Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/57

Click to flip

57 Cards in this Set

  • Front
  • Back
This is a narrowing, thickening and/or obstruction of the MV that impedes diastolic blood flow
Mitral Stenosis (MS)
What kind of murmur is found with MS?
Low pitched, diastolic rumble with an opening snap
What is the top cause of MS?
Rheumatic Fever (typically resulting from strep infection between ages of 5-15)
What are 5 causes of MS?
1. Rheumatic Fever
2. MAC (severe)
3. Congenital Anomoly (MV atresia, parachute MV)
4. LA Mass, Tumor, Veg
5. Prosthetic Valve Dysfunction
The first effect of MS is seen where?
Elevated LA Pressure
What happens to stenotic MV leaflets during systole?
Doming
If stenotic MV elevates LA pressure, what happens to the LA eventually?
LAE
LAE can cause what form of dysrhythmia?
Atrial Fibrillation
If stenotic MV elevates LA pressure, what can happen to the pulmonary veins?
Backup and Enlargement of Pulmonary Veins
The first effect of MS is seen where?
Elevated LA Pressure
What happens to stenotic MV leaflets during systole?
Doming
If stenotic MV elevates LA pressure, what happens to the LA eventually?
LAE
LAE can cause what form of dysrhythmia?
Atrial Fibrillation
If stenotic MV elevates LA pressure, what can happen to the pulmonary veins?
Backup and Enlargement of Pulmonary Veins
If backup & enlargement of pulmonary veins occur, what happens to the pulmonary artery?
Backup & Enlargement of Pulmonary Artery; Pulmonary Hypertension
Pulmonary hypertension can cause what?
RAE
RAE can cause what (outside of the RA)?
TV Annulus Enlargement, causing TR
Pulmonary Hypertension & RAE can cause what?
Dilatation of the IVC and SVC
Dilatation of the IVC/SVC can cause what?
Dilatation & Enlargement of the Hepatic Veins/Jugular Vein
Dilatation & Enlargement of the Hepatic Veins/Jugular Vein can cause what?
Ascites, Edema
Turbulent blood flow through and around the MV can put the patient at increased risk for what?
Infective Endocarditis
What effect does MS have on cardiac output?
Decreased Cardiac Output
Signs/Symptoms:
- dyspnea,
- hemoptysis
- fatigue
- chest pain
- syncope,
- right heart failure
MS
What effect does MS have on the appearance of the MV leaflets in PLAX 2D?
Doming / Hockey Stick
Does MS cause the MV leaflets to thin or thicken? By how much?
Thicken > 3mm
How does MS affect MV orifice area? Where can this be measured using planimetry?
Decreased MV Area
Measured in PSAX MV
What effect does MS have on chordae tendinaea?
Thickening & Fibrosis
Slower filling of LV (due to increased LA pressure) causes what?
LAE
What two things may be seen in the LA, associated with MS?
Smoke
Thrombus
Chronic volume and pressure overload causes what 2 effects on the right side?
RVE & RVH
Chronic volume and pressure overload causes what effect on the left side?
Small, "D" shaped LV in systole and/or diastole
Other findings of MS include dilation of what 4 structures?
RA
SVC
IVC
Hepatic Vein
In M-Mode, what effect will MS have on E-F slope?
Decreased E-F Slope (slower filling holds the valve open longer)
In M-Mode, what effect will MS have on A wave of anterior MV leaflet?
Decreased A Wave (slower filling holds the valve open longer)
In M-Mode, what effect will MS have on MV leaflet excursion?
Decreased D-E Excursion
<= 15 mm
In M-Mode, what effect will MS have on the appearance of MV leaflets?
Thicker & Brighter
In M-Mode, what effect will MS have on the posterior MV leaflet (PMVL)?
Anterior motion of the PMVL, due to stenosis & tethering
In M-Mode, what effect will MS have on the LA?
LAE
Flattening of the IVS results from what? best visualized in what view?
Increased RV Pressure
PSAX (MV/PAP/AP Levels)
What type of wall motion frequently accompanies a flattened IVS?
Paradoxical Wall Motion
(aka Septal Shift)
RV Dilatation and RVH frequently result in what?
Right Heart Failure
The following M-Mode findings indicate what?
- RVFW hypertrophy
- RVE
- flattened IVS
- small LV
- possible paradoxical wall motion
PHTN, likely due to MS
What is indicated if the IVC fails to collapse during the sniff test?
PHTN, likely due to MS
What is the most common method for assessing MS?
P1/2t (Pressure Half Time)
Besides P1/2t, what are two other methods for assessing MS?
Deceleration Time
PISA (Proximal Isovelocity Surface Area)
The time required for the peak pressure gradiant across the MV to reduce by half
P1/2t
What is the relationship between P1/2t and MS?
Directly Related
What else can be calculated from the P1/2t?
MVA (MV Area)
In what views should MS be assessed? Using what modality?
Apical 4 or 5
CW Doppler
How is P1/2t obtained from the CW doppler results?
Measure the E-F deceleration slope
How is MVA calculated from P1/2t?
MVA = 220 / (P1/2t)
Is MS milder or more severe with a flatter E-F slope (CW doppler)?
Flatter = More Severe
How can a sonographer reduce errors when attempting to evaluate MS using CW doppler?
Change sweep speed from 50 mm/s to 100 mm/s
What is the normal MV area?
4 - 6 cm(2)
What is MV area for mild MS?
1.5 - 2.5 cm(2)
What is MV area for moderate MS?
1.0 - 1.5 cm(2)
What is MV area for severe MS?
< 1.0 cm(s)