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RDCS Questions and Answers

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A patient with a systolic ejection murmur and diminished A2 has what? o :# Aortic Stenosis What is Congestive Heart Failure? o :# Clinical findings that occur when the heart ( right or left side) is unable to maintain adequate circulation for any reason. Pump failure. - Characterized by: fatigue, shortness of breath, peripheral edema and abdominal distention What is hypovolemic shock? o :# From volume loss or cardiogenic shock, unable to maintain arterial blood pressure. -Clinical findings include: prostration, hypotension, pallor, coldness, collapse of superficial veins, decreased urine output and mental abtundation Left to right VS Right to let shunts: 2024/2025 2 | P a g e o :# Mot cardiac shunts ( VSDs and ASDs) shunt left to right due to higher left side pressures. Depending on the shunt volume there will be right side enlargement and increase pressure - if uncorrected PHTN may occur. " Eisenmenger's syndrome" is the development of PHTn from a long standing left to right shunt and the reversal of the shunt to right-to-left ( patient becomes cyanotic) What is cor pulmonale? o :# Heart disease secondary to disease of the lungs or pulmonary vasculature. Failure of the right ventricle resulting from disorders of the lungs, pulmonary vessels or chest wall. Acute ( from pulmonary embolism) or chronic ( COPD, chronic asthma, emphysema or pulmonary fibrosis). -Characterized by PHTN, RV hypertrophy and dilatation What is tamponade? o :# A hemodynamic diagnosis. Increase intrapericardial pressure causes impaired ventricular filling and decreased cardiac output. Treatment is pericardiocentesis What is constrictive pericarditis? o :# Fibrosis, thickening of the pericardium restricting diastolic filling. Treatment is pericardial stripping (pericardiectomy) What is the doppler equation? 2024/2025 3 | P a g e o :# V= c/2fo cos0 x F2 Maximum flow is when the doppler beam is? o :# Parallel to flow Compare the two dopplers o :# - Pulsed wave: has range resolution and a limitation on maximum velocity ( think aliasing - Continuos wave: has range resolution and NO limitation on maximum velocity What are normal doppler velocities? o :# - Mitral diastolic: Children- 1.00(0.7-1.4) [m/sec] ; Adults- .92(.6-1.4) [m/sec] - Tricuspid diastolic: Children- .62(.5-.9) [m/sec] ; Adults- .58(.4-.8) [m/sec] - Pulmonary systolic: Children- .84(.6-1.2) [ m/sec] ; Adults- .72(.5-.9) [m/sec] - Aortic systolic: Children- 1.52(1.2-1.7) [m/sec] ; 1.40(,9-1.8) [m/sec] What is a typical gradient range for aortic stenosis? o :# 3.0 - 5.0 m/sec Which valve lesion has the highest doppler peak? o :# Mitral regurgitati

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RDCS Questions and Answers
A patient with a systolic ejection murmur and diminished A2 has what?

o :# Aortic Stenosis




What is Congestive Heart Failure?

o :# Clinical findings that occur when the heart ( right or left side) is unable to

maintain adequate circulation for any reason. Pump failure.

- Characterized by: fatigue, shortness of breath, peripheral edema and abdominal

distention




What is hypovolemic shock?

o :# From volume loss or cardiogenic shock, unable to maintain arterial blood

pressure.

-Clinical findings include: prostration, hypotension, pallor, coldness, collapse of

superficial veins, decreased urine output and mental abtundation




Left to right VS Right to let shunts:

, 2024/2025 2|Page


o :# Mot cardiac shunts ( VSDs and ASDs) shunt left to right due to higher left

side pressures. Depending on the shunt volume there will be right side

enlargement and increase pressure

- if uncorrected PHTN may occur. " Eisenmenger's syndrome" is the development of

PHTn from a long standing left to right shunt and the reversal of the shunt to right-to-left

( patient becomes cyanotic)




What is cor pulmonale?

o :# Heart disease secondary to disease of the lungs or pulmonary vasculature.

Failure of the right ventricle resulting from disorders of the lungs, pulmonary

vessels or chest wall. Acute ( from pulmonary embolism) or chronic ( COPD,

chronic asthma, emphysema or pulmonary fibrosis).

-Characterized by PHTN, RV hypertrophy and dilatation




What is tamponade?

o :# A hemodynamic diagnosis. Increase intrapericardial pressure causes impaired

ventricular filling and decreased cardiac output. Treatment is pericardiocentesis




What is constrictive pericarditis?

o :# Fibrosis, thickening of the pericardium restricting diastolic filling. Treatment

is pericardial stripping (pericardiectomy)




What is the doppler equation?

, 2024/2025 3|Page


o :# V= c/2fo cos0 x F2




Maximum flow is when the doppler beam is?

o :# Parallel to flow




Compare the two dopplers

o :# - Pulsed wave: has range resolution and a limitation on maximum velocity (

think aliasing

- Continuos wave: has range resolution and NO limitation on maximum velocity




What are normal doppler velocities?

o :# - Mitral diastolic: Children- 1.00(0.7-1.4) [m/sec] ; Adults- .92(.6-1.4) [m/sec]

- Tricuspid diastolic: Children- .62(.5-.9) [m/sec] ; Adults- .58(.4-.8) [m/sec]

- Pulmonary systolic: Children- .84(.6-1.2) [ m/sec] ; Adults- .72(.5-.9) [m/sec]

- Aortic systolic: Children- 1.52(1.2-1.7) [m/sec] ; 1.40(,9-1.8) [m/sec]




What is a typical gradient range for aortic stenosis?

o :# 3.0 - 5.0 m/sec




Which valve lesion has the highest doppler peak?

o :# Mitral regurgitation

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