Diastolic Dysfunction

Front 1

What happens in diastole

Back 1

1. isovolumic relaxation (pressure dropping in ventricles)
2. early rapid diastolic filling (e Wave)
3. diastasis ( pressure starts to = valve start to close)
4. late diastolic filling (A wave)

Front 2

Amount of LV filling during early/late diastole depends on

Back 2

elastic recoil
rate myocardial relaxation
CH compliance
LA pressure

Front 3

3 Characteristics that will affect how much blood moves through the chamber

Back 3

1. pressure difference
2. orifice valves
3. compliance CH

Front 4

Tricuspid Flow affected by

Back 4

Respiration

Front 5

How to define NORMAL diastolic function

Back 5

allows adequate filling of the ventricles during Rest/exercise w/o abnormal increase diastolic pressure

Front 6

Why is it so important for diastole to be normal

Back 6

if heart can't fill up all the way SV decreases

Front 7

Pressure will not fall if

Back 7

myo does not relax

Front 8

diastole is the interval from

Back 8

AO valve closure to MV closure

Front 9

In normal pt: primary drive force of flow

Back 9

elastic recoil
rate of relaxation LV

Front 10

IVRT time between AO valve

Back 10

closure MV opening

Front 11

Pt has LV Diastolic dysfunction
Pressure

Back 11

pressure LV is high
take longer for it too fall
IVRT= will increase

Front 12

IVRT increase MV=

Back 12

Open later (delay)

Front 13

Deceleration time in young ppl

Back 13

shorter/ decrease

Front 14

normal rapid filling - decel time

Back 14

decrease

Front 15

impaired relaxation -decel time

Back 15

increase

Front 16

IVRT in OLD PPL

Back 16

increase
A- increase
E velocities decrease with age
DT-increase

Front 17

3 Categories ABnormal Mitral inflow patterns

Back 17

1. Impaired relaxation
2. Restrictive filling
3. Pseudonormal

Front 18

Impaired relaxation (MILD)

Back 18

1st stage diastolic dysfunction
abnormal myocardial relaxation
Increase - IVRT
Low E
High A
E/A ration less than 1
Prolonged DT
Myocardium could not relax LV pressure didn't fall as much as we used too

Front 19

Restrictive FIlling (SEVERE)

Back 19

High Narrow E
Low A
decrease IVRT
decrease DT
E/A ration greater than 2
decrease LV compliance
markedly increase LA pressure
causes an earlier open of MV, LV doesn't need to drop as low, AV open earlier, Shorten IVRT

Front 20

Pseudonormal (Moderate)

Back 20

Super imposed relaxation abnormality
LVV pressure elevated
LA pressure increase = heart trying to compensate

E/A Ratio 1-1.5

Front 21

diastolic function graded

Back 21

Grade 1- impaired relaxation
Grade 2 - pseduonormal
Grade 3- reversible restrictive pattern
Grade 4- irreversible restrictive pattern (fixed)