ECHO HINTS (ARDMS)

LV Mass 9eight) remains normal in chronic:

mitral stenosis

High engulation of an M-mode tranducer bean equals to

pseudo bicuspid AV

Whatis the primary effect of long standing AI?

decreased EF

High velocity jet (4 m/sec) will be what type of trace MS or AI?

AI

Which of the following syndrome fits with AR, AO dilatation, Ao dissections & Ao aneurysm?

Marfan syndrome

Why follow chronic AI patients?

check LV size

Systolic reversal od flow is also called what?

"retrograde"

RVSP=?

PAP

Lambl's Excrescenced are sometimes listed as apotential answer

They are thin filiform strands (fronds) that form on the edges of valve leaflets

What cause a pericadial knock?

abrupt cessation of early diastolic inflow (classic in constrictive pericarditis) similar in timing to a very loud S3

What accompanies bicuspid Aortic valves?

coarctation of the aorta (50% of coarcts have a bicuspid valve)

When is mitral pressure half-time NOT accurate?

post valvuloplasty

Given TR and RA pressure What can you calculate?

Right ventricular systolic pressure (RVSP)=PAP

If your patient has a dilated LV and thin septum What might be going on with the patient?

Severe MR

What is the best way to determine the severity of MR?

pulmonary venous flow

Which cardiac pathology affects the valves?

carcinoid

Name the 2 layers of the pericardium

visceral and parietal

Which pericardial layer is the serous?

visceral or epicardial

Cardiac tamponade is rapid filling of fluid:

causing restrictive diastolic filling

Question about an indication of tamponade and the best answer was?

"RA/RV collapse in diastole"

A acyanotic shunt is?

Left to Right

A cyanotic shunt is?

Right to Left

Kids with Tuberous Sclerosis develop what type of cadiac tumors?

Rhabdomyomas

Peripheral contrast NOT useful in ?

AI

Which view shows the coronary sinus in long axis?

Apical 4-chamber with posterior angulation

What is the valve of the IVC?

Eustachian valve

What is meant by automaticity?

The ability to initiate an electric impulse or beat

What is Intrinsic?

pertaining exclusively to a part

What does amyl nitrite do to HR?

Increase heart rate

Where does a pacer wire goes to?

the right apex central venous lines stays in the RA

Where does Swan-Ganz catheters goes to?

usually DO NOT go to the RV apex

Why are the right and left coronaries called right and left?

the left artery supplies most of the LV and the right artery most of th RV

Why are th RCC, LCC and NCC called what they are?

because of the coronaries

Whre does the left anterior descending coronary artery originate?

anterior interventricular sulcus

A systolic rumble might be?

Tricuspid regurgitation

What is hematocrit?

% of blood comprised of red blood cells

If you are doing an echo on a supine patient who becomes short of breath what should you do first?

sit the patient upright

Wjat do you do first for an apneic patient after giving sedation?

check their airway

Why do an IVC "sniff" test?

to check for elevated RA pressure

What type of shunt causes cyanosis in newborns?

R to L shunts

What is a "pressure drop"?

same as a gradient across valves

Which of thevalves is LEAST likely to be affected in rheumatic heart disease?

pulmonic valve

In the CATH LAB the Gorlin Formula is used to calculate what?

valvular area

Mitral valve inflow velocity should not be affected by?

Gender

Which valve is most likely to regurgitate in normals?

Tricuspid valve

causes of acute mitral regurgitation:

-endocarditis
-ruptured chordae
-pap muscle dysfunction
-prosthetic valve dysfunction

With what disease should ypu NOT rely on M-mode for quantifying left ventricular EF?

apical infarction

Where do the coronaries drain>

into the coronary sinus

Which coronary supplies the LV apex

Left anterior descending

An MI of the inferior wall involves wqhich coronary artery?

right coronary artery

What % of normals will have PFO?

