which of the following is critical for a proper acquisition of complete cardiac cycles in digital imaging
a high quality EKG signal<\/p>\n\n\n\n
a patient presents with a clinical history of stable angina.what medication is most likely to be listed in her chart that is related to this clinical history
nitroglycerin<\/p>\n\n\n\n
a three lead EKG is used for resting echocardiography where are the electrods placed
under the right and left clavicle at the mid-clavicular line and on the lower left abdomen within the rib cage frame<\/p>\n\n\n\n
the American heart association recommends that a rescuer try to perform at least_______________compressions per minute on a child or infant
100<\/p>\n\n\n\n
when transporting a patient in a wheelchair with an IV bag
you should always transport the IV bag above the level of the patient’s heart<\/p>\n\n\n\n
which of the following describes the best patient position for obtaining the Supraternal notch view
suspine with neck extended<\/p>\n\n\n\n
which of the following describes the correct method of needle insertion for an intravenous catheter prior to a dobutamine stress echo
position the needle as parallel to the skin as possible when puncturing vein<\/p>\n\n\n\n
a patient is referred for an echo due to a history of osler Weber rendu syndrome which of the following exams would best evaluate the cardiovascular abnormalities related to this syndrome.
saline contrast echo<\/p>\n\n\n\n
if there is a weak signal and significant fluctuation in the vertical position of the EKG tracing across the screen
the skin contact with the electroids is poor<\/p>\n\n\n\n
which of the following is not the proper procedure for disinfection of instruments between patients
all needles used in. cardiocentesis procedures should be sent out for sterilization after each use<\/p>\n\n\n\n
an EKG performed during an echocardiogram requires the use of three leads which of the following is not a standard location for lead placement
right leg<\/p>\n\n\n\n
which of the following patients would need a guardian to sign an informed consent form for a pericardiocentesis
a patient with Alzheimer’s disease<\/p>\n\n\n\n
which of the following can increase the risk of a vasovagal response to contrast injection
drink a caffeinated drink the day of the exam<\/p>\n\n\n\n
which of the following describes the proper explanation of a 2d echo exam to a female patient
you will tell her that the exam uses ultrasound waves that are not harmful to look at the size and function of the heart at rest<\/p>\n\n\n\n
preparing for a microbubble contrast echo to evaluate the left ventricle requires all of the following except
explain to the patient that the contrast is sailing based and presents no risk of allergic reaction<\/p>\n\n\n\n
for the best results when performing a dedicated CW Doppler evaluation of the aortic valve with the probe located along the right sternal order the patient should be placed in the
right lateral decubitus position<\/p>\n\n\n\n
which of the following statements is false regarding requirement preparation for beginning and ultrasound exam
always place the cord around your neck or shoulder to avoid dragging the cord across open stores wounds or ulcers during the exam<\/p>\n\n\n\n
which of the following task is not normally performed prior to the start of the echo exam
offer treatment options<\/p>\n\n\n\n
what patient parameters are required to calculate the body surface area
height and centimeters in weight in kilograms<\/p>\n\n\n\n
the universal precautions standards were created by which of the following organizations
Center of disease control<\/p>\n\n\n\n
a patient presents for an echo and the order does not list an indication for the exam you review the chart for the patient history to locate an appropriate indication for the echo which of the following is an appropriate indication to perform an echo
lab work that demonstrates the presence of staphylococcus aureus<\/p>\n\n\n\n
which of the following items should be available in the echo room for a patient who is suffering from anaphylactic response caused by a contrast injection
hydrocortisone<\/p>\n\n\n\n
transesophageal transducers are considered __________devices that should be disinfected using____________<\/em><\/strong><\/em><\/strong> the American heart association recommends compressions and breaths are used in single rescuer or daughter CPR a patient presents for an echo following a recent cardiac MRI that demonstrates egg shell calcification of the pericardium what cardiac abnormality will most likely be identified on the echo why would a cardiologist request a t e e exam on a patient before performing a synchronized cardiovision for chronic atrial fibrillation which of the following is not a required part of an informed consent form if you set the game to the lowest level and slowly increase it until an echo is identified on the image what are you evaluating on the ultrasound system which of the following statements is true regarding damage to the matching layer of the transducer you are performing a resting echo with contrast for wall motion evaluation just after the injection of microbubble contrast the patient complains of feeling short of breath and their face appears to be flushed the heart rate on the EKG is 117 BPM which of the following correctly describes their symptoms which of the following describes an important reason to verify the US examination that