Apical Doppler part 2

Pulmonary valve

The ___________ ________ is really seen from the apical view due to its anterior position

Congenital reasons

What is stenosis on the left heart usually from

Smoking or obesity

What is stenosis on the right heart usually from

IAS, or more medially

What does a TR jet usually travel towards

80%

Close to ______ of people have some degree of TR

Athletes

What kind of patients may have more TR

Slight TV annular dilation

Why do athletes that do distance cardio often have more TR

First half of systole

When is physiological TR seen in the heart cycle

MR

TR occurs at almost the same time as ______

50-70cm/s

What should the colour scale be set at about for the TV

Blue jet

How does TR show up on colour Doppler

TR jet

What should the CW cursor line be aligned to

Wide/large blue or aliased colour jet

What may indicate abnormal TR instead of trace TR

Inflow and regurgitation

What is CW able to capture at the same time

Small

Inflow velocity will be _____ (E and A waves_

No

Do we usually measure TV inflow

Through the TR jet at the valve

How do you place the CW cursor for CW of the TV

Peak velocity

What do you measure in A4C CW of the TV

True, it may not be parabolic but there should be something

T/F: if you saw any TR with colour, you should be able to find a CW signal of TR

If it is clear an parabolic

When would you measure a TR jet

PW of MV

What are the wave of the TV PW the same to

TV annulus of the RV free wall

Where is the SV placed in the RV annulus TDI image

S'

What do you measure in the RV annulus TDI

Rv systolic function

What is s' a measurement of

Greater than 9.5cm/s

What is the normal RV s'

S'

What is 1

E'

What is 2

A'

What is 3

No

Do you measure the e' and a' in the RV annulus TDI

LVOT/AV/aorta colour, LVOT PW, AV CW

What order do you do the A5C images

LVOT, AV, and aorta

What must the colour box be over in A5C colour

Yes

Is some aliasing normal in the A5C AV Colour

Middle of LVOT, 5mm inferior to the AV cusps

Where do you place the PW SV in A5C

3-5mm

What should the gate size be for A5C PW

Slider laterally or dig in indicator

What are some motions you can do to help you be more aligned to the LVOT flow

No

Do you worry about regurge in the LVOT PW

Closing click

Do you want to see the opening or closing click in the LVOT PW

Trace VTI

What do you measure in the LVOT PW

1/4-1/3 from top

Where should the baseline be for the LVOT PW

1.5m/s

What is the upper normal for the LVOT peak velocity

Aliased aortic regurge

What flow is seen between the arrows

AI

What does this CW represent

Slide laterally

What do you have to do to get good alignment for the A5C CW

Alignment

What is an important aspect of getting a good A5C AV CW image

Trace VTI

What do you measure in A5C AV CW

AV peak velocity and AV peak/mean PG

What do you note from the trace VTI in the A5C AV CW

2.0m/s

What is the upper normal of AV peak velocity

10mmHg

What is the upper normal for AV peak PG

5mmHg

What is the upper normal for AV mean PG

Aliasing during systole

How would aortic stenosis show up on colour Doppler

Flow actress the valve during diastole flow back into LV

How would aortic regurgitation show up on colour Doppler

No

Do we care if we are aligned to the LVOT in A5C CW

Above the baseline

If AI is seen with colour, show AI ______ ____ ____________ in CW (in A5C)

If you find pathology

Since we do not normally add spectral to A2C, in what instance would we add them

To keep FR high

Why do we take two separate colour images in the A3C

2.0m/s

What is the upper normal for AV peak velocity

Because it is the same as A5C

Why do we not take spectral in A3C

If it is a better view than A5C

When would we actually take spectral of A3C

Ascending aorta

In the A3C AV colour, you MUST show colour in the ______________________ not just up to the AV