Cci Review Echo 2 Questions With
Complete And Correct Solutions
Right bleaflet b(the bposterior bleaflet bis bthe bnon bcoronary) b- bcorrect
banswers✔✔Which baortic bleaflet bis bthe bsuperior bone bin bthe bparasternal blong baxis
bview?
Pulmonary bartery b- bcorrect banswers✔✔From bthe bleft bparasternal bwindow bwhich bof
bthe bfollowing bare byou bmost blikely bto bget baccurate bvelocity bmeasurements?
Anterior band bmedial/ bseptal
Posterior bcan bonly bbe bseen bin bRVIT bplax b- bcorrect banswers✔✔In bthe bparasternal
bshort baxis bview b(PSAX), bwhich btricuspid bleaflets bare bseen
Sometimes bin bthe bparasternal bSAX bAortic bValve blevel b
(Typically bseen bin bthe bapical b2ch)
Normal bLAA bVelocity b46 bcm/ bsec? b- bcorrect banswers✔✔Where bis bthe bLAA bon
bTTE?
Sinuses bof bValsalva b- bcorrect banswers✔✔The bcoronary barteries bcome boff bthe?
Early bdiastole b- bcorrect banswers✔✔During bwhich bphase bdo bthe bcoronaries bfill?
Right bpulmonary bartery b- bcorrect banswers✔✔What bis bthe bstructure bunder bthe
barch?
Coarctation bof bthe baorta b(80%)
NOTE: bcoarctation b, bMVP, band bAO bdissections, bbicuspid bAOV bare ball brelated bto
bMarfans b
Systolic bclick bejection= bbicuspid bAoV
Mid bSystolic bclick b= bMVP
,**TURNERS bSYNDROME b= bMVP bAND bcoarctation b- bcorrect banswers✔✔What
bcardiac bpathology bis bassociated bwith bbicuspid baortic bvalve?
Right band bleft bsuperior b(upper) bpulmonary bveins binferior bto bthe bLV b
NOTE: bCan bbe bseen bon bapical b4 bchamber bw/ binferior bangulation. b- bcorrect
banswers✔✔Where bare bthe bpulmonary bveins blocated?
Right bAtrium
The bchiari bnetwork bis bthe bFenestrated bportion bof bthe bEustachian bvalve
it bis blocated bin bthe bRight bAtrium b- bcorrect banswers✔✔Where bis bthe bChiari
bnetwork b(system) blocated?
TTE: b2-7 bMHz b
TEE: b5-7MHz b- bcorrect banswers✔✔What bfrequency bis busually bused bfor bTTE band
bTEE?
40-50C bor bthe bhighest btemperature b- bcorrect banswers✔✔At bwhat btemperature bis bit
bunsafe bto buse ba bTEE bprobe?
That bperiod bwhen ba bmuscle bcell bis bnot bexcitable- bfrom bphase bI buntil binto bphase b3
bthe b"relative brefractory bperiod" bis bduring bphase b3 band bthe bmuscle bcell bmight
bcontract bif bthe bstimulus bis bstrong. b- bcorrect banswers✔✔What bis babsolute
brefractory bstate?
Includes bP-R bsegment b(from batrial bto bventricular bdepolarization) b- bcorrect
banswers✔✔What bdoes bthe bP-R binterval brepresent?
0.10 bsec. b- bcorrect banswers✔✔What bis ba bnormal bduration bfor bthe bQRS bcomplex?
Hyper-contractile b(Regurgitation bincreases bpreload, bmuscle btension/contractility
bincreases band beventually bresults bin bdilitation, bVolume boverloads b- bcorrect
banswers✔✔Acute bAortic bInsufficiency bor bAortic bregurgitation bis b_____ bbecause bwe
bshift bup bthe bStarling bcurve.
Failure b- bcorrect banswers✔✔Chronic bAortic bInsufficiency bor bAortic bregurgitation bis
b_____ bwhen bwe bdrop boff bthe bend.
Yes-when bthe bshunt bis bLeft bto bRight. b- bcorrect banswers✔✔Does ba bPDA bincrease
bLeft bVentricle bpreload?
CO=HR bx bCSA bOR bCO=SV bx bHR
Normal bis b4-8 bL/min bdepending bon bBSA
SV/EDV bx b100 b- bcorrect banswers✔✔Calculate bCO:
,4V2 bNOTE: bTHIS bEQUATION bIS bUSED bTO bCHANGE bVELOCITY bTO
bPRESSURES b- bcorrect banswers✔✔What bis bthe bBernoulli bequation?
