101. An intraoperative trans-esophageal echocardiogram (TEE) revealed mitral
regurgitation
with the following measurements: regurgitant jet area 4 cm2, PISA radius 0.8
cm at
a Nyquist limit of 50 cm/s at a heart rate of 82 beats/min and arterial blood
pressure
80/40 mmHg. This represents:
...
101. An intraoperative trans-esophageal echocardiogram (TEE) revealed mitral
regurgitation
with the following measurements: regurgitant jet area 4 cm2, PISA radius 0.8
cm at
a Nyquist limit of 50 cm/s at a heart rate of 82 beats/min and arterial blood
pressure
80/40 mmHg. This represents:
A. Mild mitral regurgitation (MR)
B. Moderate MR
C. Severe MR
Ans- Severe MR
,102. For the patient in the above question, if the systolic blood pressure is
increased to
145 mmHg, assuming that the effective orifice area is unchanged, then the:
A. MR jet size will double
B. MR jet size will not change
C. MR jet size will more than double
Ans- MR jet size will more than double
103. For a given regurgitant volume all of the following result in a reduction in
the jet size
except:
A. Fast heart rate
B. Doubling the sector angle
C. Increasing the imaging depth
D. Increasing the blood pressure
Ans- Increasing the blood pressure
,104. In a patient with severe MR all of the following factors increase its
hemodynamic
impact except:
A. Mitral stenosis
B. Left ventricular hypertrophy
C. Compliant left atrium
D. Concomitant aortic regurgitation
Ans- Compliant left atrium
105. In a patient undergoing aortic valve replacement (AVR) for aortic stenosis,
there was
evidence of moderate MR on a preoperative transthoracic echocardiogram.
After the
AVR, the next step to be taken is:
A. Replace the mitral valve
B. Leave the mitral valve alone
C. Assess for MR with intraoperative TEE, and decide if repair or replacement
is needed
, D. None of the above
Ans- Assess for MR with intraoperative TEE, and decide if repair or
replacement is needed
106. A patient with old inferior wall myocardial infarction (MI) has severe MR
with a
posterolaterally directed jet in the left atrium. The most likely cause of MR in
this
patient is: A. Flail posterior leaflet
B. Dilated mitral annulus
C. Tented or apically tethered posterior mitral leaflet
D. Tented or apically tethered anterior mitral leaflet
Ans- Tented or apically tethered posterior mitral leaflet
107. Presence of severe aortic regurgitation (AR) in a patient with mitral
stenosis is likely to
do the following to the calculated mitral valve area by the pressure half-time
method:
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