932724
| Question | Answer |
| Narrowing of the left atrioventricular valve is... | Mitral Stenosis |
| What are the 2 causes of ms? | Rheumatic fever and MAC(mitral annular calcification) |
| Which type of ms is the most common? | Rheumatic fever |
| MAC can generally be associated with which patient? | Elderly |
| Common clinical S&S of ms (4) | Dyspnea upon exertion, Hemoptysis, CP, Murmur |
| What is hemoptysis? | Coughing/Spitting up blood from respiratory tract |
| What is causing the hemoptysis? | Backup of blood flow into the lungs |
| What is the most common symptom of ms? | Dyspnea upon exertion |
| 2nd most common symptom of ms? | Hemoptysis |
| What does the murmur sound like for ms? | Diastolic rumble with and opening snap |
|
Image:
MV1 (image/jpg)
|
Diastolic doming of the anterior mv leaflet. Referred to as a "hockey stick appearance" in the field |
| What view is best for doing planimetry to determine mv area? | PSAX |
| Why would the left atrium become enlarged in ms? | The LA pressure increases and empties slower |
| Why does the RV and RA enlarge with ms? When does this occur? | Back up of volume and pressure. Happens after longstanding ms |
| What other condition will occur with long standing ms and indicates that it is severe? | Pulmonary HTN |
| In regards to pulmonary HTN, what happens to the PA? | Dilate due to increased pressure |
| In regards to pulmonary HTN, what happens the the IVC and Hepatic veins? | Dilate with IVC failing to collapse 50% |
|
Image:
MV2 (image/jpg)
|
RVVO |
|
Image:
MV3 (image/jpg)
|
Paradoxical Septal Motion |
| Normal degree of ms by Pressure half time is... | 30-60msec |
| Mild degree of ms by Pressure half time is... | 90-150msec |
| Moderate degree of ms by Pressure half time is... | 150-219msec |
| Severe degree of ms by Pressure half time is... | >or=to 220msec |
| What is the formula to calculate MV area? | 220/P 1/2t |
|
Image:
MV4 (image/jpg)
|
Severe(Mean gradient of 18mmHg) |
| Mild mean gradient value? | < 5mmHg |
| Moderate mean gradient value? | 5-12 mmHg |
| Severe mean gradient value? | > 12 mmHg |
| Normal degree of ms by the MV area method? | 2.5-4cm² |
| Mild degree of ms by the MV area method? | 1.5-2.5cm² |
| Moderate degree of ms by the MV area method? | 1-1.5 cm² |
| Severe degree of ms by the MV area method? | < 1 cm² |
| Backward flow of blood into the left atrium during systole? | Mitral regurg |
| Causes of MR? | Any abnormality of the MV apparatus |
| Causes of MR (Leaflet related) | Prolapse, Endocarditis, Flail, Stenosis, Myxomatus degeneration |
| Causes of MR (Chordae related) | Elongation, Ruptured |
| Causes of MR (Pap muscle related) | Fibrosis, calcification, ischemia, rupture |
| Causes of MR (other causes) | Prosthetic valve dysfuntion, congenital anomalies, vegetations |
| What is the earliest symptom of MR? | Fatigue |
| Other S&S of MR? | Dyspnea upon exertion, Orthopnea, Palpatations, Murmur |
| Describe the murmur associated with MR | Harsh holosystolic that radiates to the axilla |
| Common 2d findings in MR (7) | LAE, LVE, RVE, Hyperkinetic LV wall motion, LV dilatation, PHTN |
| What 2d finding might be found in M-Mode? | AoV notching(partial mid-systolic closure due to sudden decrease in volume leaving the LV) |
|
Image:
MV5 (image/jpg)
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Image:
MV6 (image/jpg)
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| What does PISA measure? | The effective regurgitant orifice area |
| How is Vena Contracta defined? | The narrowest region of a jet that occurs just below the orifice of a regurgitant valve |
| What is the PISA formula? | RV= A MR EOA x VTI MR CW |
| Grade 1 RV=? | < 30 ml |
| Grade 2 RV=? | 30-44 ml |
| Grade 3 RV=? | 45-59 ml |
| Grade 4 RV=? | >or=to 60 ml |
|
Image:
MV7 (image/jpg)
|
Left Ventricular systolic performance, or ventricular contractility assessment |
| In the DP/DT formula, what is being measured? | The increase in pressure divided by the time interval necessary for that increase to occur |
| How is the DP number obtained? |
Image:
MV8 (image/jpg)
|
| Normal dp/dt values? | >1200 mmHg/sec |
| Borderline dp/dt values? | 1000-1200 mmHg/sec |
| Abnormal dp/dt values? | < 1000 mmHg/sec |
| A.S.E. guidelines for severity of MR Grade 1(mild) =? | MR jet extends just beyond the leaflet |
| A.S.E. guidelines for severity of MR Grade 2(moderate) =? | MR jet extends 1/3 way into LA |
| A.S.E. guidelines for severity of MR Grade 3(moderate/severe) =? | MR jet extends 1/2 way into LA |
| A.S.E. guidelines for severity of MR Grade 4(severe) =? | MR jet extends mid to back wall of LA |
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