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87 Cards in this Set
- Front
- Back
A 3 leaflet structure anatomically similar to the Aortic Valve, is called? |
Pulmonic Valve |
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What lies inside the Pulmonary Artery Annulus? |
Pulmonic Valve |
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What lies between the RVOT and the Pulmonary Artery? |
Pulmonic Valve |
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How many leaflets of the Pulmonic Valve are typically seen simultaneously in 2D echo? |
1-2 |
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Optimal VIEWS of the Pulmonary Artery are? (3) |
PSAX (Ao level) PLAX (RVOT) Sub SAX (Ao level) *w/ anterior angulation RVOT and PV leaflets are seen |
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RV inflow can be recorded from which VIEWS? (2) |
Apical ParaSternal RVOT |
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What is the normal RVIT velocity? |
0.3 - 0.7 m/s |
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Pulmonic Stenosis is a _______________, __________________ and/or _________________ of the Pulmonic Valve. |
Narrowing Thickening Obstruction |
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Heart condition that impedes Systolic blood flow traveling from the RV through the Pulmonary Valve into the Pulmonary Artery, is called? |
Pulmonic Stenosis |
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Pulmonic Stenosis impedes ______________ blood flow from the _____________ into the _______________________. |
Systolic RV Pulmonary Artery |
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Pulmonary Stenosis Murmur is a _____________, ________________, _________________ murmur. |
Harsh Systolic Ejection |
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A Pulmonary Stenosis Murmur is heard best in the? |
2nd Left Intercostal space |
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What may be present during a Pulmonary Stenosis Murmur? |
Thrill |
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What is a normal Pulmonic Valve area? |
3 - 5 cm sqd. |
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What is the most common cause of Pulmonary Stenosis? |
Congenital |
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What is the most uncommon cause of Pulmonary Stenosis? |
Rheumatic Heart Disease |
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A Sinus of Valsalva Aneurysm is a cause of what? |
Pulmonary Stenosis |
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When a Sinus of Valsalva Aneurysm protrudes into the RVOT obstructing the flow, this is a form of? |
SubValvular Pulmonary Stenosis |
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Pulmonary Stenosis may occur in conjunction with other congenital abnormalities, such as? |
TGA Tetralogy of Fallot |
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What are the 3 different areas of the PV that Pulmonary Stenosis can occur? |
Valvular SubValvular (Infundibular)(below the valve) SupraValvular (above the valve) |
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Carcinoid Heart Disease is involved in causing which Heart conditions? |
Pulmonary Stenosis Pulmonary Regurgitation |
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What are 3 complications of Pulmonary Stenosis? |
Dyspnea on exertion Jugular Venous Distention RVH |
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RVH, flattening of the IVS, and a 'D' shaped LV are due to? |
RV Pressure Overload |
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What are the visual characteristics of Pulmonary Stenosis in 2D echo? |
Thickened PV leaflets Systolic Doming |
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RV Pressure Overload can cause? (3) |
RVH Flattening of the IVS 'D' Shaped LV |
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Post-Stenotic Dilitation of the Main Pulmonary Artery is due to? |
High velocity Pulmonic Stenosis Jet |
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What can happen in the later stages of Pulmonary Stenosis? |
RV failure |
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What is the normal 'A' wave dip for the Pulmonic Valve? |
2-3 mm |
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What is the 'A' wave depth for Severe Pulmonic Stenosis? |
> 8 mm |
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When using M-Mode to evaluate the Pulmonic Valve, place the line through the? |
Posterior (right) PV Cusp |
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Pulmonic Stenosis creates ___________________ Systolic flow that travels from the ______________ into the _____________________. |
Turbulent RV Pulmonary Artery |
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When there is no 'A' wave present, this is a sign of? |
Pulmonary Hypertension |
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Which 2 methods are most helpful in defining the site of PS flow disturbance and site of obstruction? |
Color Flow PW Doppler |
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Which views are utilized to differentiate which area of the Pulmonic Valve is Stenotic (ie. subvalvular)? |
RVOT PSAX (Ao level) |
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Which transducer has a better Doppler signal-to-noise ratio? |
Non-Imaging (Pedoff) |
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True/False: A smaller transducer can be angled to be more parallel with a jet. |
TRUE |
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In the Peak Pressure Gradient Severity Scale: Mild PS Moderate PS Severe PS |
Pressure Gradient: Mild: 5 -30 mmHg Mod: 30 - 64 mmHg Sev: > 64 mmHg |
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The Pulmonic Valve Area is calculated using which equation? |
Continuity Equation |
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Measurements from which 2 areas are used in the Continuity Equation to find the Pulmonic Valve Area? |
RVOT PV |
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Measurement for Mild Pulmonic Stenosis is? |
> 2.0 cm sqd. |
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Measurement for Moderate Pulmonic Stenosis is? |
1 -2 cm sqd. |
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Measurement for Severe Pulmonic Stenosis is? |
< 1.0 cm sqd |
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The Retrograde (backward) flow through the Pulmonic Valve into the RV during __________________, may be ____________ or ___________________. |
Diastole Acute Chronic |
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What percentage of patients with otherwise normal hearts, appear to have Pulmonary Regurgitation? |
87% |
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Significant Chronic Pulmonary Regurgitation is a? |
Right Ventricular Volume Overload |
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A Pulmonary Regurge Murmur is a _______________ pitched, _________________ murmur. |
Low pitched Diastolic |