20 to 30%

What 2D finding would you see ina patient with a PLSVC?

a dilated coronary sinus

Pre-systolic opening of the artic leaflets causes..

an elevated LVEDP

Patients with ankylosing spondylitis may develop?

aortic regurgitation

What is kyphosis?

Exaggerated anterior spinal curvature. Skeletal deformity may compress PA and cause PA hypertension

What can cause contrast to dissipate too quickly?

Hi MI

What is Uhl's anomaly?

Congenital absent RV myocardium also called "parchment heart"- may be confused clinically with Ebstein's

Does a PDA increase LV preload?

yes (when the shunt is L-R)

Name the 3 heart muscle layers:

-epicardium-thin outer layer
-myocardium-mid wall (thickest)
-endocardium-inside

Normally how much pericardial fluid is there?

40cc

All of the following may result in jugular venous distension:

-Cardiac tamponade
-PHTN
-TS
-Constrictive pericarditis

If a poatient has Cor Pulmonale which of the following conditions are MOST likely to exist?

right ventricular increase

How do cardiac problems cause renal failure, jugular venous pulsation and peripheral edema?

mostly through systolic failure and low perfusion causing multi system complications

An enlarged heart on chest x-ray could be all oth the following:

-pericardial effusion
-AS
-Hypertrophic cardiomyopathy

How many weeks until the heart is developed?

6 weeks

What is persistent fetal circulation?

PHTN with R to L shunting across the foramen and ductus

Whic embryonic aortic arch (1-6) develops into the transverse arch?

Fourth

What is preload?

volume=thin walls

What is afterload?

pressure=thick walls

Are right-sided pressures elevated with a Valsava maneuver?

during the strain phase-NO
during the rease phase-YES

What kind of murmur will a patient with a VSD have?

Harsh holosystolic

A patient with a secundum ASD has a bubble study. It shows all:

-Bubbles from RA to LA
-Neg. contrast jet in RA
-bubbles in Pulm. Artery

Which clinical finding is associateed with a friction rub?

Pericardial effusion

BiPlane Simpsons rule is used for calculating?

EF

Where is the chiari network (system)located?

right atrium

What causes a left parasternal friction rub?

pericarditis

Aortic regurgitation starts at the?

bennining of IVRT

The frequency for TEE probes are?

are usually higher- 5-7 MHz

the frequency for TTE probes are?

2-7 MHz

PFO 's are found in % of normals

20 to 30%

In the apical 4 chamber view where ypu would see a reverberation artifact?

apex

QRS complex equals what?

depolarization

All of the following can lead to a false diagnosis of PE on M-mode:

-descending aorta
-cakcified mitral annulus
-ascites
-----EXCEPT: MVP

Where are most fibroelastomas found?

Usually on the valves (mitral & aortic). may be described as FROND-LIKE (feathery)

What might ypu see in a patient with scleroderma?

usually pulmonary hypertension or a pericardial effusion is the second thing

The reason for using ultrsoundjgel is to:

Keep the air out

Will an ascending Ao dissection cause severe MR?

no- not severe, maybe mild

What is the most common type of pediatric cardiac tumor?

Rhabdomyomas

Why the SA node is the primary pacemaker?

The SA node has the fastest (higher) intrinsic rate of any cardiac tissue. SA node=60 to 70/minute
AV node=50/minute
myocardium=30/minute

What is the rate for SA node?

60 to 70/ minute

What is the rate for AV node?

50/ minute

What ias the rate for myocardium?

30/ minute

The wave of contraction (depolarization) moves from the endocardiuum to the epicardium....How?

inside to outside

What is the Ao valve doing during the Q-T interval?

the valve is open

What are the 4 defecs that make up Shone's Syndrome?

-Supravalvular mitral membrane
-Paravhute MV
-Subaortic stenosis
-Coarctation of the Ao

When is LV pressure the lowest?

early diastole

What is the primary cause for papillary muscle dysfunction?

apical infarction

Which valve event starts isovolumic contraction?

MV close

Which valve event ends isovolumic contraction?

Ao open

Which valve event starts isovolumic relaxation?

Ao close