(0.5x0.5=.025 band b0.25x4=1
1mmHg bNOTE: b4(0.5)2 bBORNOULIS bEQUATION bTO bCONVERT bVELOCITIES bTO
bPRESSURES, bALSO bUSES bTHE b4 bM/S b= b64 bmmHg b- bcorrect banswers✔✔With
ba bvelocity bof b0.5m/sec bwhat bis bthe bgradient?
Doppler bstroke bvolume bor bSV=VTI bX bCSA b- bcorrect banswers✔✔What bdoes bVTI
b(velocity btime bintegral) band bCSA b(cross-sectional barea) bequal?
Decreases
Note: bTricuspid bValve bvelocity bincreases bwith binspiration
REMEMBER bI=IV b( bIncrease bon bInspiration bin bVENOUS) bThe brevers bis btrue bfor
bthe bleft bsystemic bside. bInspiration bcauses bdecreases bon bthe bleft bside b- bcorrect
banswers✔✔Mitral bvalve bvelocity bduring binspiration?
Decreased bafter bload
-Vasodilator
-BP bdrops
-less bblood bcomes bback
-HR bincreases
Decreases bvascular bresistance. bIncreases bforward bflow bmurmurs bdecreases
bAR/MR b( bretro bflow bmurmurs) b- bcorrect banswers✔✔Inhalation bof bamyl bnitrite
bcauses?
After bR bwave=Isovolemic bcontraction b
After bT bwave=Isovolemic brelaxation b- bcorrect banswers✔✔What bis bthe bIsovolemic
btiming bon bthe bECG?
Aortic bvalve bopen b- bcorrect banswers✔✔During bthe bcardiac bcycle bthis bevent
bNEVER bhappens?
The bvalve bis bopen b- bcorrect banswers✔✔What bis bthe bAortic bvalve bdoing bduring
bthe bQ-T binterval?
70 bms b- bcorrect banswers✔✔What bis bthe bduration bof bIVRT band bIVCT?
-Starts bMitral bValve bclose
-Ends bAortic bValve bOpens
-70 bms bduration b- bcorrect banswers✔✔Valve bevent
-Starts bAortic bclose
-Ends- bMitral bValve bopens
, -70 bms bduration b(time bdecreases bin bbradycardia) b- bcorrect banswers✔✔valve bevent
Early bdiastole b- bcorrect banswers✔✔When bis bLeft bVentricle bpressure bthe blowest?
Left bVentricle bangiogram
Angiographic btechniques bmultiple bSV bx bHR b- bcorrect banswers✔✔Best bcath
btechnique bfor bLeft bVentricle bfunction?
Left batrial bpressure b- bcorrect banswers✔✔What bis bPCW b(pulmonary bcapillary
bwedge) bmeasuring?
One bin bthe bLeft bVentricle band bone bin bthe baorta bor bone bin bthe bLeft bVentricle band
b"pulled bback" bacross bthe bAortic bValve bor bone bcatheter bwith btwo bseparate bsensors
b- bcorrect banswers✔✔To bdetermine bAortic bStenosis bwhere bcatheters bare bplaces?
Thicker bvalve bleaflets b- bcorrect banswers✔✔What bdoes bTissue bHarmonic bImaging
bresult bin?
Left bventricular bhypertrophy
Note: bStenosis bis ba bAfterload bwhich bleads bto bhypertrophy b- bcorrect banswers✔✔A
bsecondary bfinding bin baortic bstenosis bis?
Narrow b
(Pulse bpressure bis bthe bdifference bbetween bsystolic band bdiastolic bpressures-it bis
bwide bin bAortic bInsufficiency b( bAortic bregurgitation) band bnarrow bin bAortic bStenosis b-
bcorrect banswers✔✔In baortic bstenosis bis bpulse bpressure bwide bor bnarrow?
Also bcalled baortic barch bsyndrome bthis bdisease boccurs bmore bin byoung bwomen
bfrom bAsia. bThere bis bfibrosis bof bthe barch band bdescending bAortic bof bunknown
betiology. bIn badvances bstated bmultiple bCoarctations bmay boccur b(look bfor
bSupravalvular bAortic bStenosis). b- bcorrect banswers✔✔What bis bTakayasu's barteritis?
3-4cm2
less bthan b1 bis bsevere bstenosis b- bcorrect banswers✔✔The bnormal baortic bvalve barea
bis:
VTI bworks bbetter bin bpatients bwith bpoor bLeft bVentricle bfunction band bwhen bmoderate
bto bsevere bAortic bInsufficiency bor bAortic bregurgitation bis bpresent bthan bpeak
bvelocities. b- bcorrect banswers✔✔When bdoes bVTI bwork bbetter?
LVOT bmeasured btoo blarge b- bcorrect banswers✔✔Using bthe bcontinuity bequation
bwhen bwould bthe bseverity bof bAortic bStenosis bbe bunderestimated?