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A Pulmonary Regurge Murmur may ________________ with inspiration. |
Increase |
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Where is a Pulmonary Regurge Murmur heard best? |
along 3rd or 4th intercostal space adjacent to the left sternal border |
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Which Murmur is heard best along the 3rd or 4th intercostal space adjacent to the left sternal border? |
Pulmonary Regurge Murmur |
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When Pulmonary Hypertension is present, a ____________ pitched, blowing, _______________ decrescendo Murmur may be heard. |
High pitched Diastolic |
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A patient with Pulmonary Hypertension and a high pitched, blowing, diastolic decrescendo sound in their chest, has a Murmur called? |
Graham Steele Murmur |
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A Graham Steele Murmur is a ____________ pitched, ______________, _________________ decrescendo murmur. |
High pitched Blowing Diastolic |
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What is the most common cause of Pulmonic Regurge? |
Pulmonary Hypertension |
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True/False: Pulmonary Hypertension causes insufficiency secondary to dilatation of the valve ring. |
TRUE |
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What are some causes of Pulmonary Regurge? (6) |
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What are 4 complications related to Pulmonary Regurge? |
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True/False: In 2D, Pulmonic Regurge may be present with Infective Endocarditis or Valvular Pulmonic Stenosis. |
TRUE |
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In 2D, what are an RVD or RV Volume Overload pattern indicative of? |
Pulmonary Regurge |
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In M-Mode, RV enlargement or RV Volume Overload pattern are an indication of? |
Pulmonary Regurge |
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In M-Mode, fine diastolic flutter of the Tricuspid Valve is an indication of? |
Pulmonary Regurge |
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In M-Mode, premature opening of the Pulmonic Valve opening on/before the QRS complex is due to? |
Severe Acute Pulmonary Insufficiency (PR) |
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How do you differentiate between true and physiologic Pulmonary Insufficiency? |
Calculate the length and duration of the PR jet |
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A Pulmonary Insufficiency Jet is < ____ cm in length and not ___________________ in duration. |
< 1 cm HoloDiastolic |
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Which technique is used to measure the severity of Pulmonary Insufficiency? |
Mapping Technique (PW at the RVOT) |
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What is the Mapping Technique? |
Pulse Wave the RVOT |
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In CW, intensity and shape of a signal (wave) provides an indication of? |
Pulmonary Insufficiency Severity |
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How do you document a Pulmonary Insufficiency Jet? |
CW Doppler |
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The Pulmonary Insufficiency waveform is seen ____________ the baseline, while the normal Pulmonary Valve waveform is seen _____________ the baseline. |
Above Below |
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What do you use to determine the Pulmonary Artery End-Diastolic Pressure (PAEDP)? |
CW Doppler |
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Color Doppler Flow determines the ______________ and ______________ of the Pulmonary Insufficiency Jet from multiple windows, providing an estimate of the ________________ of the Pulmonary Insufficiency. |
Length Width Severity |
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What is the normal Pulmonary Artery End-Diastolic Pressure (PAEDP)? |
4-12 mmHg |
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What is the equation used to calculate the Pulmonary Artery End-Diastolic Pressure (PAEDP)? |
4 x (PR end diastolic velocity) sqd. + RAP *PAEDP = LA mean pressure |
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What is the normal Systolic Pulmonary Artery Pressure (SPAP)? |
15 -30 mmHg |
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In the absence of RVOT obstruction, what is the Systolic Pulmonary Artery Pressure (SPAP) equal to? |
RVSP *SPAP = RVSP |
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In the presence of RVOT obstruction, which equation is used to calculate the Systolic Pulmonary Artery Pressure? |
SPAP = RVSP - PV transvalvular peak PG |
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What is the normal Mean Pulmonary Artery Pressure (MPAP)? |
9-18 mmHg |
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What is the equation used to calculate the Mean Pulmonary Artery Pressure (MPAP)? |
4 x (PR peak velocity) sqd. |
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If Pulmonary Insufficiency is considered physiologic, the waveform will be _________ cm in length and not _______________ in duration. |
< 1 cm not HoloDiastolic |
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If Pulmonary Insufficiency is considered borderline, the waveform will be ________ cm in length and _________________ in duration. |
1 -2 cm HoloDiastolic |
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If Pulmonary Insufficiency is found clinically significant, the waveform will be _________ cm in length with a peak velocity of _____________ m/s and ______________________ in duration. |
> 2 cm >1.5 m/s HoloDiastolic |
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Mild Jet width/RVOT width is? |
< 40% |
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Severe Jet width/RVOT width is? |
> 70% |
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True/False: A thicker Jet indicates more severe Pulmonary Insufficiency. |
TRUE |
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A Jet size by Color Flow Doppler has a narrow origin and is < 10 mm in length and has a soft/slow deceleration time, describes what level of Pulmonary Regurge? |
Mild PR (according to ASE) |
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A Jet size by Color Flow Doppler has intermediate values (not well validated), describes which level of Pulmonary Regurge? |
Moderate PR (according to ASE) |
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A Jet size by Color Flow Doppler is usually large with a wide origin, may be brief in duration, and has a dense CW envelope w/ a steep deceleration slope, describes which level of Pulmonary Regurge? |
Severe PR (according to ASE) |
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If the Pulmonary Valve is abnormal and the RV is dilated, which level of Pulmonary Regurge is this? |
Severe PR (according to ASE) |