male simpsons EF
52-72
Females simpsons EF
54-74
When using A4C and A2C for simpsons there should be no more than how much of a difference in lengths
10%
1cm
Normal female linear method FS
27-45%
Normal female parasternal EF
_> 55%
Normal female LV size
_< 53mm
Severe female linear method FS
_<16%
Severe female parasternal EF %
_< 30%
Severe female LV size
_> 62mm
Severe female simpsons EF
<30 %
Normal male linear method FS
25-43 %
Normal male parasternal EF
_> 55%
Normal male LV size
_< 59mm
Severe male linear method FS
_<14%
Severe male parasternal EF
_<30%
Severe male LV size
_> 69mm
Severe male simpsons EF
<30%
For Dp/Dt what velociraptor do you measure at?
1 m/s and 3m/s
Dp/Dt measures how much time it takes for the LV pressure to raise by
32 mmHg
During Dp/Dt the sweep speed is increased to
100-200 cm/s
Normal Dp/Dt values
> 1200 mmHg/s
Severe LV systolic dysfunction Dp/Dt values
<800 mmHg/s
Normal time for LV to generate 33mmHg
<27ms
Severe LV systolic dysfunction time for LV to generate 32mmHg
> 40ms
MPI conventional Doppler method (preferred method) for normal LV
<0.44
Normal LV tissue Doppler (LIMP)
<0.6
Tissue Doppler RV normal (RIMP)
<0.55
RV basal cavity diameter
_<41mm
RV mid cavity diameter
_<35mm
RV length (long axis)
_<86mm
RVOT diameter (proximal)
_< 33 mm
RVOT diameter (distal)
_< 27 mm
RV systolic function - Doppler tissue imaging S prime
_> 9.5 cm/s
RV systolic function - fractional area change
_>35%
RV systolic function - MPI conventional method Doppler
_<0.43
RV systolic function TASPE
_> 17 mm
M-mode LA dimension normal women
27-38mm
M-mode LA dimension normal men
30-40mm
2D linear LA dimension normal women
27-38mm
2D linear LA dimension normal men
30-40mm
When measuring the LA in both A4C and A2C the lengths should not differ by more then
5mm
LA volume index normal
16-34 ml/m sq
LA volume index mild
35-41 ml/m sq
LA volume index moderate
42-48 ml/m sq
LA volume index severe
_> 48 ml/m sq
2D linear LA dimension severe male
> 52mm
2D linear LA dimension severe women
> 47mm
RA minor axis normal
<44mm
RA minor axis abnormal
> 44mm
RA major normal
<53mm
RA major abnormal
> 53mm
RA area normal
<18cm sq
RA area abnormal
> 18 cm sq
RA volume index normal female
_< 27 ml/m sq
RA volume index normal male
_< 32 ml/m sq
RA volume index abnormal female
> 27 ml/m sq
RA volume index abnormal male
> 32 ml/m sq
Systolic/forward failure/ HFrEF has a EF of
<40%
Diastolic/backward failure/ HFnEF has a EF of
> 55%
Systolic/forward failure/ HFrEF makes up what percent of all CHF
50-60%
Diastolic/backward failure/ HFnEF makes up what percent of all CHF
40-50% with increasing prevalence
Normal LAP
6-12 mmHg
A LAP of what equals pulmonary hypertension
> 18 mmHg
Normal IVC
_<21 mm
Abnormal IVC
> 21 mm
Normal amount for IVC to collapse
> 50%
RAP with ALL normal values
3 mmHg
RAP with no normal values
15 mmHg
RAP with one of two criteria being normal
8mmHg
Normal length for IVRT
50-100ms
<94 ms
Early filling contributes —— of the total diastolic filling
70-80%
Normal length of time for early filling to last
150-200 ms
Up to 220 ms
Late filling (atrial contraction) contributes —— amount to total diastolic filling
20-30%
Abnormal LA volume index
> 34 ml/meter squared
Normal PLAX female LA size
<38
Normal PLAX male LA size
<40
Normal LA mean pressure
3-12 mmHg
Normal E/A ratio
0.8-2
Normal deceleration time
160-200ms
Up to 220ms
Normal E (early filling) wave
0.6-1.3 m/s
Normal E prime for medial (septal) wall
> 7 cm/s
Normal e prime for lateral wall
> 10 cm/s
Normal TR jet
<2.8 m/s
Normal E/e ratio
<14
Pulmonary vein S to D ratio
S < D
Normal PVa-MVA
<20 ms
Severe DD PVa-MVA
_> 30 ms
Normal LA volume index
16-34 ml/meter squared up
Severe DD (LAE) LA volume index
> 48 ml/meter squared
Normal mitral E/A ratio
_>0.8
Abnormal mitral E/A ratio
> 2
Normal E/e ratio
<10
Severe abnormal E/e ratio
> 14
Mild Jet height /LVOT diameter
<25%
Severe jet height/LVOT diameter ratio
_>65%
Mild jet area/LVOT area ratio
<5%
Moderate jet area/LVOT area ratio
5-59%
Severe jet area/LVOT area ratio
> 60%
AI mild vena contracta
<3mm
AI severe vena contracta
_> 6 mm
Mild AR pressure half time
> 500 ms
Severe MR pressure half time
<200 ms
25% of all adults have aortic sclerosis what percentage of this individuals will develop aortic stenosis
10-15%
CW Doppler velocity through AV sclerosis
<2.5 m/s
CW Doppler velocity through AV stenosis
> 2.5 m/s
LVOT diameter normal (most people)
18-22 mm
AV sclerosis jet velocity
_<2.5 m/s
Mild AV stenosis jet velocity
2.5-2.9 m/s
Severe AV stenosis jet velocity
> 4 m/s
Mild AV stenosis mean gradient
<20 mmHg
Severe AV stenosis mean gradient
> 40 mmHg
Mild AV stenosis AVA
> 1.5 cm squared
Severe AV stenosis AVA
<1 cm squared
Mild AV stenosis indexed AVA to BSA
> 0.85 cm squared / meter squared
Severe AV stenosis indexed AVA to BSA
<0.6 cm squared / meter squared
Mild AV stenosis velocity ratio
> 0.5
Severe AV stenosis velocity ratio
<0.25
There are over how many chords in the MV
120
The posteromedial pap muscle has how many heads and bodies and how many arteries feeding it
2 bodies
3 heads
1 artery
The anterolateral pap muscle has how many heads and bodies and how many arteries feeding it
1 body
2 heads
2 arteries
What is normal MV leaflet thickness
1-2 mm
Mild MV by mean gradient
<5 mmHg
Severe MV by mean gradient
> 10 mmHg
A misalignment of 20 degrees equals a —— reduction of velocity
6-7%
Normal MVA
4-6 Cm squared
Mild MS MVA
> 1.5 cm squared
Severe MS MVA
<1.0 cm squared
Mild AR jet height / LVOT diameter ratio
<25%
Severe AR jet height / LavOT diameter ratio
_> 65%
Mild AR jet area / LVOT area ratio
<5%
Moderate AR jet area / LVOT area ratio
5-59%
Severe AR jet area / LVOT area ratio
> 60%
AR vena contracta zone mild
<3 mm
AR vena contracta zone severe
_> 6mm
AR mild pressure half time
> 500 ms
AR severe pressure half time
<200 ms
AR regurgitate volume mild
<30ml
AR regurgitate volume severe
> 60 ml
AR regurgitate fraction mild
<30%
AR regurgitate fraction severe
> 50%
AR effective regurgitate office area mild (PISA)
<0.10 cm squared
AR effective regurgitate orfice area severe
_> 0.30 cm squared
