Echo A Test 3 Bhaa

Front 1

Normal MV flow appears as ____

Back 1

RED

Front 2

Normal MV flow occurs during ____

Back 2

Diastole

Front 3

Describe the Coronary circulation

Back 3

Sinus of Valsalva --> RCA & LMCA ... RCA --> PDA LMCA --> LAD and Circumflex. These arteries are drained into the Small Cardiac vein, middle cardiac vein and great cardiac vein

Front 4

What does RCA supply

Back 4

Right Atrium and RV

Front 5

What does PDA supply

Back 5

Inferior surface of Rt Heart and Inferior septum

Front 6

What does LAD supply

Back 6

Anterior Wall
Anterior Septum
Apex

Front 7

What does Circumflex supply

Back 7

Left Atrium
Lateral Wall
Infero-lateral wall (Posterior wall)

Front 8

Describe Bernoulli principle

Back 8

The relationship between pressure and velocity. INVERSE if pressure goes up, velocity goes down

Front 9

What is the Simplified Bernoulli equation?

Back 9

P1-p2 = 4 (V-squared)
Delta P = 4(Vsquared)

Front 10

What is the unit for Bernoulli equation

Back 10

Meters per sec

Front 11

Simplified Bernoulli equation used in Doppler echocardiography to measure _____

Back 11

Pressure gradient

Front 12

Delta P (pressure gradient) and Velocity have what kind of relationship?

Back 12

Direct. One goes up the other goes up

Front 13

What is Ejection Fraction?

Back 13

% of blood ejected with each beat/contraction

Front 14

What is normal range for EF?

Back 14

55-75%

Front 15

What is EF used for?

Back 15

Systolic function of LV

Front 16

What are the ways to measure EF?

Back 16

M-Mode
Simpson
2D
Eyeball it
M-mode EPSS

Front 17

If EPSS is 1-2 cm what is EF?

Back 17

30-50%

Front 18

If EPSS is > 2 cm what is EF

Back 18

Less than 30%

Front 19

What is aliasing in color and PW

Back 19

Aliasing is high velocity wrap around to color on the other side. Lighter colors indicate higher velocities.

Front 20

How do you correct aliasing?

Back 20

Increase baseline
increase scale
switch to CW

Front 21

Using Color doppler MR jet will be detected in

Back 21

Left atrium during systole. Blue in color

Front 22

Using color doppler TR jet will be detected in

Back 22

Right atrium during systole. Blue in color

Front 23

Using color doppler AR jet will be detected in

Back 23

LVOT during Diastole. Red in color

Front 24

Using color doppler PR jet detected in

Back 24

RVOT/Infundibulum during diastole. Red in color

Front 25

Where is best place to check for pulmonic regurge?

Back 25

Short Axis @ aortic level

Front 26

What is Pulmonary Capillary Wedge Pressure?

Back 26

It is equal to left Atrium pressure.
Catherization way to measure pressure in LA

Front 27

Describe the venous return to RA from Heart walls

Back 27

3 cardiac veins (great, small and middle) are drained back into Coronary Sinus and then into RT Atrium

Front 28

The great cardiac vein runs with ____

Back 28

LAD and CX

Front 29

The Small cardiac vein runs with _____

Back 29

RCA

Front 30

The middle cardiac vein runs with _____

Back 30

PDA

Front 31

The doppler shift frequency from moving reflectors is the _________

Back 31

Doppler shift is the difference between received frequency and transmitted frequency

Front 32

True or False. SV is equal everywhere?

Back 32

TRUE

Front 33

What is normal range for SV?

Back 33

70-100 cc

Front 34

Which angle is used for cardiac examination?

Back 34

O or 180 degrees. Angle MUST BE parallel to blood flow for maximum doppler shift.

Front 35

What does aliasing look like with pulsed wave doppler?

Back 35

Wrap around

Front 36

What are the 3 branches of the aortic arch?

Back 36

Brachiocephalic/Inominent
- RT CCA
- RT Subclavian
Common Carotid Artery
Subclavian

Front 37

Define Grade I dyastolic dysfunction

Back 37

Impaired early relaxation during diastole with normal filling pressure

Front 38

Define Grade II diastolic dysfunction

Back 38

Impaired early relaxation during diastole with moderate decrease in LV compliance (ventricle is stiffening)

Front 39

Define Grade III diastolic dysfunction

Back 39

Severe decrease in LV compliance with increased filling pressure.
Diastolic dysfunction along with systolic

Front 40

Define Grade IV diastolic dysfunction

Back 40

Same as grade III but irreversible

Front 41

What does normal MV inflow waveform look like?

Back 41

E bigger than A

Front 42

What does normal Pulmonary waveform look like?

Back 42

S slightly bigger than D and small AR

Front 43

What does normal tissue doppler waveform look like?

Back 43

E' and A' under baseline but with E' bigger than A'

Front 44

Which diseases of the heart cause concentric hypertrophy of LV?

