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Ultra P.A.S.S ECHO CH. 3 Valvular Heart Disease
echo
89
Other
Undergraduate 2
02/10/2016

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Term
At end systole, when ventricular contraction is complete, the pressure in the LV is approx. ___.
Definition
0-5 mmHg
Term
At end systole, the pressure in the LA is higher at __ since it has been filling during systole.
Definition
10-12 mmHg
Term
When pressure begins to equalize between the two chambers and the MV begins to close, this phase of diastole is called
Definition
Diastasis
Term
Interval between the end of systole and closure of the AOV, and just before the onset of ventricular filling and opening of MV is called?
Definition
IVRT
Term
Brief phase between the closure of the MV and before the opening of the AOV is called?
Definition
IVCT
Term
The E wave reflects what kind of filling?
Definition
passive or early filling velocity
Term
The A wave reflects what kind of filling?
Definition
Late filling velocity from atrial contraction
Term
Which MV leaflet is somewhat long and triangular in shape?
Definition
Anterior leaflet
Term
What are the names of the papillary muscles in the MV?
Definition
anterolateral and inferomedial
Term
The most common casue of MS is?
Definition
rheumatic fever
Term
A frequent comorbidity of MS is ?
Definition
MR
Term
When MS is present, the pressure in the LA stays elevated through most of diastole. The pressure difference pressure difference from the LA to the LVED pressure is called the?
Definition
Pressure Gradient
Term
Other sequelae of MS include:
Definition

1.) Low CO exercise augments hemodynamic event

2.) LAE causes A-fib & risk for thrombus

Term
Congenital MS is uncommon, but the two major forms are __ & __ , which is hemodynamically and anatomically similar to rheumatic MS.
Definition

mitral arcade (leaflets fused together)

parachute MV

Term
With congenital MS parachute MV deformity, there are three other obstructive processes that commonly occur, they are?
Definition

1.) supravalvular ring of the LA

2.) subaortic stenosis

3.) coarctation of the AO

Term

MAC occurs on the fibrosa of the mitral ring. It is more common in females and is considered a degenerative, age related condition.

True or False

Definition
True
Term
Normal MV area:
Definition

Normal: 4-6 cm²

Mild: 1.6 to 2.0 cm²

Moderate: 1.1 to 1.5 cm²

Severe: 1.0 or less cm²s 

Term
MVA calculation
Definition
220/PHT
Term
The most common cause of MS is
Definition
Rheumatic fever
Term
A commonly seen arrhythmia with MS is
Definition
A-fib
Term
Name the type of MV deformity that occurs when both chordae insert into a single papillary muscle
Definition
parachute MV
Term
Which of the following is not a probable cause for calcification of the MV annulus?
Definition
TR
Term
The most common tumor mass to cause MV obstruction is?
Definition
atrial myxoma
Term
Which of the following is NOT a prbable finding on the M-mode exam of a patient with MS?
Definition
SAM
Term
What would you probably find on an M-mode exam of a patient with MS?
Definition
Flying W, flattened E-F slope, reduced D-E distance
Term
When the mitral leaflets are tethered together the 2-D apperance may be termed:
Definition
Hockey stick
Term
Severe MS is considered when the MVA is:
Definition
< 1.0 cm²
Term
Severe MS is considered when the mean PG is :
Definition
> 10 mmHg
Term
Barlow's syndrome is another term used when referring to:
Definition
MVP
Term
On the M-mode tracing of the MV, a prolapse is considered when the leaflet(s) are displaced ____ below the C-D points?
Definition
> 3 mm
Term
Which leaflet of the MV is more commonly involved in a spontaneous rupture of the chordae tendinae?
Definition
posterior leaflet
Term
When one of the MV leaflets  are flail, the leaflet tip points toward the:
Definition
LA
Term
The most common cause of papillary muscle dysfunction is:
Definition
CAD
Term
When the MV leaflet is flail left ventricular function is commonly:
Definition
hyperkinetic
Term
What flow velocity can be used to calculate PA pressure?
Definition
TR
Term
On the Doppler exam, severe MR is indicated when:
Definition
systolic reversal of pulmonary vein flow is detected
Term
Severe AS is considered when the AOV area is:
Definition
< 0.75 cm²
Term
To calculate the peak PG in AS, what equation is used?
Definition
modified Bernouli equation
Term
When severe AS is present, the LV walls usually:
Definition
hypertrophy
Term
The most common congenital malformation of the heart is:
Definition
bicuspid AOV
Term
Another possible coexsisting defect seen with bicuspid AOV is:
Definition
Coarctation of the AO
Term
In severe cases of AS, the AO root may ?
Definition
Dilate
Term
Severe AS is considered when the mean PG is?
Definition
> 50 mmHg
Term
Type I bicuspid AOV has the CA arising:
Definition
anterior to the anterior cusp
Term
When the AOV is bicuspid, a larger cusp may be the result of a :
Definition
raphe
Term
Causes of AO root dilation:
Definition