Complete And Correct Solutions
Right bleaflet b(the bposterior bleaflet bis bthe bnon bcoronary) b- bcorrect
banswers✔✔Which baortic bleaflet bis bthe bsuperior bone bin bthe bparasternal blong baxis
bview?
Pulmonary bartery b- bcorrect banswers✔✔From bthe bleft bparasternal bwindow bwhich bof
bthe bfollowing bare byou bmost blikely bto bget baccurate bvelocity bmeasurements?
Anterior band bmedial/ bseptal
Posterior bcan bonly bbe bseen bin bRVIT bplax b- bcorrect banswers✔✔In bthe bparasternal
bshort baxis bview b(PSAX), bwhich btricuspid bleaflets bare bseen
Sometimes bin bthe bparasternal bSAX bAortic bValve blevel b
(Typically bseen bin bthe bapical b2ch)
Normal bLAA bVelocity b46 bcm/ bsec? b- bcorrect banswers✔✔Where bis bthe bLAA bon
bTTE?
Sinuses bof bValsalva b- bcorrect banswers✔✔The bcoronary barteries bcome boff bthe?
Early bdiastole b- bcorrect banswers✔✔During bwhich bphase bdo bthe bcoronaries bfill?
Right bpulmonary bartery b- bcorrect banswers✔✔What bis bthe bstructure bunder bthe
barch?
Coarctation bof bthe baorta b(80%)
NOTE: bcoarctation b, bMVP, band bAO bdissections, bbicuspid bAOV bare ball brelated bto
bMarfans b
Systolic bclick bejection= bbicuspid bAoV
Mid bSystolic bclick b= bMVP
,**TURNERS bSYNDROME b= bMVP bAND bcoarctation b- bcorrect banswers✔✔What
bcardiac bpathology bis bassociated bwith bbicuspid baortic bvalve?
Right band bleft bsuperior b(upper) bpulmonary bveins binferior bto bthe bLV b
NOTE: bCan bbe bseen bon bapical b4 bchamber bw/ binferior bangulation. b- bcorrect
banswers✔✔Where bare bthe bpulmonary bveins blocated?
Right bAtrium
The bchiari bnetwork bis bthe bFenestrated bportion bof bthe bEustachian bvalve
it bis blocated bin bthe bRight bAtrium b- bcorrect banswers✔✔Where bis bthe bChiari
bnetwork b(system) blocated?
TTE: b2-7 bMHz b
TEE: b5-7MHz b- bcorrect banswers✔✔What bfrequency bis busually bused bfor bTTE band
bTEE?
40-50C bor bthe bhighest btemperature b- bcorrect banswers✔✔At bwhat btemperature bis bit
bunsafe bto buse ba bTEE bprobe?
That bperiod bwhen ba bmuscle bcell bis bnot bexcitable- bfrom bphase bI buntil binto bphase b3
bthe b"relative brefractory bperiod" bis bduring bphase b3 band bthe bmuscle bcell bmight
bcontract bif bthe bstimulus bis bstrong. b- bcorrect banswers✔✔What bis babsolute
brefractory bstate?
Includes bP-R bsegment b(from batrial bto bventricular bdepolarization) b- bcorrect
banswers✔✔What bdoes bthe bP-R binterval brepresent?
0.10 bsec. b- bcorrect banswers✔✔What bis ba bnormal bduration bfor bthe bQRS bcomplex?
Hyper-contractile b(Regurgitation bincreases bpreload, bmuscle btension/contractility
bincreases band beventually bresults bin bdilitation, bVolume boverloads b- bcorrect
banswers✔✔Acute bAortic bInsufficiency bor bAortic bregurgitation bis b_____ bbecause bwe
bshift bup bthe bStarling bcurve.
Failure b- bcorrect banswers✔✔Chronic bAortic bInsufficiency bor bAortic bregurgitation bis
b_____ bwhen bwe bdrop boff bthe bend.
Yes-when bthe bshunt bis bLeft bto bRight. b- bcorrect banswers✔✔Does ba bPDA bincrease
bLeft bVentricle bpreload?
CO=HR bx bCSA bOR bCO=SV bx bHR
Normal bis b4-8 bL/min bdepending bon bBSA
SV/EDV bx b100 b- bcorrect banswers✔✔Calculate bCO:
,4V2 bNOTE: bTHIS bEQUATION bIS bUSED bTO bCHANGE bVELOCITY bTO
bPRESSURES b- bcorrect banswers✔✔What bis bthe bBernoulli bequation?
