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45 Cards in this Set
- Front
- Back
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Reduction in the size of pulmonary valve orifice area
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Pulmonary Stenosis
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What are some causes of pulmonary stenosis
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-congenital -Rheumatic Fever -Carcinoid HD -Aneurysm of sinus of valsalva -hypertrophic cardiomyopathies |
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What is the most common cause of PS?
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Congenital
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What are some signs/symptoms of PS?
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-DOE -JVD -Systolic Ejection Murmur |
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What are some 2D findings of PS?
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-Thickening of PV leaflets w/ systolic doming -RAE -Later stages develop RV failure |
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An aneurysm of the sinus of Valsalva physically blocks the _______
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outflow tract
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What 2 other things might you see on 2D of PS?
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-post stenotic dilatation of main PA -RVH due to state of RVVO |
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PS mmode will reveal an increase "A" dip of
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> 8 mm
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What does a normal "A" dip measure
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2-7 mm
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What is the best view to evaluate the PV using mmode?
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PSAX
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With severe PS, it will be ________ to obtain mmode.
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difficult
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mmode will also show _____ because RV has to work really hard to force blood through _____
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RVH, PV
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T or F Use PW and CW velocities in PV and RVOT |
True
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What # represents mild PS?
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5-30mmHg
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What # represents moderate PS?
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30-64 mmHg
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What # represents severe PS?
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>64 mmHg
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PS Doppler waveform will be ______ the baseline
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below
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What is the PVA formula?
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PVA= (.785)(RVOT diameter)^2 (V1)/ V2
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Congenital anomaly consisting of 4 defects
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Tetralogy of Fallot
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What are the 4 defects associated with Tetralogy of Fallot?
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1. PS 2. Overriding aorta 3. VSD 4. RVH |
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Cath Lab Pressure!!!! The ventricular systolic pressure _____ creating a _______ pressure gradient between ventricle and great artery. |
increases, systolic
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defective valve closure allowing blood to flow /leak back into RV
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Pulmonary Regurgitation
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T or F Majority of pts have a normal variant/ mild amount of PI |
True
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What kind of murmur is heard with PI?
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low pitched diastolic that may increase with inspirtation
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If a pt has severe PI what is the name of the murmur and what does it sound like
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Graham-Steel Murmur, high pitched and blowing
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A murmur with PI is secondary to
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pulmonary HTN
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T or F PI causes can be primary or secondary |
True
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name some primary causes of PI
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-congenital valvular stenosis -congenital anomaly (tetralogy of fallot) |
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What are some secondary cause of PI?
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-pulmonary HTN causing rind dilatation -Endocarditis -Valvular PS -Carcinoid HD -pacemaker wires/catheters |
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What are some signs/symptoms of PI?
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-Dypsnea -often asymptomatic |
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PI 2D findings include
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-visible calcific/ thick PV -Diastolic flutter of TV |
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2D findings of severe PI will include
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-RVVO pattern -premature opening of PV -PHTN and associated findings |
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With severe PI backward flow can go into the pulmonary ________
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branches
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Acute or severe PI will quickly_____ volume and increase _____ pressure making PV open ______
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increase, RV end diastolic, prematurely
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PI creates a turbulent jet moving into _____ during _____
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RV, diastole
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PV outflow is ____ the baseline
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below
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PI is ______ the baseline
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above
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PI color flow is _____
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red
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A steep slope for PI is ______
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BAD
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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 milder the ____
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regurgitation
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If PI waveform is more boxlike then the P 1/2 T is _____
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longer
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What are some complications with PI
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-Dyspnea -increased risk of endocarditis -Severe PI leads to Right Heart Failure |
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T or F PI is usually tolerated well for years. |
True
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Cath Lab Pressures!!!! The arterial diastolic pressure____ throughout diastole, thus decreasing _____ pressure gradient between the artery and ventricle |
decreases, diastolic
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