Echo Registry TOP Exam Questions and CORRECT Answers
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Echo Registry
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Echo Registry
Mitral Valve Which valve seperates the areas of greatest pressure differences?
Mild = >1.5cm2
Moderate = 1 - 1.5cm2
Severe = <1cm2 What is the Mitral valve area (MVA) of Mild Mitral Stenosis?
Moderate Stenosis? Severe Stenosis?
Diastolic Fluttering of MV leaflets How can Aortic Insuffic...
Echo Registry TOP Exam Questions and CORRECT Answers Mitral Valve ✔✔✔ Which valve seperates the areas of greatest pressure differences? Mild = >1.5cm2 Moderate = 1 - 1.5cm2 Severe = <1cm2 ✔✔✔ What is the Mitral valve area (MVA) of Mild Mitral Stenosis? Moderate Stenosis? Severe Stenosis? Diastolic Fluttering of MV leaflets ✔✔✔ How can Aortic Insufficiency (AI) affect the Mitral Valve? With Severe MR (+4 MR) ✔✔✔ When would you see pulmonary venous systolic flow reversal? LA dilates to accomodate increased volume without increasing Left Atrial Pressure (LAP) which would cause pulmonary edema. ✔✔✔ What is the physiologic advantage to Left A trial dilatation with MR? Systolic movement of one or both mitral leaflets into the Left atrium ✔✔✔ What is Mitral Valve Prolapse (MVP)? LV Mass is Normal ✔✔✔ How does chronic Mitral Stenosis (MS) affect Left Ventricle Mass? Chronic Heart Failure (CHF) Pulmonary Hypertension (PHTN) LA dilatation A-Fib ✔✔✔ What does chronic Mitral Stenosis lead to? ( 4 answers) -Rheumatic -fusion (most common cause) -Congenital - parachute MV (rare) -Acquired (MAC) -Prosthetic Valve dysfunction ✔✔✔ What causes Mitral Stenosis (MS)? ( 4 answers) posterior leaflet prolapse has an anterior jet anterior leaflet prolapse has a posterior jet ✔✔✔ How is the MR jet determined by Mitral valve prolapse? -Holosystolic murmur radiating to the axilla -symptoms of CHF and PHTN with long sta nding MR complicated by Left ventricle dysfunction ✔✔✔ What are the clinical signs and symptoms of Mitral Regurgitation (MR)? -usually asymptomatic, may have fatigue, dyspnea or anxiety -atypical chest pain -palpitations and arrhythmias -skeletal abnormali ties (straight back, pectus excavatum) ✔✔✔ What are the clinical signs and symptoms of MVP? Severe MR ✔✔✔ If a patient had a dilated LV and a thin septum, what is a possible diagnosis? -Endocarditis -Ruptured chordae tendinae -Papillary muscle dysfunction -Prosthetic Valve dysfunction ✔✔✔ What causes acute MR? ( 4 answers) Mild = 20 -30% Moderate = 30 -50% Severe = >50% ✔✔✔ What is the regurgitant fraction (RF) for Mild, Moderate and Severe regurgitation? DIstal to the Left subclavian artery or within the aort ic isthmus ✔✔✔ Where do most aortic coarctations occur? 3-4cm2 ✔✔✔ What is the normal Aortic Valve area? elevated LVEDP (Left ventricular end diastolic pressure) ✔✔✔ What causes pre -systolic opening of the aortic valve leaflets? AS = narrow pulse pressure AI = Wide pulse pressure ✔✔✔ How does pulse pressure appear with AS? With AI? The difference between systolic and diastolic pressures ✔✔✔ What is pulse pressure? To follow changes in systolic and diastolic size ✔✔✔ Why do chronic AI patients have serial echoes? Coarctation of the Aorta (5o% of coarcts has bicuspic valves) ✔✔✔ What accompanies bicuspid aortic valves? Aortic Regurgitation (AI) ✔✔✔ Doppler may show retrograde flow velocities within the ascending aorta during diastole with what pathology? Coarctation of the Aorta ✔✔✔ A "shelf" of tissue arising from the posterior -lateral aspect of the aorta and projecting into the aortic lumen toward the ductal attachment describes what? Mild JH/LVOT ratio = <25% Moderate JH/LVOT ratio = 25 -65% Severe JH/LV OT ratio = >65% ✔✔✔ What's the Jet Height/LV Outflow Tract (JH/LVOT) ratio for Mild AI? Moderate AI? Severe AI? Anterior to the anterior cusp ✔✔✔ Where do the coronary arteries arise with type I bicuspid aortic valve? Type I = thin, discrete membrane Type II = A fibromuscular ridge Type III = Diffuse tunnel like narrowing of the LVOT Type IV = Accessory or anamalous MV tissue ✔✔✔ What are 4 types of subvalvular aortic stenosis? Cause the AO valve to close mid -systole ✔✔✔ How does an LVOT obstruction affect t he Aortic Valve? -possible eccentric closure, 25% will have normal closure ✔✔✔ How does bicuspid aortic valve appear on M -mode? Mild = 2.6 -2.9m/s Moderate = 3 -4m/s Severe = >4m/s ✔✔✔ What are the values for aortic jet velocity with mild AS? moderate AS? severe AS? Angina Syncope Dyspnea ✔✔✔ What symptoms might a patient with severe AS present with? ( 3 answers) -Angina, dyspnea, syncope or sudden death -harsh systolic ejection murmur -decrease or absent A2 (valve not moving) -decreased and delayed carotid u ptake with bruit,trill transmitted from AO valve ✔✔✔ What are the clinical signs of Aortic Stenosis? (4 answers) Patent Ductus Arteriosus (PDA) ✔✔✔ In an interrupted aorta where does the descending aorta receive its blood from?
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