Marfan's Syndrome

HTN

Cystic medial necrosis

Term
The water balloon apperance is associated with :
Definition
Marfan's Syndrome
Term
The most common risk factor for AO Dissection is?
Definition
Chronic HTN
Term
Fine fluttering of the anterior MV leaflet may suggest?
Definition
AI
Term
When chronic AI is present, the left ventricle shape may become:
Definition
spherical
Term
Severe AI is 100% sensitive when:
Definition
holodiastolic flow reversal is in the DAO
Term
If the cause of TS is rheumatic valvulitis, what other lesion almost always coexsists?
Definition
MS
Term
An ausculatory finding in TS of an increased intensity of diastolic murmur w/ inspiration is reffered to as?
Definition
Carvallo's sign
Term
Severe TS is considered when the TVA is:
Definition
< 1.5 cm²
Term
TS resulting from a metastatic tumor is referred to as:
Definition
Carcinoid syndrome
Term
Up to 10% of all cardiac disease is a result of endomyocardial fibrosis in:
Definition
Africa
Term
Which TV leaflet is almost always involved in Epstein's anomally?
Definition
Septal
Term
Epstein's anomally is considered when the separation of the TV from the MV is :
Definition
> 10 mm
Term
When severe TR is suspected, systolic flow reversal may be noted in the :
Definition
IVC, SVC, middle hepatic vein
Term
Normal RV systolic pressure is:
Definition
< 35 - 40 mmHg
Term
PS in adults is usually the result of:
Definition
congenital disease
Term
The best view to evaluate the Pulmonic Valve is?
Definition
Parasternal SAX
Term
The least likley region for PS to occur in patients with Tetralogy of Fallot is the :
Definition
subinfundibular
Term
The more likley regions for PS to occur in patients with Tetralogy of Fallot are the :
Definition
Infundibulum, pulmonic valve, pulmonic trunk
Term
Infective endocarditis is usually the result of:
Definition
Bacteria
Term
A non-bacterial form of endocarditis that results in an accumulation of debris in the endocardium is:
Definition
Atypical verrucous
Term
U/S may not detect vegitations that are:
Definition
< 3 mm
Term
A small fibroelastic protrusion seen on the AOV in older patients may represent?
Definition
Lambl's excrescence
Term
TV vegetations occur most often in patients with ?
Definition
I.V. drug abuse
Term
A frequent complication of TV vegetation is?
Definition
septic pulmonary emboli
Term
The least common site for endocarditis is what valve?
Definition
pulmonic valve
Term
This prosthetic valve is made from human AOV:
Definition
Homografts
Term
The most common cause of a bioprosthetic valve to dysfunction is:
Definition
tissue degeneration
Term
This is not a cause of mechanical valve failure:
Definition
valve leaflet tears
Term
TV and MV repair done at the same time is called?
Definition
DeVaga
Term
PHTN is a result of pulmonary arteriole constriction, and sometimes referred to as the?
Definition
second obstruction of MS
Term
MVP is the most common lesion causing?
Definition
MR
Term
A condition that is histologically characterized by disarray of the MV leaflet, thickening, and an increase in mucopolysaccharides within the leaflet tissue is called?
Definition
Myxomatous degeneration
Term
Non-bacterial thrombotic endocarditis is the result of:
Definition
Libman- Sachs vegetations in patients with: systemic Lupus, infiltrative diseases
Term
Patients with Ankylosing Spondylitis may develop heart lesions. This is a progressive form of arthritis affecting men. If the AV is involved the lesions are located ?
Definition
above and below the AOV
Term
Reiter's Syndrome affects young men. It consists of urethritis, arthritis, and conjunctivitis. _____ usually occurs 15 yrs after the desease begins
Definition
AI
Term
Rheumatoid arthritis may develop AI as a result of focal valvular lesions which begin where?
Definition
the center of the valve leaflet
Term
Rheumatic valve disease affects ___and ___valve is usually involved first
Definition
the whole cusp/ MV
Term
___ is a common cause of AO root dilation
Definition
Chronic HTN
Term
Other diseases causing AO root dilation are:
Definition
Marfan's syndrome, cystic medial necrosis, & AO dissection
Term
Left atrial pressure may cause what wave on the pressure curve?
Definition
V wave
Term
If the IVC is normal in size < 2.0 cm and collapses more than 50% with inspiration, the RA pressure is assumed to be:
Definition
10 - 15 mmHG
Term
If the IVC is dilated, but collapses more than 50%, the RA pressure is assumed to be:
Definition
10 - 15 mmHG
Term
If the IVC is dilated and fixed with inspiration, the RA pressure is assumed to be
Definition
15 - 20 mmHG
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