Fichas
Left ventricle
Fichas del conjunto (21)
- 1How do you measure internal LV diameter?Maximum LV diameter measured at the level of the papillary muscles at end-diastolic diameter (EDD), just before the QRS complex
- 2What is a normal LVEDD?< 5cm
- 3When do you measure LV wall thickness and what is the rough normal value?- End-diastole
- 1 cm - 4Name quantitative measurements of LV function- Fractional shortening
- Fractional area change (FAC)
- Teicholz method
- Simpson's biplane method of discs - 5How do you calculate fractional shortening?FS = (EDD x (ESD/EDD)) x 100
- 6What values of fractional shortening indicate normal function and impairment?Normal function 25-43%
Severe impairment <15%. - 7How do you obtain fractional area change?Use the trace tool to trace around the internal endocardial border at end-diastole. Papillary muscles must be excluded. This gives the end-diastolic area (EDA). Repeat the process at ESD, giving End-Systolic Area (ESA)
FAC(%) = (EDA – ESA / EDA) x 100% - 8What is the normal value of FAC?Normal >36%
- 9What can be calculated from the Teicholz method and how?- You cube diameter measurements
- Stroke volume = EDV - ESV
- Ejection fraction = (SV / EDV) x 100 - 10Describe the EFs correlating to LV functionNormal LV function >55%
Mildly impaired LV 45-54%
Moderately impaired LV 36-44%
Severely impaired LV <35% - 11How do you perform Simpson's biplane method of discs?- Optimise views of A4Ch and A2Ch planes
- Measure ESA and EDA using trace tools in both planes
- Software renders the LV as a pile of 20 discs of uniform height, to calculate LV volume and then ejection fraction - 12How can you differentiate between LVH and underfilling?Measure LVEDD which is reduced (<4cm) in underfilling
Look for other underfilling echo signs - 13What value of LV wall thickness indicates severe LVH?>1.7cm
- 14Give causes of LVH- Chronic HTN
- Aortic stenosis
- Marathon running
- HOCM
- Cocaine abuse - 15What is the rule of thumb value for LVD?< 5cm normal
>6cm = sever LVD - 16Give causes of LVDChronic volume overload (e.g. severe aortic or mitral regurgitation)
Alcoholic, ischaemic and peri-partum cardiomyopathy
Myocarditis (often viral)
Thyrotoxicosis
Sepsis
Drugs - 17Describe systolic wall thickening and inward movement of the LV endocardial wallsNormal: >30% of wall thickness
Severely impaired: <10% of wall thickness
Akinetic: No thickening/movement detected
Dyskinetic: Outward wall movement in systole - 18How can positive pressure ventilation affect echo?Increases intrathoracic pressure, reducing cardiac filling, which reduces RV and LV pre-load
- 19How might LV function appear differently when on ionotropic support?Jerky movement on contraction
- 20How can LV function appear in LBBB or ventricular pacing?Septum shows paradoxical septal motion, where it appears to contract towards the centre of the RV and not the LV
LV contraction appears uncoordinated ('dyssynergic') - 21What dose failure to wean from ventilatory support in the setting of apparently 'good' LV systolic function indicate?Formal echo
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- Descripción
- FOCUS Fichas sobre Left ventricle, creado por Liam Musselbrook el 08/08/2020.
- Creado por
- Liam Musselbrook
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