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Get a good on-axis 2D image
What is the first and most important step in doppler
If the valve is leaking or stenotic
What does colour Doppler tell you
Both normal and abnormal flows
What does spectral quantify
Qualitative
What kind of value is colour Doppler
Quantitative
What kind of value is colour Doppler
AV colour and MV colour
What Doppler images do we take in PLAX
TV colour and TV CW
What Doppler images do we take in PLAX TV view
PV colour, RVOT PW, PV CW
What Doppler images can you take in PLAX PV view
No, we take them in PSAX
For the SAIT protocol, do we do the PV view images in PLAX
Towards, red
Normal flow through the aortic valve will travel ________ the probe, do it should be _______
Aortic stenosis and aortic regurgitation/insuffciency
What are we assessing in the PLAX AV colour image
Aortic stenosis
What does AS stand for
Aortic insufficiency
What does AI stand for
Toward the probe, will be red/aliased
What way would flow travel in an aortic stenosis and what colour would this show up as
Away from the probe, will be blue
How would flow travel in AR/AI and what colour would this visualize as
LVOT to AV leaflet tips
What should the colour box in the PLAX AV colour image
Because in the view the MV is pretty much perpendicular to the beam
Why do we not get a lot of colour info and don't do spectral on PLAX MV
Mitral regurgitation
What is the PLAX MV view good at assessing for
Blue jets heading back into the atrium
How does MV regurgitation show up on colour
MR
What are you assessing for when sweeping the MV in PLAX
AR and AS
What are you assessing for when sweeping the AV in PLAX
LA
In the MV PLAX colour image, should the box be more towards the LV or LA
Because this is where regurgitation will show up
Why do we want the colour box more on the LA than the LV in the MV PLAX colour image
Systole
When does mitral regurgitation occur
Because they are eccentric
Why are MV regurgitation rets often seen better with colour Doppler
Systole
When does aortic stenosis occur
Diastole
When does aortic regurgitation occur
Regurgitation
What is the most common thing we assess for on colour Doppler of the Tricuspid valve
True
T/F: the tricuspid valve is aligned close to 0 degrees so we usually get lots of colour flow through it
Away from the probe, will be blue
How is the flow in tricuspid regurgitation flowing and what colour will it show up as
Systole
When does TR occur
TR
What are we assessing for when sweeping the TV
Flow from the IVC
What is the red flow in the bottom of the screen in this TV PLAX view
True
T/F: flow is not 100% laminar in the heart and you may get some splash back in low velocity when the valve closes, but this is perfectly normal
TV stenosis is uncommon and do not quantify normal function
Why is PW not normally done on the TV PLAX image
Quantify TR
What is the main purpose of the TV CW image
Peak TR velocity
What do we measure on TV CW PLAX image
Below the baseline
Where will TR show up on CW trace
Pressure in right heart and lungs
What else can peak TR velocity tell us, besides quantifying TR
RVSP
What equation do we use the peak TR velocity found in CW
RVSP = 4 (peak TR vel)^2 + RAP
What is the equation for RVSP
Subcostal view
What is RAP in the RVSP equation found in
True
T/F: RVSP is an extremely important calculation that we use in every patient
Right ventricular systolic pressure
What does RVSP stand for?
Middle of TR jet or TV if no jet seen
Where is the cursor aligned in for the PLAX TV CW image
1/4-1/3 down from the top
How is the baseline placed in TV CW
240cm/sec
What is the scale set for TV CW
Because that is where TR commonly peaks
Why is the scale set to 240 for TV CW
Lost info
What can happen if the spectral gains are too dark
Over estimation
What can happen if the spectral gains are too bright
False, one done when patient has a jet with a parabolic shape
T/F: peak TR is done when on any patient that has even a trace of TR
Less than 35mmHg
What is the normal RVSP value
Centered at the peak TR velocity
Where is the calliper placed for TR
True
T/F: any RVSP value above 35mmHg is concerning
Increasing reject
How can the beard effect be minimized
True
T/F: occasionally, some background noise is required to see the TV CW waveform more clearly
28
Usually, if you get a TR jet velocity of ____ or more the RVSP is most likely abnormal
M/s
What unit does the peak TR velocity have to be in for the RVSP calculation
3
Usually, the RAP is at least _____ mmHg
True
T/F: any images or measurements of the PV in PLAX can also be done in PSAX
Blue
Which line of this TR jet should be measured
Note 
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