1/30
Looks like no tags are added yet.
Name | Mastery | Learn | Test | Matching | Spaced |
---|
No study sessions yet.
What to measure for Diastolic Fx (9)
2D echo Eval
LA Volume
MV inflow Doppler
TDI at MV Annulus (lateral wall & septum)
E/e’ Ratio - Mitral Doppler E/TDI e’
Pulm Venous Pressure
PAP - Pulm Artery Pressure
IVRT - Isovolumetric relaxation time
Color M-Mode - Flow propagation velocity
Which HF results in HFrEF and HFpEF
HFrEF - Systolic HF: Inability of the heart to pump enough blood to meet the bodys needs
HFpEF - Diastolic HF: Diastolic dysfunction with symptoms
3 most clinically relevant diastolic Fx parameters
ventricular relaxation
ventricular compliance
filling pressures
Abnormal relaxation =
Abnormal relaxation = Prolonged IVRT
Impaired Compliance (Severe diastolic dysfunction) =
Impaired Compliance (Severe diastolic dysfunction) = Shortened ivrt
E/A Ratio
Normal adult
Grade 1 Abnormal relaxation
Grade 2 Pseudonormal
Grade 3 Restrictive*
E/A Ratio
Normal adult | > or = 0.8 |
Grade 1 Abnormal relaxation | < or = 0.8 |
Grade 2 Pseudonormal | 0.8 - 2 reversal w/ Valsalva |
Grade 3 Restrictive* | >2 |
Deceleration time ms
Normal adult
Grade 1 Abnormal relaxation
Grade 2 Pseudonormal
Grade 3 Restrictive*
Deceleration Time ms
Normal adult | <150 - 240 ms |
Grade 1 Abnormal relation | > or = 240 ms |
Grade 2 Pseudo normal | 150 - 240 ms |
Grade 3 Restrictive* | < 150 ms |
IVRT ms
Normal adult
Grade 1 Abnormal relaxation
Grade 2 Pseudonormal
Grade 3 Restrictive*
IVRT ms
Normal adult | 70 - 90 ms |
Grade 1 Abnormal relation | > 90 ms |
Grade 2 Pseudo normal | < 90 ms |
Grade 3 Restrictive* | < 50 ms |
PV S/D
Normal adult
Grade 1 Abnormal relaxation
Grade 2 Pseudonormal
Grade 3 Restrictive*
pv a Duration ms
Normal adult
Grade 1 Abnormal relaxation
Grade 2 Pseudonormal
Grade 3 Restrictive*
PV a Duration ms
Normal adult | > or = 30 ms |
Grade 1 Abnormal relation | < or = 0 ms OR > or = 30 ms |
Grade 2 Pseudo normal | > or = 30 ms |
Grade 3 Restrictive* | > or = 30 ms |
PV a reversal velocity cm/s
Normal adult
Grade 1 Abnormal relaxation
Grade 2 Pseudonormal
Grade 3 Restrictive*
PV a reversal velocity cm/s
Normal adult | < 35 cm/s |
Grade 1 Abnormal relation | < 35 cm/s |
Grade 2 Pseudo normal | > or = 35 cm/s |
Grade 3 Restrictive* | > or = 35 cm/s |
Color M- mode Propagation velocity m/s
Normal adult
Grade 1 Abnormal relaxation
Grade 2 Pseudonormal
Grade 3 Restrictive*
Color M- mode Propagation velocity m/s
Normal adult | > 55 m/s |
Grade 1 Abnormal relation | > 45 m/s |
Grade 2 Pseudo normal | < 45 m/s |
Grade 3 Restrictive* | < 45 m/s |
E’ cm/s
Normal adult
Grade 1 Abnormal relaxation
Grade 2 Pseudonormal
Grade 3 Restrictive*
E’ cm/s
Normal adult | > 8 cm/s |
Grade 1 Abnormal relation | < 8 cm/s |
Grade 2 Pseudo normal | < 8 cm/s |
Grade 3 Restrictive* | < 8 cm/s |
E/E’
Normal adult
Grade 1 Abnormal relaxation
Grade 2 Pseudonormal
Grade 3 Restrictive*
E/E’
Normal adult | < 10 |
Grade 1 Abnormal relation | > 10 |
Grade 2 Pseudo normal | > 10 |
Grade 3 Restrictive* | > 10 |
TR Velocity m/s
Normal adult
Grade 1 Abnormal relaxation
Grade 2 Pseudonormal
Grade 3 Restrictive*
TR velocity m/s
Normal adult | < 2.8 |