(0.5x0.5=.025 band b0.25x4=1
1mmHg bNOTE: b4(0.5)2 bBORNOULIS bEQUATION bTO bCONVERT bVELOCITIES bTO
bPRESSURES, bALSO bUSES bTHE b4 bM/S b= b64 bmmHg b- bcorrect banswers✔✔With
ba bvelocity bof b0.5m/sec bwhat bis bthe bgradient?
Doppler bstroke bvolume bor bSV=VTI bX bCSA b- bcorrect banswers✔✔What bdoes bVTI
b(velocity btime bintegral) band bCSA b(cross-sectional barea) bequal?
Decreases
Note: bTricuspid bValve bvelocity bincreases bwith binspiration
REMEMBER bI=IV b( bIncrease bon bInspiration bin bVENOUS) bThe brevers bis btrue bfor
bthe bleft bsystemic bside. bInspiration bcauses bdecreases bon bthe bleft bside b- bcorrect
banswers✔✔Mitral bvalve bvelocity bduring binspiration?
Decreased bafter bload
-Vasodilator
-BP bdrops
-less bblood bcomes bback
-HR bincreases
Decreases bvascular bresistance. bIncreases bforward bflow bmurmurs bdecreases
bAR/MR b( bretro bflow bmurmurs) b- bcorrect banswers✔✔Inhalation bof bamyl bnitrite
bcauses?
After bR bwave=Isovolemic bcontraction b
After bT bwave=Isovolemic brelaxation b- bcorrect banswers✔✔What bis bthe bIsovolemic
btiming bon bthe bECG?
Aortic bvalve bopen b- bcorrect banswers✔✔During bthe bcardiac bcycle bthis bevent
bNEVER bhappens?
The bvalve bis bopen b- bcorrect banswers✔✔What bis bthe bAortic bvalve bdoing bduring
bthe bQ-T binterval?
70 bms b- bcorrect banswers✔✔What bis bthe bduration bof bIVRT band bIVCT?
-Starts bMitral bValve bclose
-Ends bAortic bValve bOpens
-70 bms bduration b- bcorrect banswers✔✔Valve bevent
-Starts bAortic bclose
-Ends- bMitral bValve bopens
, -70 bms bduration b(time bdecreases bin bbradycardia) b- bcorrect banswers✔✔valve bevent
Early bdiastole b- bcorrect banswers✔✔When bis bLeft bVentricle bpressure bthe blowest?
Left bVentricle bangiogram
Angiographic btechniques bmultiple bSV bx bHR b- bcorrect banswers✔✔Best bcath
btechnique bfor bLeft bVentricle bfunction?
Left batrial bpressure b- bcorrect banswers✔✔What bis bPCW b(pulmonary bcapillary
bwedge) bmeasuring?
One bin bthe bLeft bVentricle band bone bin bthe baorta bor bone bin bthe bLeft bVentricle band
b"pulled bback" bacross bthe bAortic bValve bor bone bcatheter bwith btwo bseparate bsensors
b- bcorrect banswers✔✔To bdetermine bAortic bStenosis bwhere bcatheters bare bplaces?
Thicker bvalve bleaflets b- bcorrect banswers✔✔What bdoes bTissue bHarmonic bImaging
bresult bin?
Left bventricular bhypertrophy
Note: bStenosis bis ba bAfterload bwhich bleads bto bhypertrophy b- bcorrect banswers✔✔A
bsecondary bfinding bin baortic bstenosis bis?
Narrow b
(Pulse bpressure bis bthe bdifference bbetween bsystolic band bdiastolic bpressures-it bis
bwide bin bAortic bInsufficiency b( bAortic bregurgitation) band bnarrow bin bAortic bStenosis b-
bcorrect banswers✔✔In baortic bstenosis bis bpulse bpressure bwide bor bnarrow?
Also bcalled baortic barch bsyndrome bthis bdisease boccurs bmore bin byoung bwomen
bfrom bAsia. bThere bis bfibrosis bof bthe barch band bdescending bAortic bof bunknown
betiology. bIn badvances bstated bmultiple bCoarctations bmay boccur b(look bfor
bSupravalvular bAortic bStenosis). b- bcorrect banswers✔✔What bis bTakayasu's barteritis?
3-4cm2
less bthan b1 bis bsevere bstenosis b- bcorrect banswers✔✔The bnormal baortic bvalve barea
bis:
VTI bworks bbetter bin bpatients bwith bpoor bLeft bVentricle bfunction band bwhen bmoderate
bto bsevere bAortic bInsufficiency bor bAortic bregurgitation bis bpresent bthan bpeak
bvelocities. b- bcorrect banswers✔✔When bdoes bVTI bwork bbetter?
LVOT bmeasured btoo blarge b- bcorrect banswers✔✔Using bthe bcontinuity bequation
bwhen bwould bthe bseverity bof bAortic bStenosis bbe bunderestimated?
