CCI ECHO (Surgery) EXAM REVIEW QUESTIONS AND ANSWERS COMPLETE AND ACCURATE RATED A.

CCI ECHO (Surgery) EXAM REVIEW QUESTIONS
AND ANSWERS COMPLETE AND ACCURATE
RATED A.
What P1/2t would you expect in a patient with severe Aortic Insufficiency or Aortic
regurgitation?
<200 meters a second this would give a steep slope and mean the pressure between
the aorta and Left Ventricle are almost equal by end diastole
Etiology of acute Aortic Insufficiency or Aortic regurgitation?
Infective endocarditis (most common cause)
Complications of Aortic Insufficiency or Aortic regurgitation?
LVVO with Left Ventricle dilatation and hyperkinesis
M-mode findings with Aortic Insufficiency or Aortic regurgitation?
1. Diastolic flutter of the anterior Mitral Valve leaflet, posterior Mitral Valve leaflet,
chordae, papillary muscle, and/or the IVS.
2. LVVO (hyperkinesis of the Left Ventricle walls w/Left Ventricle dilatation).
CW findings with Aortic Insufficiency or Aortic regurgitation?
1. Determine the slope of the Aortic Insufficiency or Aortic regurgitation spectral
display. In general, the steeper the slope, the more sever the Aortic Insufficiency or
Aortic regurgitation; a slope of > or equal to 3 m/sec2 may indicate severe Aortic
Insufficiency or Aortic regurgitation.
2. A pressure half time (PHT) of < 200 indicates severe Aortic Insufficiency or Aortic
regurgitation.
3. A pressure half time (PHT) of >500 indicates mild Aortic Insufficiency or Aortic
regurgitation.
Color flow Doppler findings with Aortic Insufficiency or Aortic regurgitation?

,1. Determine the regurgitation jet height/LVOT height in the PLAX
2. Determine the regurgitation jet area/LVOT area in the PSAX Aorta
3. Reversal of flow in the DAO and/or Abdominal Aorta indicates Aortic Insufficiency
or Aortic regurgitation is 3 or 4 (holodiastolic flow reversal)
Chronic severe Aortic Insufficiency or Aortic regurgitation results in?
LVE
The classic M-mode finding for Aortic Insufficiency or Aortic regurgitation is?
Diastolic flutter of the Mitral Valve
Mitral Valve findings with Aortic Insufficiency or Aortic regurgitation?
1. Premature closure
2. Fine diastolic flutter
This will indicate increased LVEDP
Aortic Insufficiency or Aortic regurgitation is the only regurgitation that is
holodiastolic?
true
Severe Aortic Insufficiency or Aortic regurgitation by CW parameters?
1. PHT = < or equal to 200msec
2. Aortic Insufficiency or Aortic regurgitation decal slope > or equal to 3 m/sec2
(steep slope)
3. darkened spectrum of regurgitation jet
How can Aortic Insufficiency or Aortic regurgitation affect the Left Ventricle size
and wall motion?
Left Ventricle dilation
Hyperkinesis of Left Ventricle walls and IVS
When you see a b-bump on the mitral valve, what does the probably mean the Left
atrium is starting to look like?
Starting to dilate because of increased LVEDP translating to the atria

,How does aortic regurgitation effect ventricles?
Mild aortic regurgitation does not effect ventricles. In contrast, moderate to severe
aortic regurgitation results in left ventricular dilatation because of volume overload.
In such cases, left ventricular contractility is hyperdynamic. The left ventricle
continues to dilate and tuntil decompensation sets in and ventricular function
decreases.
How is diastolic flow reversal used to quantitate Aortic regurg?
Retrograde=diastolic flow reversal AO.
Pt w/ mild AO regurg will not usually cause diastolic flow reversal in descending AO.
Mod -severe AO regurg will. Pt w/ severe Ao regurg will usually have holo diastolic
flow reversal in descend Ao
*AS*A secondary finding in aortic stenosis is?
LVH
Which valve lesion is most commonly associated with LBBB?
Calcified aortic Stenosis
T/F, in Aortic Stenosis the Left Ventricle SYSTOLIC pressure exceeds that of the
aorta
True- in moderate and sever AoV STENOSIS= AFTERLOAD=HYPERTROPHY,
AFTERLOAD IS WHAT IS LEFT AFTER SYSTOLE
What is the common secondary finding of Aortic Stenosis?
Left Ventricular Hypertrophy
Stenosis= afterload= hypertropy
Systolic pressure overload, increase in afterload (Left Ventricle end diastolic
pressure) which leads to increase in Left Atrial pressure NOTE: STENOSIS =
AFTERLOAD=HYPERTROPHY PRELOAD=REGURITATION=DILITATION
What are the symptoms of Aortic Stenosis?

, Decrease CO
Chest pain
Syncope
CVA
What is the Etiology of Aortic Stenosis
1. Degenerative (senile, fibrocalcific)
2. Congenital (eg. bicuspid Aorta)
3. Rheumatic fever (inflammatory)
Most common etiology of Aortic Stenosis?
Degenerative
If the peak velocity of the aortic valve is 3.0 m/s. The peak pressure gradient is?
36mmHg (4V2)
All of the following are types of supravalvular aortic stenosis (SAS) EXCEPT:
A. Hourglass (most common)
B. Membranous
C. Strand
D. Hypertrophic
D. hypertrophic
What should you automatically think of when a patient has a history of rheumatic
fever?
Mitral Stenosis or Aortic stenosis
ava=0.785(v1)squared x(v2)
v1=lvot pw, v2=aov cw
How does the Aortic valve area correlate with the degree of stenosis?
Mild= 1.5 to 2.5 cm².
Mod = 0.7 to 1.5 cm².
Severe = <0.7 cm²