Echocardiography| 376 Question Book| WITH COMPLETE SOLUTIONS

What does partial closure of the aortic valve in mid-systole suggest? This is a classic feature of subvalvular obstruction caused by either the dynamic gradient of HCM or fixed obstruction of a subaortic membrane How can you distinguish aortic stenosis flow from MR or TR flow on continuous wave doppler? Look for the abrupt bright spikes in the CW spectral Doppler signal. Aortic stenosis flow should only start after the aortic valve opens Name a condition in which the modified Bernouli equation for measuring transaortic valve gradient would be rendered less accurate Severe aortic regurgitation This is because in severe AI, the LVOT velocity is increased and is no longer negligible compared with the AV velocity What is the cutoff dimensionless index for severe aortic stenosis? <0.25 What is the definition of an intact contractile reserve? Increase in stroke volume by 20% or more with dobutamine What is the global hemodynamic load? Global hemodynamic load = (Systolic BP + transaortic valve gradient)/stroke volume index In the gorlin equation, what is the valve area proportional to? - Cardiac Ouptut - Inverse square root of the mean gradient What is the definition of pressure recovery? Variable increase in pressure downstream from the vena contracta due to conversion of a certain amount of kinetic energy to potential energy True or false: pressure recovery can lead to falsely elevated prosthetic valve gradients, especially bileaflet mechanical valves True True or false: the presence of moderate/severe calcification is a predictor of outcome in patients with asymptomatic severe AS True True or false: calcific degenerative AS of trileaflet valve accounts for more cases of AVR compared with bicuspid AV disease False. It's the other way around. Name 3 congenital defects associated with subvalvular aortic stenosis Patent ductus arteriosus Aortic coarctation VSD True or false: subvalvular aortic stenosis is not associated with risk of endocarditis False. Subvalvular aortic stenosis is associated with high risk of endocarditis Name a genetic condition associated with supravalvular aortic stenosis Williams syndrome - due to mutation of elastin gene