Back 44

Stenosis of aorta
Coarchtation of aorta
Systemic hypertension

Front 45

What effect does impaired LV relaxation have over diastolic filling?

Back 45

Grade I ... More flow in late diastole, less flow in early diastole.
Seen in waveform as E to A reversal

Front 46

What diseases cause Grade I diastolic dysfunction?

Back 46

Systemic hypertension

Front 47

What disease causes Grade III diastolic dysfunction?

Back 47

Dilated cardiomyopathy

Front 48

What effect does impaired LV relaxation AND compliances have over diastolic filling?

Back 48

Grade II, III, IV ... More filling early diastole with a severe decrease in filling during late diastole. Results in less flow to LV and more flow back to the lungs.

Front 49

What stage of diastolic dysfunction has Normal DT?

Back 49

Grade II Pseudonormal

Front 50

What stage of diastolic dysfunction has Increased DT

Back 50

Grade I

Front 51

What stages of diastolic dysfunction have decreased DT?

Back 51

Grade III and IV

Front 52

What is the effect of valsalva maneuver on Grade I diastolic dysfunction

Back 52

Very little change

Front 53

What is the effect of valsalva maneuver on Grade II

Back 53

Changes to Grade I

Front 54

What is the effect of valsalva maneuver on grade III

Back 54

Changes to Grade II

Front 55

What is the effect of valsalva maneuver on grade IV

Back 55

No Change. Grade IV is irreversible

Front 56

What measurments are used to evaluate diastolic function of LV?

Back 56

7 measurements
1) E to A Ration
2) A duration
3) Deceleration Time (E slope)
4) AR duration
5) IVRT length
6) CMM (color M mode)
7) Vp (velocity of LA)

Front 57

A B notch in the MV m-mode indicates ______

Back 57

Elevated LV end-diastolic pressure

Front 58

Blood flow velocity calculations are dependent on what 3 things?

Back 58

Angle
Operating frequency
Prop Speed

Front 59

Blood flow to LA comes from _____ During _____ and is used to evaluation _____

Back 59

Blood from from Left Atrium comes from PULMONARY VEINS during SYSTOLE AND DIASTOLE and is used to evaluate DIASTOLIC DYSFUNCTION

Front 60

WHat causes rheumatic heart disease

Back 60

The antibodies that are produced to fight bacteria (Group A Beta Strep) from untreated Strep throat.

Front 61

What is EPSS measurement used for?

Back 61

To calculate EF and evaluate the dilalation of LV

Front 62

What is the normal range for EPSS

Back 62

0.2 to 0.7 cm

Front 63

What is the effect aortic stenosis on LV and aortic pressure?

Back 63

Increased pressure gradient between LV and AoR. (increased pressure in LV and decreased pressure in Aor.
Causes concentric hypertrophy of LV

Front 64

Filling of the coronary arteries occurs during _____

Back 64

Diastole

Front 65

What is the normal range for IVRT

Back 65

80-100 msec

Front 66

An IVRT of > 100 is what grade of diastolic dysfunction?

Back 66

Grade I

Front 67

An IVRT of < 80 is what grade of diastolic dysfunction?

Back 67

Grade III and IV

Front 68

What is the normal range for Color M Mode (CMM)?

Back 68

> 45 cm/sec

Front 69

Define hyperkinesis

Back 69

Excessive motion of walls

Front 70

Define hypokinesis

Back 70

Diminished or abnormall slow movement

Front 71

Define Akinesis

Back 71

Abscence or loss of movement

Front 72

Define Dyskinesis

Back 72

Outward motion or movement in opposite direction

Front 73

What is the indication of normal systolic function of LV?

Back 73

Normal EF, FS, CO, CI

Front 74

An akinetic inferior LV wall is most consistent with blockage in _____

Back 74

RCA/PDA

Front 75

An akinetic lateral LV wall is most consistent with blockage in _____

Back 75

Circumflex

Front 76

An akinetic LV apex is most consistent with blockage in ______

Back 76

LAD

Front 77

Name the views to visualize Anterior wall of LV

Back 77

PSAX and Apical 2

Front 78

Name the views to visualize anterolateral wall of LV

Back 78

PSAX and Apical 4 & 5

Front 79

Name the views to visualize the inferolateral wall of LV

Back 79

PSAX, PLAX and Apical 3

Front 80

Name the views to visualize the inferior septum

Back 80

PSAX and Apical 4

Front 81

Name the views used to visual the Anterior septum

Back 81

PSAX, PLAX, Apical 3 and 5

Front 82

Name the views used to visualize the inferior wall of LV

Back 82

PSAX and Apical 2

Front 83

What pathologies causes Grade I diastolic dysfunction

Back 83

HYPERTENSION or any pathology causing thickening of the walls

Front 84

What pathologies cause grade III diastolic dysfunction

Back 84

Dilated cardiomyopathy ... or anything causing damage to elasticity of ventricle causing dilation

Front 85

True or False. Rt heart supplies blood to systemic circulation?

