Right leaflet (the posterior leaflet is the non coronary) Correct Answer: Which aortic leaflet is the superior one in the parasternal long axis view?
Pulmonary artery Correct Answer: From the left parasternal window which of the following are you most likely to get accurate velocity measuremen...
cci review echo 2| 1679 questions| 147 pages| with complete solutions
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CCI Review Echo 2| 1679 QUESTIONS| 147 PAGES| WITH
COMPLETE SOLUTIONS
Right leaflet (the posterior leaflet is the non coronary) Correct Answer: Which aortic leaflet is
the superior one in the parasternal long axis view?
Pulmonary artery Correct Answer: From the left parasternal window which of the following are
you most likely to get accurate velocity measurements?
Anterior and medial/ septal
Posterior can only be seen in RVIT plax Correct Answer: In the parasternal short axis view
(PSAX), which tricuspid leaflets are seen
Sometimes in the parasternal SAX Aortic Valve level
(Typically seen in the apical 2ch)
Normal LAA Velocity 46 cm/ sec? Correct Answer: Where is the LAA on TTE?
Sinuses of Valsalva Correct Answer: The coronary arteries come off the?
Early diastole Correct Answer: During which phase do the coronaries fill?
Right pulmonary artery Correct Answer: What is the structure under the arch?
Coarctation of the aorta (80%)
NOTE: coarctation , MVP, and AO dissections, bicuspid AOV are all related to Marfans
**TURNERS SYNDROME = MVP AND coarctation Correct Answer: What cardiac pathology
is associated with bicuspid aortic valve?
Right and left superior (upper) pulmonary veins inferior to the LV
NOTE: Can be seen on apical 4 chamber w/ inferior angulation. Correct Answer: Where are the
pulmonary veins located?
Right Atrium
The chiari network is the Fenestrated portion of the Eustachian valve
it is located in the Right Atrium Correct Answer: Where is the Chiari network (system) located?
TTE: 2-7 MHz
,TEE: 5-7MHz Correct Answer: What frequency is usually used for TTE and TEE?
40-50C or the highest temperature Correct Answer: At what temperature is it unsafe to use a
TEE probe?
That period when a muscle cell is not excitable- from phase I until into phase 3 the "relative
refractory period" is during phase 3 and the muscle cell might contract if the stimulus is strong.
Correct Answer: What is absolute refractory state?
Includes P-R segment (from atrial to ventricular depolarization) Correct Answer: What does the
P-R interval represent?
0.10 sec. Correct Answer: What is a normal duration for the QRS complex?
Hyper-contractile (Regurgitation increases preload, muscle tension/contractility increases and
eventually results in dilitation, Volume overloads Correct Answer: Acute Aortic Insufficiency or
Aortic regurgitation is _____ because we shift up the Starling curve.
Failure Correct Answer: Chronic Aortic Insufficiency or Aortic regurgitation is _____ when we
drop off the end.
Yes-when the shunt is Left to Right. Correct Answer: Does a PDA increase Left Ventricle
preload?
CO=HR x CSA OR CO=SV x HR
Normal is 4-8 L/min depending on BSA
SV/EDV x 100 Correct Answer: Calculate CO:
4V2 NOTE: THIS EQUATION IS USED TO CHANGE VELOCITY TO PRESSURES Correct
Answer: What is the Bernoulli equation?
(0.5x0.5=.025 and 0.25x4=1
1mmHg NOTE: 4(0.5)2 BORNOULIS EQUATION TO CONVERT VELOCITIES TO
PRESSURES, ALSO USES THE 4 M/S = 64 mmHg Correct Answer: With a velocity of
0.5m/sec what is the gradient?
Doppler stroke volume or SV=VTI X CSA Correct Answer: What does VTI (velocity time
integral) and CSA (cross-sectional area) equal?
Decreases
Note: Tricuspid Valve velocity increases with inspiration
REMEMBER I=IV ( Increase on Inspiration in VENOUS) The revers is true for the left systemic
side. Inspiration causes decreases on the left side Correct Answer: Mitral valve velocity during
inspiration?
,Decreased after load
-Vasodilator
-BP drops
-less blood comes back
-HR increases
After R wave=Isovolemic contraction
After T wave=Isovolemic relaxation Correct Answer: What is the Isovolemic timing on the
ECG?
Aortic valve open Correct Answer: During the cardiac cycle this event NEVER happens?
The valve is open Correct Answer: What is the Aortic valve doing during the Q-T interval?
70 ms Correct Answer: What is the duration of IVRT and IVCT?
-Starts Mitral Valve close
-Ends Aortic Valve Opens
-70 ms duration Correct Answer: Valve event
-Starts Aortic close
-Ends- Mitral Valve opens
-70 ms duration (time decreases in bradycardia) Correct Answer: valve event
Early diastole Correct Answer: When is Left Ventricle pressure the lowest?
Left Ventricle angiogram
Angiographic techniques multiple SV x HR Correct Answer: Best cath technique for Left
Ventricle function?
Left atrial pressure Correct Answer: What is PCW (pulmonary capillary wedge) measuring?
One in the Left Ventricle and one in the aorta or one in the Left Ventricle and "pulled back"
across the Aortic Valve or one catheter with two separate sensors Correct Answer: To determine
Aortic Stenosis where catheters are places?
Thicker valve leaflets Correct Answer: What does Tissue Harmonic Imaging result in?
Left ventricular hypertrophy
Note: Stenosis is a Afterload which leads to hypertrophy Correct Answer: A secondary finding
in aortic stenosis is?
, Narrow
(Pulse pressure is the difference between systolic and diastolic pressures-it is wide in Aortic
Insufficiency ( Aortic regurgitation) and narrow in Aortic Stenosis Correct Answer: In aortic
stenosis is pulse pressure wide or narrow?
Also called aortic arch syndrome this disease occurs more in young women from Asia. There is
fibrosis of the arch and descending Aortic of unknown etiology. In advances stated multiple
Coarctations may occur (look for Supravalvular Aortic Stenosis). Correct Answer: What is
Takayasu's arteritis?
3-4cm2
less than 1 is severe stenosis Correct Answer: The normal aortic valve area is:
VTI works better in patients with poor Left Ventricle function and when moderate to severe
Aortic Insufficiency or Aortic regurgitation is present than peak velocities. Correct Answer:
When does VTI work better?
LVOT measured too large Correct Answer: Using the continuity equation when would the
severity of Aortic Stenosis be underestimated?
Peak instantaneous (echo) and versus peak-to-peak (cath ) Correct Answer: Know that echo
gradients are usually higher than cath gradients.
Classified as a cardiofacial syndrome with Pulmonic Stenosis, HCM and ASD (30%) Correct
Answer: What is Noonan Syndrome?
... Correct Answer: Know that Pulmonic Stenosis does NOT cause pulmonary hypertension.
Subcostal short-axis Correct Answer: Asked if unable to obtain Pulmonic Stenosis gradient from
the parasternal window where else you can go?
Parachute mitral valve
NOTE: MOST COMMON FORM OF CONGENITAL MITRAL STENOSIS--it is a rare cause
of mitral stenosis
Remember that in pediatric question this is not a valid answer Correct Answer: Which type of
mitral deformity occurs where there is only ONE PAPILLARY MUSCLE into which both
chordae insert
OR insertion of mitral chord into a single papillary muscle?
C. Left ventricular dilatation-
Mitral stenosis is a right sided pressure overload (backs up and affects the right side). The
chambers behind it are the left atria and the pulmonary vein.
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