Echo Registry TOP Exam Questions and CORRECT Answers

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?