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36 Cards in this Set
- Front
- Back
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Are Rhuematoid Athritis and Rhuematoid Valvular Heart Disease the same disease?
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No. They are distinctly different diseases
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What is RHD secondary to?
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RHD is secondary to Group A Streptococcal infection
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What % of MS cases are the result of RHD?
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99%
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What % of AS cases are the result of RHD?
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9%
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If Stenosis is the primary pathology, what also may be present?
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Regurgitation
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What are some 2D Echo findings?
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Thickening at the leaflet tips working backward towards the annulus
Hocky stick appearance LAE RVH with severity LA thrombus LVE w/AR LVH w/AS |
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What are some M Mode Echo findings?
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Anterior motion of the posterior leaflet with severity
Diastolic flutter of the anterior leaflet of the MV (AR) Premature closure of the MV (AR) |
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What are some colorflow Echo findings?
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Increased turbulence and velocity through stenotic/regurgitant valve
PISA convergence zone Increased TR with MS |
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What are some Spectral Doppler Echo findings?
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CW stenotic & regurgitant velocities/gradients/VTIs/Pht
PW component of CE/diastology, MPAP |
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What are the Essential Measurements for 2D & M-Mode?
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Chamber sizes
LV systolic function RVH/LVH? |
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What are the Essential Measurements for Doppler of affected valve(s)?
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Velocities and VTIs
Diameter for CE Pht |
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What are the Essential calculations?
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Peak and Mean Gradients
Valve area (MVA, AVA) 2-D Planimetry when possible, CE, Pht, PISA Regurgitant Orifice Area (MR, AR) PISA Regurgitant Orifice Volume (MR, AR) CE (RF also) PISA Secondary Findings (SPAP, MPAP, PAEDP) |
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What are some ways of calculating MVA?
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Planimetry, Pht, CE or PISA
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what is the simplified DT method?
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759/DT=MVA
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What are the MVA values with categories of severity?
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Normal 4-6 cm²
Mild stenosis 1.6-2.5 cm² Mod stenosis 1.0-1.5 cm² Severe stenosis <1.0 cm² |
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What is the Pht formula for MVA?
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220/Pht=MVA
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What is Normal, Abnormal and grey area with Pht of MV?
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Normal: 30-60 ms, Abnormal: 90-400 ms, Gray area: 60-90 ms
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What your Pht values with MS?
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Mild MS: 90-150 ms
Moderate MS: 150-219 Severe MS: >220 ms |
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What are the values for MV RV, FR and ERO (PISA)
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1+ (mild) RV <30 ml/beat RF <30% ERO 1+ <0.20cm²
2+ (mod) RV 30-44 ml/beat RF 30-39% ERO 2+ 0.20-0.29cm² 3+ (mod-sev) RV 45-59 ml/beat RF 40-49% ERO 3+ 0.30-0.39cm² 4+ (severe) RV >60 ml/beat RF >50% ERO 4+ >0.40cm² |
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MR Vena Contracta values?
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0.3 cm Mild, >0.7 cm Severe
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Values for Simplified Mmode Pisa for MR severity
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1+ <4mm
2+ 5-7mm 3+ 8-10mm 4+ >10mm |
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What are the AVA values?
(by Planimetry or CE) |
Normal 3.0-5.0 cm²
Mild stenosis >1.5 cm² Mod stenosis 1.0-1.5 cm² Severe stenosis <1.0 cm² |
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Values for AV RV, RF & ERO (PISA)
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1+ (mild) RV <30 ml/beat RF <30% ERO <0.1cm²
2+ (mod) RV 30-44 ml/beat RF 30-39% ERO 0.1-1.9cm² 3+ (mod-sev) RV 45-59 ml/beat RF 40-49% ERO 0.2cm²-2.9cm² 4+ (severe) RV >60 ml/beat RF >50% ERO >3.0cm² |
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AR CF Jet height:LVOT ratio:
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Mild <25%
Moderate 25-65% Severe >65% |
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AR CW Doppler Pht:
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Mild >500 ms
Moderate 350-500 ms Severe <200ms |
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MV Mean Gradients
(Stenosis Related) |
Mean:
Mild: < 5 mmHg Moderate: 6-10 mmHg Severe: >10 mmHg |
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MV Peak Gradients
(Stenosis Related) |
Peak:
Not specific, generally <1.5 m/s Depends on filling pressures, LV function, volume status, as well as MR and or MS |
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AV velocities/gradients
Stenosis related: Velocities |
Velocities:
<2.0 m/s normal <3.0 m/s mild 3.0-4.0 m/s moderate >4.0 m/s severe |
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AV velocities/gradients
Stenosis related Mean |
Mean:
<30 mmHg mild 30-50 mmHg moderate >50 mmHg severe |
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AV velocities/gradients
Stenosis related Peak |
Peak:
<16 mmHg normal 16-36 mmHg mild 36-50 mmHg moderate 50-64 mmHg mod-severe >64 mmHg severe |
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Increased gradients may be the result of what?
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significant regurgitation. CE should reveal this as well as AV 2-D appearance
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what is SPAP equivalent to?
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SPAP=RVSP (in the absence of RVOT obstruction)
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Formula for RVSP?
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TR + RA pressure
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Values of indication for PHTN?
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Normal 15-30 mmHg
Mild 30-40 mmHg Moderate 40-70 mmHg Severe >70 mmHg |
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What is normal MPAP? (and how do you get it?)
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Normal 9-18 mmHg
(80 - RVOT PW AT x 0.5) |
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What is normal PAEDP?
(Formula?) |
Normal 4-12 mmHg
(4 x (PR end-diast velocity²) + RA pressure |
