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50 Cards in this Set
- Front
- Back
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Backflow of blood through the aortic valve during diastole
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Aortic Regurgitation
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What are some causes of ACUTE AI?
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-dissection of the ascending aorta -trauma -flail aortic valve leaflet |
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What are some causes of CHRONIC AI? |
-idiopathic dilatation of aortic root and annulus -Aortic stenosis -Infective endocarditis |
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What is the most common cause of Acute AR?
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infective endocarditis
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What is the most common cause of Chronic AR?
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idiopathic dilatation of aortic root and annulus
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T or F A bicuspid AoV can cause AR |
True
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Name some other (less common) causes of AR
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-Marfan's syndrome - Hypertension -Ascending Aortic Aneurysm (AAA) -Incomplete closure |
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Why would a AAA cause AR? |
Becuase it stretches out the annulus |
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What can cause incomplete closure of the AoV that will lead to AR?
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prolapse or VSD pulling cusp up to the septum
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What is the name of the murmur associated with severe AR?
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Austin-Flint Murmur
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If a murmur is heard with mild to moderate AI, what will it sound like?
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a high-pitched, blowing, diastolic decrescendo
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Where will the high pitched murmur be heard
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left sternal boarder
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What does the Austin-Flint murmur sound like?
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low pitched, mid diastolic rumble
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Where is the Austin-Flint murmur heard?
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at the apex
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People are typically ________ until regurgitation becomes significant
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asymptomatic
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Name the signs and symptoms of Chronic AR
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-SOB/DOE -Angina -Diaphoresis (sweating) -Tachycardia -PVC's -CHF |
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What are the signs and symptoms of Acute AR?
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-Severe Dyspnea -Tachypnea -Orthopnea -Weakness -Hypotensive -Quickly leads to CHF |
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Why does Acute AR quickly lead to CHF?
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because there is no time for the LA to enlarge and accommdate extra blood
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With 2D findings, there will be visible _______ flutterof the anterior mitral valve leaflet |
diastolic
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Why will there by diastolic flutter of the AMVL with AR?
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becuase the AR jet is hitting the MV leaflet
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T or F LV volume overload creates LVH and LVE with AR |
True
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What does AR increase?
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preload and stroke volume
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T or F Dilatation----> Thickening------> Failure |
F thickening --> Dilatation--> Failure |
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Long standing AR creates decreased LV function and eventually ________
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failure
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How is AR monitored? |
serial echoes
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AI doppler waveform is _____ the baseline
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above
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With AR, we ________ it to take a long time for the blood to leak back into the LV
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want |
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If waveform is steep or very steep then blood is _______ flowing back into the LV
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quickly
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Severe acute AR will cause increased__________.
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preload
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The heart is unable to compensate causing the LV end diastolic pressure to exceed aortic pressure resulting in
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Aov to open early, and MV closes early
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What is the principle that relates to LV dilatation with hyperkinetic LV wall motion
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Frank-Starling Principle
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The longer the P 1/2 T the _______
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better
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the straighter the slope the ______ the regurgitation
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milder
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A steep slope = |
BAD
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What are the degree of AR by P 1/2 T method?
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mild >500 m/sec moderate 350-500 m/sec mod/severe 200-350 m/sec severe <200 m/sec |
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What doppler should be used to find P 1/2 T
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CW
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If the rhythym is normal, obtain ______ measurments
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2-3
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What can falsly rate AR severity?
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combine color flow of the inflow of MV with the AR in the apical views |
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AR creates a ___________, ___________ jet fromt he AoV into the LVOT and LV
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turbulent, diastolic
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What color scale do physicians use?
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1+ to 4+
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The wider the color jet, the more ______
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severe
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What will happen to the LVOT velocity with severe AR?
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increase
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_________ reversal of descendign aorta incidates severe AR
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holodiastolic
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Why would there be flow reversal of the ascending /descending aorta with severe AR
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blood literally flowing backward in the aorta and blood is flwoing back into the LV instead of the body
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What 2 dopplers look very siimilar
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AR and MS
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Why is P 1/2 T often not the best measurement for AR?
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becuase of eccentric jets
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What are some complications of AR
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-LV volume overload -LV dilatation -Decreased LV function -CHF -increased risk of infective endocarditis |
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ACUTE AR must be surgically corrected when?
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immediately
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The arterial diastolic pressure decreases throughout _______ for cath lab pressure
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diastole
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Why doe arterial diastolic pressures decrease during diastole
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because blodd isn't going to the body and leaking back to the heart
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