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CCI Review Echo 2| 1679 QUESTIONS 100% VERIFIED SOLUTIONS WITH IMAGES 2023
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CCI Review Echo 2| 1679 QUESTIONS 100% VERIFIED SOLUTIONS WITH IMAGES 2023
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CCI Review Echo 2| 1679 QUESTIONS 100%VERIFIED SOLUTIONS WITH IMAGES 2023
Right leaflet (the posterior leaflet is the non coronary) - ANSWER Which aortic leaflet
is the superior one in the parasternal long axis view?
Pulmonary artery - ANSWER From the left parasternal window which of the following
are you most likely to get accurate velocity measurements?
Anterior and medial/ septal
Posterior can only be seen in RVIT plax - ANSWER In the parasternal short axis
view (PSAX), which tricuspid leaflets are seen
Sometimes in the parasternal SAX Aortic Valve level
(Typically seen in the apical 2ch)
Normal LAA Velocity 46 cm/ sec? - ANSWER Where is the LAA on TTE?
Sinuses of Valsalva - ANSWER The coronary arteries come off the?
Early diastole - ANSWER During which phase do the coronaries fill?
Right pulmonary artery - ANSWER What is the structure under the arch?
Coarctation of the aorta (80%)
NOTE: coarctation , MVP, and AO dissections, bicuspid AOV are all related to
Marfans
Systolic click ejection= bicuspid AoV
Mid Systolic click = MVP
**TURNERS SYNDROME = MVP AND coarctation - ANSWER What cardiac
pathology is associated with bicuspid aortic valve?
Right and left superior (upper) pulmonary veins inferior to the LV
NOTE: Can be seen on apical 4 chamber w/ inferior angulation. - ANSWER Where
are the pulmonary veins located?
Right Atrium
The chiari network is the Fenestrated portion of the Eustachian valve
it is located in the Right Atrium - ANSWER Where is the Chiari network (system)
located?
,TTE: 2-7 MHz
TEE: 5-7MHz - ANSWER What frequency is usually used for TTE and TEE?
40-50C or the highest temperature - ANSWER At what temperature is it unsafe to
use a TEE probe?
That period when a muscle cell is not excitable- from phase I until into phase 3 the
"relative refractory period" is during phase 3 and the muscle cell might contract if the
stimulus is strong. - ANSWER What is absolute refractory state?
Includes P-R segment (from atrial to ventricular depolarization) - ANSWER What
does the P-R interval represent?
0.10 sec. - ANSWER What is a normal duration for the QRS complex?
Hyper-contractile (Regurgitation increases preload, muscle tension/contractility
increases and eventually results in dilitation, Volume overloads - ANSWER Acute
Aortic Insufficiency or Aortic regurgitation is _____ because we shift up the Starling
curve.
Failure - ANSWER Chronic Aortic Insufficiency or Aortic regurgitation is _____ when
we drop off the end.
Yes-when the shunt is Left to Right. - ANSWER Does a PDA increase Left Ventricle
preload?
CO=HR x CSA OR CO=SV x HR
Normal is 4-8 L/min depending on BSA
SV/EDV x 100 - ANSWER Calculate CO:
4V2 NOTE: THIS EQUATION IS USED TO CHANGE VELOCITY TO PRESSURES
- ANSWER What is the Bernoulli equation?
(0.5x0.5=.025 and 0.25x4=1
1mmHg NOTE: 4(0.5)2 BORNOULIS EQUATION TO CONVERT VELOCITIES TO
PRESSURES, ALSO USES THE 4 M/S = 64 mmHg - ANSWER With a velocity of
0.5m/sec what is the gradient?
Doppler stroke volume or SV=VTI X CSA - ANSWER What does VTI (velocity time
integral) and CSA (cross-sectional area) equal?
Decreases
Note: Tricuspid Valve velocity increases with inspiration
REMEMBER I=IV ( Increase on Inspiration in VENOUS) The revers is true for the left
systemic side. Inspiration causes decreases on the left side - ANSWER Mitral valve
velocity during inspiration?