Grade 1 Abnormal relation | > 2.8 |
Grade 2 Pseudo normal | > 2.8 |
Grade 3 Restrictive* | > 2.8 |
Pathophysiology
Normal
Mild Grade 1
Moderate Grade 2
Severe Grade 3
Severe Grade 4
Pathophysiology
Normal | |
Mild Grade 1 | ↓Relaxation |
Moderate Grade 2 | PseudoNormal ↓Relaxation ↑LVEDP |
Severe Grade 3 | ↓Relaxation ↓Compliance ↑LVEDP |
Severe Grade 4 | ↓Relaxation ↓↓Compliance ↑↑LVEDP |
MV Inflow DT
Normal
Mild Grade 1
Moderate Grade 2
Severe Grade 3
Severe Grade 4
MV Inflow DT
Normal | 160 - 240 ms |
Mild Grade 1 | > 240 ms |
Moderate Grade 2 | 160 - 240 ms |
Severe Grade 3 | < 160 ms |
Severe Grade 4 | < 130 ms |
MV E/A
Normal
Mild Grade 1
Moderate Grade 2
Severe Grade 3
Severe Grade 4
MV E/A
Normal | 0.9 - 1/5 |
Mild Grade 1 | <0.9 |
Moderate Grade 2 | 0.9 - 1.5 |
Severe Grade 3 | > 2 |
Severe Grade 4 | > 2.5 |
Valsalva
Normal
Mild Grade 1
Moderate Grade 2
Severe Grade 3
Severe Grade 4
Valsalva
Normal | Negative |
Mild Grade 1 | Positive |
Moderate Grade 2 | Positive |
Severe Grade 3 | Positive |
Severe Grade 4 | Negative |
TDI - e’
Normal
Mild Grade 1
Moderate Grade 2
Severe Grade 3
Severe Grade 4
TDI - e’
Normal | > or = 10 |
Mild Grade 1 | < 10 |
Moderate Grade 2 | < 8 |
Severe Grade 3 | < 5 |
Severe Grade 4 | < 5 |
E/e’ Septal
Normal
Mild Grade 1
Moderate Grade 2
Severe Grade 3
Severe Grade 4
E/e’ Septal
Normal | 1 - 14 |
Mild Grade 1 | > or = 15 |
Moderate Grade 2 | > or = 15 |
Severe Grade 3 | > or = 20 |
Severe Grade 4 | > or = 25 |
Pulm Vein
Normal
Mild Grade 1
Moderate Grade 2
Severe Grade 3
Severe Grade 4
Pulm Vein
Normal | S>D (S<D in young pt) |
Mild Grade 1 | S>>D |
Moderate Grade 2 | S<D |
Severe Grade 3 | S<<D |
Severe Grade 4 | S<<D |
Color doppler Vp
Normal
Mild Grade 1
Moderate Grade 2
Severe Grade 3
Severe Grade 4
Color doppler Vp
Normal | >50 |
Mild Grade 1 | <50 |
Moderate Grade 2 | <50 |
Severe Grade 3 | <50 |
Severe Grade 4 | <50 |
IVRT ms
Normal
Mild Grade 1
Moderate Grade 2
Severe Grade 3
Severe Grade 4
IVRT ms
Normal | 70 - 90 ms |
Mild Grade 1 | >90 ms |
Moderate Grade 2 | < 90 ms |
Severe Grade 3 | < 50 ms |
Severe Grade 4 | < 50 ms |
Mitral inflow
Normal (young)
Normal (adult)
Stage 1* Impaired relaxation
Stage 2 Pseudonormal
Stage 3 Restrictive (reversible)
Stage 4 Restrictive (Fixed)
Pulm venous flow
Normal (young)
Normal (adult)
Stage 1* Impaired relaxation
Stage 2 Pseudonormal
Stage 3 Restrictive (reversible)
Stage 4 Restrictive (Fixed)
Mitral annulus velocity
Normal (young)
Normal (adult)
Stage 1* Impaired relaxation
Stage 2 Pseudonormal
Stage 3 Restrictive (reversible)
Stage 4 Restrictive (Fixed)
color M-Mode doppler
Normal (young)
Normal (adult)
Stage 1* Impaired relaxation
Stage 2 Pseudonormal
Stage 3 Restrictive (reversible)
Stage 4 Restrictive (Fixed)
LV relaxation
Normal (young)
Normal (adult)
Stage 1* Impaired relaxation
Stage 2 Pseudonormal
Stage 3 Restrictive (reversible)
Stage 4 Restrictive (Fixed)
LV Compliance
Normal (young)
Normal (adult)
Stage 1* Impaired relaxation
Stage 2 Pseudonormal
Stage 3 Restrictive (reversible)
Stage 4 Restrictive (Fixed)
LA Pressure
Normal (young)
Normal (adult)
Stage 1* Impaired relaxation
Stage 2 Pseudonormal
Stage 3 Restrictive (reversible)
Stage 4 Restrictive (Fixed)