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29 Cards in this Set
- Front
- Back
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What is the most complex of the 4 valves?
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The Tricuspid Valve
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Which Tricuspid Leaflet is typically the largest?
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Anterior
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Which Tricuspid Valve Leaflet is the smallest?
Where does it insert? |
Septal
Inserted more apically compared to anterior |
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Valve as a whole sits anatomically ____ to apex in the cardiac crux as compared to the _____
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Closer, Mitral Valve
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There is a _______ degree of TR in normal valves, usually confined to _____ _______
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Mild, Early Systole
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Prevalence of Tricuspid Regurg increases with ____
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Age
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Tricuspid Valve Disease:
Primary: - _______ Abnormalities - _______ Abnormalities: - - ______ Valve Disease |
- Congenital
- Acquired - Endocarditis - Carcinoid Valve Disease |
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Tricuspid Valve Disease:
Secondary Disease: - Secondary TR due to _________ of the leaflets from either ________ ___________ or RV ________ (From Pulm. Hypertension, or anything causing RV dilation.) |
Malcoaptation, Annular Dilation, Dilation
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Tricuspid Stenosis:
Most common Etiology |
Rheumatic Heart Disease
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Tricuspid Stenosis:
2nd Most common etiology |
Carcinoid Heart Disease
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Tricuspid Stenosis:
Other Reasons - - - |
Congenital
Tumors Veggies |
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Tricuspid Stenosis:
Uncommon in ______ _________ |
Adult Patients
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Patient Symptoms:
Symptoms similar to MS: - _________ on Exertion - - - Heart Failure - Fatigue, Orthopnea, Peripheral Edema |
- Dyspnea
- Hemoptysis - Chest Pain |
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TS is a pressure overload of the ________.
Increased _______ pressure causes RA _________, and eventually causes - - |
- RA
RA, Dilitation - Peripheral Edema - Decreased Cardiac Output |
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TS almost never occurs as isolated lesion; usually accompanies _____ or other valves affected by _____________ ___________.
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MS, Rheumatic Fever
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TS Physical Exam:
___________ rumble heard along ____, may be accentuated with inspiration. - Opening Snap - ___________ venous distention - Possible ______________, Ascites, ___________ edema, peripheral ___________ |
Diastolic, Left Lower Sternal Boarder
-Jugular - Jaundice, Peripheral, Cyanosis |
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ECG
Possible ______ |
Afib
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Echocardiographic TS Evaluation:
- ____________ Valve Leaflets - Decreased _________ slope of the ___________ TV Leaflet - Diastolic ___________ of the tricuspid valve w/commissural fusion of leaflets - _____ Enlargement - Dilated _______ and ________ |
-Thickened
- E-F, Anterior - Doming - RA - IVC, Hepatic veins |
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Echocardiographic TS Evaluation:
-Leftward protrusion of _______ - Pulmonary __________ (from coexisting MV disease) - Increased TV ____ velocity (>1.0m/s); mead gradient > __ mmHg is diagnostic - CF Doppler: Diastolic Jet - has laminar aliased flow, or candle flame appearance. - Flow ________ zone on RA side of valve |
- IAS
- Hypertension - E, 2mmHg -CF Doppler: Diastolic Jet - has laminar aliased flow, or candle flame appearance. - Convergence |
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Echocardiographer Role
- - - - - - |
- Etiology
- Severity - Co-existing TR - RA - IVC & Pulmonary Vasculature -Other findings: MV involvement, LA size, etc... |
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You see ________ _____ and________ ______ with TS in 2D
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Diastolic Doming, RA dilation
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Carcinoid Heart Disease:
________-_______ tumor releases ______ serotonin into bloodstream. - Inflammatory Rxn on ___________ _________ of valves & ___________, particularly the TV - The active metabolite is ________ in the lungs so ____ ______ structures are spared - Will resemble regular TS but valve is ________ and _______ in open position |
-Endocrine-Secreting, Increased
- Endothelial surface, Endocardium - Deactivated, Left-Heart - Narrowed, fixed |
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M-Mode of TS
- __________ Valve Leaflets - _________ EF Slope |
- Thickened
- Decreased |
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TS with Doppler:
-Orifice area is _____ than MV so velocities are inherently ________. -Increased _______ of TV inflow - > _______ m/sec |
Greater, Lower
-Velocity - 1.0 m/sec |
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TS Doppler:
What can you use to calculate Valve area? |
Pressure Half time
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TS Doppler:
Decreased EF so ___________ decel time |
Increased
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TS Doppler:
Use constant of ______ msec, instead of 220 msec for TS |
190msec
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TS Doppler:
TVA = |
190/PHT
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Severity of Stenosis TVA Criteria:
Valve Area: - Normal ____ to _____ cm2 - Severe < _____cm2 Mean Gradient - Mild < ____mmHg - Moderate ____-____ mmHg -Severe > ____ mmHg |
- 5-8 cm2
- <2 cm2 - <2mmHg - 2-5 mmHg - > 6 mmHg |