Back 85

FALSE. it supplies the pulmonary circulation

Front 86

True or False. Rt heart normal pressure is approx 25 mmHg

Back 86

True

Front 87

True or False. Blood returning to the RT heart has lower oxygen saturation?

Back 87

True

Front 88

True or False. The right heart contains the TV

Back 88

True

Front 89

Describe the color and timing of MV/TV

Back 89

Red ... diastole

Front 90

Describe the color and timing of AoV/PV

Back 90

Blue ... Systole

Front 91

MR is seen where, what color and when

Back 91

MR is seen in LA, blue, during systole

Front 92

TR is seen where, what color and when

Back 92

TR is seen in RA, blue, systole

Front 93

AR is seen where, what color and when

Back 93

AR is seen in LV, red, diastole

Front 94

PR is seen where, what color and when

Back 94

PR is seen in RV, red, diastole

Front 95

Hemodynamic disturbances affecting the MV during systole (MR) would alter the appearance of what part of M-mode appearance?

Back 95

CD segment (the systolic part of the waveform)

Front 96

During IVRT, the pressure in LV ____ and volume of blood in LV ____ and all valves are ________

Back 96

During IVRT, the pressure in left vent DECREASES and the volume of blood STAYS THE SAME and all valves are CLOSED

Front 97

How many was can you measure systolic function of LV?

Back 97

Five.
1) Stroke volume
2) Cardiac Output
3) Cardiac Index
4) Ejection Fraction
5) Fractional Shortening

Front 98

What is the advantage of CW doppler over PW doppler?

Back 98

Ability to measure high velocities without aliasing

Front 99

Describe in order the phases of diastole

Back 99

IVRT - All valves closed
Rapid Filling/early - 70% of blood ejected
Diastasis/mid - 0-9% of blood ejected
Atrial kick/end - 20-30% of blood ejected

Front 100

What is the formula for CI?

Back 100

CO/BSA

Front 101

What is the formula for CO?

Back 101

SV x HR

Front 102

What is the formula for SV using doppler

Back 102

VTI x CSA

Front 103

During IVCT the pressure in LV ____ the volume in LV _____ and all valves are _____

Back 103

During IVCT the pressure in left vent INCREASES the volume STAYS THE SAME and all valves are CLOSED

Front 104

What is the normal range for E/A ratio

Back 104

.75 to 1.5

Front 105

What is the normal range for Decelleration Time (DT)

Back 105

140 -220 m/sec

Front 106

What is normal range for IVRT

Back 106

80-100

Front 107

What is normal range for Color M-mode

Back 107

> 45 cm/sec

Front 108

What is normal range for LA volume

Back 108

18 to 58 cc

Front 109

What is normal range for E to E' (prime) ratio

Back 109

< 8

Front 110

What are abnormal findings in grade I diastolic dysfunction

Back 110

E/A reversal
DT >200
IVRT >100
E' to A' reversal

Front 111

What are ABNORMAL findings in Grade II diastolic dysfunction?

Back 111

E' to A' reversal
Increased AR velocity & duration
AR > A
Increased Lt Atrium volume
S < D
E to E' is < 15
during valsalva changes to Grade I

Front 112

What are ABNORMAL findings in Grade III diastolic dysfunction?

Back 112

E/A ratio > 1.5
DT < 140
IVRT < 80
E to E' increased
AR duration increased
AR duration > A
S/D reversal
E' to A' ratio < 10 cm/sec
during valsalva changes to Grade II

Front 113

Describe Grade IV diastolic dysfunction

Back 113

Same as grade III but no changes with Valsalva maneuveur

Front 114

Define Left heart failure

Back 114

Failure to adequately supply systemic circulation

Front 115

Define Right Heart failure

Back 115

Failure to adequately supply pulmonary system

Front 116

Numerate left heart failure signs and symptoms

Back 116

Shortness of breathe due to back up in lungs
- Dyspnea
-paroximal nocturnal dyspnea
- orthopnea
- fatigue
- cough
-weight gain

Front 117

numerate the right heart failure signs and symptoms

Back 117

Edema of lower extremities, blood backing up into liver and jugular dissention
-ascites
-neck pain
-anasarca
- liver enlargement

Front 118

What diseases cause left heart failure?

Back 118

Systolic and diastolic dysfunction resulting from
1) preload
2)afterload
3) contractility

Front 119

What diseases cause Rt heart failure?

Back 119

RCA disease
shunt
regurge
stenosis
pulmonary hypertension
ALL RESULTING FROM INCREASE PRELOAD, AFTERLOAD and DECREASED CONTRACTILITY

Front 120

Describe the continuity rule

Back 120

Blood flow volume must be same EVERYWHERE.

STROKE VOLUME IS EQUAL!!!!!