Sanjay: MV questions

The normal MV:

a. Is made up of two leaflets each with three lobes or scallops

b. Is in continuity with the AV via the anterior leaflet

c. Is more apically positioned than the TV

d. Is the most posterior valve seen in the parasternal long-axis view

e. Is attached to the papillary muscles by the chordae tendineae

a. True – MV has anterior and posterior leaflets

b. True – Anterior MV leaflet is in fibrous continuity with the aortic valve.

c. False – The tricuspid valve is more apically positioned.

d. True – MV is the most posterior valve in PLAX.

e. True – Chordae tendineae attach leaflets to papillary muscles."

The normal MV: a. two leaflets each with three scallops b. continuity with AV via anterior leaflet c. more apically positioned than TV d. most posterior valve in PLAX e. attached to papillary muscles by chordae tendineae a. True – anterior & posterior leaflets each have three scallops b. True – anterior leaflet is in fibrous continuity with AV c. False – TV is more apically positioned d. True – MV is most posterior valve in PLAX e. True – chordae attach leaflets to papillary muscles

Recognised causes of mitral regurgitation: a. infective endocarditis b. MI c. myxomatous leaflets d. rheumatic disease e. LV dilatation a. True – leaflet/chordal destruction b. True – papillary muscle dysfunction/rupture c. True – leaflet prolapse d. True – leaflet thickening/dysfunction e. True – annular dilatation (functional MR)

In the parasternal views: a. PISA optimally imaged b. jet direction identified c. E/A waves measured d. MVP less accurate than apical 4C e. annular calcification identified a. False – PISA best in apical 4C b. True – jet direction visible c. False – E/A need apical PW Doppler d. False – PLAX is best for MVP e. True – annular calcification seen

True statements about MR: a. apical 4C & PLAX best qualitative views b. LA dilates in chronic MR c. posterior leaflet prolapse causes posterior jet d. EF increases in acute MR e. broad-based jet indicates severity a. True b. True c. False – posterior leaflet prolapse causes anterior jet d. True – dual outflow increases EF e. True – broad jet suggests severe MR

Vena contracta in MR: a. narrowest jet diameter b. useful in eccentric jets c. independent of flow/LV pressure d. best in apical 2C e. >0.7 cm severe MR a. True b. True c. True d. False – apical 2C may overestimate e. True

MR PISA case (r=1.1 cm

Va 35 cm/s

Findings suggesting severe MR: a. RV 50 ml b. ROA 0.5 cm2 c. PV systolic flow reversal d. eccentric jet e. low-density CW >4 m/s a. False b. True c. True d. False e. False

Complications of severe MR: a. systolic anterior motion b. pulmonary hypertension c. absent A wave d. slow CW rise e. RWMA a. False b. True c. True d. True e. False

True statements about MR: a. PV systolic reversal may be absent if LA dilated b. RF 25% moderate MR c. not subject to Coandă effect d. 50% LA jet = moderate MR e. prominent E waves a. True b. False c. False d. False e. True

Mitral valve abnormalities: a. leaflet perforation implies ischaemia b. posterior leaflet best in apical 2C c. Marfan causes redundant anterior leaflet d. cleft MV resembles TV e. MVP always causes MR a. False b. False c. True d. True e. False

The normal MV: a. two leaflets each with three scallops b. continuity with AV via anterior leaflet c. more apically positioned than TV d. most posterior valve in PLAX e. attached to papillary muscles by chordae tendineae

a. True – anterior & posterior leaflets each have three scallops b. True – anterior leaflet is in fibrous continuity with AV c. False – TV is more apically positioned d. True – MV is most posterior valve in PLAX e. True – chordae attach leaflets to papillary muscles

Recognised causes of mitral regurgitation: a. infective endocarditis b. MI c. myxomatous leaflets d. rheumatic disease e. LV dilatation

a. True – leaflet/chordal destruction b. True – papillary muscle dysfunction/rupture c. True – leaflet prolapse d. True – leaflet thickening/dysfunction e. True – annular dilatation (functional MR)

In the parasternal views: a. PISA optimally imaged b. jet direction identified c. E/A waves measured d. MVP less accurate than apical 4C e. annular calcification identified

a. False – PISA best in apical 4C b. True – jet direction visible c. False – E/A need apical PW Doppler d. False – PLAX is best for MVP e. True – annular calcification seen

True statements about MR: a. apical 4C & PLAX best qualitative views b. LA dilates in chronic MR c. posterior leaflet prolapse causes posterior jet d. EF increases in acute MR e. broad-based jet indicates severity

a. True b. True c. False – posterior leaflet prolapse causes anterior jet d. True – dual outflow increases EF e. True – broad jet suggests severe MR

Vena contracta in MR: a. narrowest jet diameter b. useful in eccentric jets c. independent of flow/LV pressure d. best in apical 2C e. >0.7 cm severe MR

a. True b. True c. True d. False – apical 2C may overestimate e. True

MR PISA case (r=1.1 cm

Va 35 cm/s

Findings suggesting severe MR: a. RV 50 ml b. ROA 0.5 cm2 c. PV systolic flow reversal d. eccentric jet e. low-density CW >4 m/s

a. False b. True c. True d. False e. False

Complications of severe MR: a. systolic anterior motion b. pulmonary hypertension c. absent A wave d. slow CW rise e. RWMA

a. False b. True c. True d. True e. False

True statements about MR: a. PV systolic reversal may be absent if LA dilated b. RF 25% moderate MR c. not subject to Coandă effect d. 50% LA jet = moderate MR e. prominent E waves

a. True b. False c. False d. False e. True

Mitral valve abnormalities: a. leaflet perforation implies ischaemia b. posterior leaflet best in apical 2C c. Marfan causes redundant anterior leaflet d. cleft MV resembles TV e. MVP always causes MR

a. False b. False c. True d. True e. False