Decreased after load
-Vasodilator
,-BP drops
-less blood comes back
-HR increases
Decreases vascular resistance. Increases forward flow murmurs decreases AR/MR (
retro flow murmurs) - ANSWER Inhalation of amyl nitrite causes?
After R wave=Isovolemic contraction
After T wave=Isovolemic relaxation - ANSWER What is the Isovolemic timing on the
ECG?
Aortic valve open - ANSWER During the cardiac cycle this event NEVER happens?
The valve is open - ANSWER What is the Aortic valve doing during the Q-T interval?
70 ms - ANSWER What is the duration of IVRT and IVCT?
-Starts Mitral Valve close
-Ends Aortic Valve Opens
-70 ms duration - ANSWER Valve event
-Starts Aortic close
-Ends- Mitral Valve opens
-70 ms duration (time decreases in bradycardia) - ANSWER valve event
Early diastole - ANSWER When is Left Ventricle pressure the lowest?
Left Ventricle angiogram
Angiographic techniques multiple SV x HR - ANSWER Best cath technique for Left
Ventricle function?
Left atrial pressure - ANSWER What is PCW (pulmonary capillary wedge)
measuring?
One in the Left Ventricle and one in the aorta or one in the Left Ventricle and "pulled
back" across the Aortic Valve or one catheter with two separate sensors - ANSWER
To determine Aortic Stenosis where catheters are places?
Thicker valve leaflets - ANSWER What does Tissue Harmonic Imaging result in?
Left ventricular hypertrophy
Note: Stenosis is a Afterload which leads to hypertrophy - ANSWER A secondary
finding in aortic stenosis is?
Narrow
(Pulse pressure is the difference between systolic and diastolic pressures-it is wide
in Aortic Insufficiency ( Aortic regurgitation) and narrow in Aortic Stenosis - ANSWER
In aortic stenosis is pulse pressure wide or narrow?
, Also called aortic arch syndrome this disease occurs more in young women from
Asia. There is fibrosis of the arch and descending Aortic of unknown etiology. In
advances stated multiple Coarctations may occur (look for Supravalvular Aortic
Stenosis). - ANSWER What is Takayasu's arteritis?
3-4cm2
less than 1 is severe stenosis - ANSWER The normal aortic valve area is:
VTI works better in patients with poor Left Ventricle function and when moderate to
severe Aortic Insufficiency or Aortic regurgitation is present than peak velocities. -
ANSWER When does VTI work better?
LVOT measured too large - ANSWER Using the continuity equation when would the
severity of Aortic Stenosis be underestimated?
Peak instantaneous (echo) and versus peak-to-peak (cath ) - ANSWER Know that
echo gradients are usually higher than cath gradients.
Classified as a cardiofacial syndrome with Pulmonic Stenosis, HCM and ASD (30%)
- ANSWER What is Noonan Syndrome?
... - ANSWER Know that Pulmonic Stenosis does NOT cause pulmonary
hypertension.
Subcostal short-axis - ANSWER Asked if unable to obtain Pulmonic Stenosis
gradient from the parasternal window where else you can go?
Parachute mitral valve
NOTE: MOST COMMON FORM OF CONGENITAL MITRAL STENOSIS--it is a rare
cause of mitral stenosis
Remember that in pediatric question this is not a valid answer - ANSWER Which
type of mitral deformity occurs where there is only ONE PAPILLARY MUSCLE into
which both chordae insert
OR insertion of mitral chord into a single papillary muscle?
C. Left ventricular dilatation-
Mitral stenosis is a right sided pressure overload (backs up and affects the right
side). The chambers behind it are the left atria and the pulmonary vein.
Stenosis= pressure= afterload, it affects the chambers that precede it ( for mitral that
is the pulmonary vein and the right atria) - ANSWER Longstanding Mitral Stenosis
leads to all the following EXCEPT:
A. congestive heart failure
B. pulmonary hypertension
C. left ventricular dilatation
D. left atrial dilatation
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