Echo 3 - Valves

Front 1

When area of a valve is reduced resulting in a smaller orifice than is normally present

Back 1

Stenosis

Front 2

When a valve has a pressure difference proximal to the valve compared distally to the valve, this is called what?

Back 2

Pressure Gradient

Front 3

Maximum Instantaneous Pressure Gradient equation (MIPG)

Back 3

p1-p2=4Vsq

Hint 3

Simplified Bernoulli equation

Front 4

The ventricles response to a pressure increase

Back 4

increase muscle mass

Front 5

Rheumatic disease causes the aortic cusps to...

Back 5

become fibrotic

Front 6

Define Sclerotic

Back 6

thickening of cusps, valve opening normally

Front 7

Narrowing of the aortic valve orfice causing partial obstruction to blood flowing into the aorta

Back 7

Aortic Stenosis

Front 8

A valve that is thickened but opens normally is?

Back 8

Sclerotic

Front 9

A valve that has a narrow orifice for any reason is described as?

Back 9

Stenotic

Front 10

In Aortic stenosis, What is the most commonly involved cusp?

Back 10

Right coronary cusp

Front 11

In Aortic stenosis, What is the less commonly involved cusp?

Back 11

Left coronary cusp

Front 12

In parasternal long axis, what is the normal ratio between the LA and the AoR?

Back 12

1:1

Front 13

Bicuspid valves occur in what percent of the population?

Back 13

2%

Front 14

What happens to the myocardium of the LV when it must push blood through a smaller orifice?

Back 14

LVH, myocardium will enlarge

Front 15

One or all cusp are involved in stenosis. Right coronary is the? The left coronary cusp is the ?

Back 15

Most commonly involved.

Least common..

Front 16

When dialation and failure of the L.V occur what are the common complications?

Back 16

Atrial dilation, pulmonary congestion and edema

Front 17

The least common cause of aortic stenosis in adults?

Back 17

Congenital aortic stenosis

Front 18

Surgery for aortic stenosis only perfomed when the pt is?

Back 18

Symptomatic

Front 19

What kind of doppler is needed to obtain the LVOT velocity?

Back 19

Pulsed Wave Doppler

Front 20

Measurement of the LVOT area must be taken in what caridac cycle?

Back 20

Systole

Front 21

The velocity of the aortic valve is obtained using which dopple? And at which window?

Back 21

Continuous Wave Dopple at the Apical window

Front 22

The retrograde flow of blood from the aorta into the left ventricle?

Back 22

Aortic insuffiency

Front 23

What medications are used to treat AI?

Back 23

Digitalis and Diuretics

Front 24

What is the easiest way to assess the presence, extent, direction and severity of AI?

Back 24

Color flow imaging

Front 25

Coditions that will cause AI?

Back 25

Senile, rheumatic feve, congenital heart disease, infective endocarditis, aortic valve prolapse

Front 26

A patient may abruptly become symptomatic to AI during which decade of life?

Back 26

4th decade

Front 27

Clinical findings of AI ?

Back 27

Exertional or paroxysmal dyspnea, angina, dizziness, syncope

Front 28

When a damaged aortic leaflet points to the left ventricle during diastole and points to the aoritic root in systole its known as?

Back 28

Flail aortic leaflet

Front 29

During auscultation, an aortic insufficiency will have the sound of what murmur?

Back 29

Decrescendo diastolic murmur

Hint 29

DDM

Front 30

True or False - Left ventricle volume overload causes LVH

Back 30

True

Front 31

What murmur is heard at the apex in patients with severe AI?

Back 31

Austin Flint murmur

Hint 31

AFM

Front 32

True or False - Once the LV fails, surgery can be preformed to repair the myocardium

Back 32

FALSE!! it is to late for surgery, when the LV fails, its done.

Front 33

What type of changes can occur on the aortic valve cusps, that can cause aortic valve insufficiency, as part of aging?

Back 33

Sclerotic

Hint 33

A degenerative change

Front 34

What disease can result in calcific aortic stenosis later in life?

Back 34

Rheumatic disease

Front 35

During an M-Mode of the Aortic valve, what two leaflets are shown?

Back 35

Non-coronary cusp and the Right coronary cusp

Front 36

During an M-Mode of the Aortic valve, what leaflet is on top (proximal to the transducer)?

Back 36

Right Coronary Cusp

Front 37

During an M-Mode of the Aortic valve, what leaflet is on the bottom (Distal to the transducer)?

Back 37

Non-Coronary Cusp

Front 38

In color flow doppler, what color represents blood flowing away from the transducer?

Back 38

Blue

Front 39

In color flow doppler, what color represents blood flowing towards the transducer?

Back 39

Red

Front 40

Range for moderately Stenotic Ao Valve area

Back 40

1.1-1.9

Front 41

Name two causes of acute aortic regurgitation

Back 41

endocarditis and aortic dissection

Front 42

Shape of the LV in chronic aortic regurgitation

Back 42

spherical

Front 43

LV systolic function in chronic aortic regurgitation

Back 43

preserved

Front 44

What types of doppler can be used to evaluate a regurgitant jet

Back 44

pulse-wave, color flow, and continuous wave

Front 45

LV mass in chronic regurgitation

Back 45

LVH, mass will increase

Front 46

How common is AR in people under the age of 40 years old?

Back 46

rare, less than 1%

Front 47

What is the most common doppler used to assess AR?

Back 47

Color flow

Front 48

What are the most common causes for aortic valve disease?

Back 48

degenerative
rheumatic
infective

Front 49

When does peak velocity through the aortic valve occur? Normally

Back 49

Mid systole

Front 50

During aortic stenosis, peak velocity through the aortic valve occurs when?

Back 50

Late systole