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Echo Semester Final > Valvular Heart Disease > Flashcards

Valvular Heart Disease Flashcards

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1
Q

Has valvular heart disease incidence increased or decreased over time?

A

decreased

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2
Q

When a normal valve is open, the pressure on either side of the valve is effectively equal so there is not a significant pressure gradient across the open valve. T or F?

A

true

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3
Q

What is normal flow through a valve called?

A

laminar or parabolic flow

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4
Q

The circulatory system is made up of independent “hoses”, therefore a kink in one hose will not effect the workings of another. T or F?

A

false

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5
Q

Stenotic valves can cause what in the circulatory system?

A

loss of laminar flow, areas of turbulent flow, pressure/volume overload

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6
Q

Stenotic valve leads to:

A

pressure overload, turbulent flow, and hypertrophy

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7
Q

Regurgitant valve leads to:

A

volume overload, turbulent flow, and dilation

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8
Q

Doppler above the baseline represents flow (away from, towards) transducer?

A

towards

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9
Q

What is a narrowing, thickening, fusion, or blockage of a valve that impedes or obstructs blood flow through the valve?

A

Valvular stenosis

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10
Q

What are the three levels of impact of valvular stenosis?

A

proximal, at the level of the stenosis, and distal

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11
Q

(Proximal, distal, at the level of) the stenotic valve, blood backs up and pressure increases.

A

proximal

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12
Q

Pressure overload pattern is present in what chamber to the stenotic valve?

A

proximal chamber

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13
Q

Pressure overload pattern is also known as what?

A

increased afterload

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14
Q

(Hypertrophy, dilation) in the proximal chamber is a result of a stenotic valve.

A

hypertrophy

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15
Q

When atrioventricular valves are stenotic, atria cannot compensate for increased pressure and volume, therefore they enlarge. T or F?

A

true

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16
Q

At the level of the stenotic valve, the stenotic leaflets experience what during the open phase?

A

doming

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17
Q

Valvular area (increases, decreases) within the valve orifice in a stenotic valve.

A

decreases

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18
Q

What causes doming in a stenotic valve?

A

increase in pressure in the proximal chamber pushes on the undersurface of the leaflets

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19
Q

If a valve’s orifice area decreases, what happens to velocity?

A

increases in attempt to maintain cardiac output

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20
Q

Distal to the stenotic valve, flow is ________ and pressure ________.

A

turbulent, decreases

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21
Q

What is the first imaging technique to locate and evaluate a stenotic valve?

A

TTE with doppler

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22
Q

What is pressure half time?

A

the time required for the peak gradient across the valve to reduce to one-half

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23
Q

What is calculated via the P1/2T equation?

A

MVA and TVA

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24
Q

What is a mean pressure gradient?

A

averages the instantaneous gradients across the open valve

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25
What is calculated via the continuity equation?
AVA and PVA
26
What is the maximum pressure gradient?
peak instantaneous gradients across an open valve
27
What is another name for valvular regurgitation?
insufficiency
28
What is classified as primary (organic) regurgitation?
structural changes to the valve itself causes regurgitation
29
What is classified as functional (secondary) regurgitation?
regurgitation caused by chamber remodeling (changes to the atria/ventricles)
30
What is the vena contracta?
high velocity laminar flow within the narrowest portion of the regurgitant jet
31
What does a MS murmur sound like?
low-pitched, diastolic rumble with opening snap
32
2 main causes of mitral stenosis are:
rheumatic fever, severe mitral annular calcification
33
Follow the chain reaction of mitral stenosis:
MS---increased in LAP---MV leaflet doming---LAE---backup and enlargement of Pul.Veins---increased PAP---PHTN---increased RA and RV pressure---etc.
34
2 associations of MS:
mitral regurgitation due to LAE and dilated annulus, prohibiting leaflet closure, LA thrombus due to LAE and swirling of blood
35
2 complications of MS:
increased risk of infective endocarditis decreased cardiac output
36
5 Echo findings of MS:
diastolic doming of anterior mitral valve leaflet, MV leaflet thickening, decreased MVA (<4cm^2), anterior motion of the posterior mitral valve leaflet, LAE
37
2 M-mode findings of MS:
decreased MV excursion, anterior motion of the posterior mitral valve leaflet
38
3 Echo findings of PH resulting from MS:
flattened IVS, small, D-shaped LV in diastole and systole
39
MV Pressure Half Time Equation:
MVA = 220 / P(1/2)T
40
MS severity:
mild: >1.5, severe: <1.0
41
What is the most common primary valve disease?
aortic stenosis
42
3 Etiologies of AS:
calcific AS congenital bicuspid AS rheumatic AS
43
What is the most common etiology of AS in the US?
calcific AS
44
What is the most common etiology of AS worldwide?
rheumatic AS
45
What does the AS murmur sound like?
systolic crescendo decrescendo, heard at sternal border, radiates to carotids
46
Two complications of AS:
LV pressure overload leads to LV hypertrophy increase risk of infective endocarditis
47
Continuity Equation:
AVA= (VTI(LVOT)) X (CSA(LVOT)) / VTI(AOV)
48
Aortic stenosis severity:
mild: >1.5cm^2 severe:<1.0cm^2
49
What are two causes of acute AR?
ascending aortic dissection infective endocarditis
50
What are two causes of chronic AR?
Aortic stenosis bicuspid AOV
51
What does the AR murmur sound like?
high-pitched, blowing, diastolic decrescendo at left sternal border
52
What is an Austin Flint murmur?
severe AR murmur, sounds like low-pitched rumble at apex
53
Complications of AR:
overtime, LV dilation decreased LV function heart failure
54
AR echo findings:
diastolic flutter of anterior mitral valve leaflet left ventricular dilation which may lead to hypertrophy
55
What does the TS murmur sound like?
diastolic rumble varies with respiration and has opening snap
56
3 causes of TS:
rheumatic heart disease Ebstein anomaly RA thrombus/tumor
57
TS echo findings:
thickened leaflets diastolic doming RA enlargement
58
TVA equation:
190 / P(1/2)T
59
What does the TR murmur sound like?
holosystolic that increases with inspiration
60
3 causes of TR:
secondary TR due to RA/RV enlargement myxomatous degeneration primary TR
61
Complications of TR:
RA/RV enlargement leads to A-fib enlarged IVC
62
Echo findings of TR:
RA enlargement dilated IVC diastolic flutter of TV leaflets
63
RVSP equation:
RVSP= 4V^2 + RAP
64
PH severity:
normal: 10-25 mmHg severe: >70 mmHg
65
What does the PS murmur sound like?
harsh systolic ejection heard at left upper sternal border
66
3 levels of PS:
subvalvular/infundibular valvular supravalvular
67
Causes of PS:
congenital carcinoid heart disease
68
PS Echo findings:
thickening of leaflets RV hypertrophy flattened IVS D-shaped LV
69
What does the PR murmur sound like?
low-pitched diastolic murmur increased with inspiration
70
What is a Graham-Steele Murmur?
TR murmur heard when PH is present high-pitched blowing diastolic murmur
71
PR causes:
PH causes annular dilation infective endocarditis/vegetation

Echo Semester Final (8 decks)

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