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Exam (elaborations)

General Echocardiography| 165 Questions| WITH COMPLETE SOLUTIONS

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What is the normal value for coronary flow reserve? 4 What does this mean? Flow can increase 4-fold in response to vasodilators, such as adenosine. What is TAPSE? What does it indicate? Tricuspid Annular Plane Systolic Excursion is an indication of RV function with better inter- and intraobserver accuracy than wall motion. How can TAPSE be measured by TEE? TAPSE can be measured in 2D or MMode. What is the normal value for TAPSE? > 20 mm What is another use for TAPSE measurements, aside from RV function? Serial TAPSE measurements can be utilized to monitor reverse remodeling of the RV following CRT. What is the pattern of pulmonary venous inflow with relation to age? Young patients = d-wave predominates Equalization around age 50 Older patients = s-wave predominates What can happen to the atrium following cardioversion? The atrium can become stunned following cardioversion. What do we know of the predictive value of pulmonary venous inflow pattern for maintenance of sinus rhythm? One study looked at pulmonary vein flow after cardioversion and found that re-establishment of a systolic dominance of the pulmonary vein flow pattern was predictive of patient's remaining in sinus rhythm 1 year later. While one wouldn't think there would be any difference in which vein was used for Doppler examination, they did find that if the systolic flow fraction exceeded 0.5 in the right upper pulmonary vein, that it was predictive that 95% of patients would remain in normal sinus rhythm. What is the normal PHT across the MV? 20 - 60 msec What PHT value correlates with MVA of 1.0 cm2? 220 msec Which valvular dysfunction can lead to misinterpretation of MV PHT? Moderate or severe AI can decrease the MV pressure half-time because the ventricle is filling from more than one source, leading to a more rapid rise in ventricular pressure. In which direction does AI shift estimation of MS? MV PHT is falsely shorter in the setting of AI, which will overestimate the valve size and underestimate the degree of mitral stenosis. What else can lead to overestimation of MV size? Decreased LV compliance will also

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