is ordered is the exam that should really be performed which of the following is an inappropriate reason to contact the physician to request cancellation of a treadmill stress test for a patient which of the following is an absolute contraindiction for a stress echo which of the following describes the expacted procedure to verify you have the proper patient for the requested exam what type of precautions is required for patient that had a renal transplant yesterday if a patient takes a beta blocker the morning of their stress echo which of the following correctly describes the best patient position for performing a transesophageal echo if a patient has a pacemaker in the left chest where is the electrode for the left arm placed for a three lead EKG a 76-year-old female with diabetes htn and COPD is sent to the vascular lab for a 6-month follow-up on a aortic stenosis what is the best patient position to use for the exam which of the following is the responsibility of the sonographer before the transthoracic echo exam begins according to American heart association guidelines where do you place your hands to perform abdominal thrust on a conscious female who is 36 weeks pregnant and is choking all of the following tasks are normally performed prior to the start of the echo exam except which of the following best describes the primary reason why the te probe are soaked in a disinfectant for a specific amount of time you are reviewing prior reports for today’s exams and note that one of the patients just had a echo for months ago when the patient arrives he states that he has no new symptoms but was told to come for a follow-up exam by his referring doctor the only finding on the prior exam was aortic insufficiency with a pressure have time of 230 milliseconds which of the following should you do next when placing the electrodes on a patient for a 12-lead EKG for a stress echo the electrodes for V1 and V2 are placed what is benzoin tincture used for a patient presents for an echo and the order does not list an indication for the exam you review the patient history in the chart to locate an appropriate indication for the echo which of the following is an appropriate indication to perform an echo which of the following information should be never be entered into the ultrasound system as identifying information when using an automated external defibrillator on a patient in ventricular fibrillation the protocol by the American heart association is which lab values are most important for the physician to review prior to scheduling a pericardiocenthesis which of the following transducers can be used to safely scan the patient when placing the electrodes on a patient for a 12-lead EKG for two a stress echo the electrode for a left leg is placed which of the following describes how to obtain the diastolic systemic blood pressure which of the following is a responsibility of the sonographer assisting with a pericardiocentesis infection control procedures and precautions utilized for all patients are collectively referred which of the following is not an expected symptom of a vasovagal response a patient presents for an echocardiogram that is 63 and 320 lbs which transducer would be the best transducer to use to perform the echo you notice the cord of the echo transducer is slightly separated from the back of the probe which of the following describes the appropriate action to take next you arrive at the hospital to start your shift at 7:00 a.m. and there are numerous orders for patients exams there is a stat echo in the ER due to chest trauma is that echo in ICU for severe pulmonary htn pre ventilator assessment an echo ordered on the third floor for suspected CHF and t e e for pre-op for a mitral valve replacement at 10:00 a.m. which of the following lists the proper order to perform these exams based on exam indication in physician requests which of the following drugs should be immediately available in case of an anaphylactic reaction when performing a contrast echo a patient presents for suspected loeffler endocarditis which of the following related information should you look for in the charts that would support the diagnosis which of the following is a common symptom of anaphylactic reaction to contrast media patience having a t e e or stress echo the ultrasound system relies on the ____________for accurate recording of the motion clips on an echo which of the following must be reviewed on a prior echo when following the progression of aortic stenosis what type of precautions is required for a patient with MRSA why can’t tea eat pros be thermally sterilized which of the following statements is correct regarding inspecting a TEE probe for a potential electrical hazard which of the following patients would benefit the most from a te exam which of the following lab tests should be performed regularly for a patient with a star Edwards valve if a patient experiences significant left-sided trepapnea how will this change how you perform the echo exam when placing the electrodes on a patient for a 12-lead EKG for to a stress echo the electrode for left arm is placed which of the following is true regarding hand washing recommendations in the standard precautions guidelines which of the following would be a contradiction for using only amyl nitrate to evaluate MVP which of the following items is not part of a standard patient history required prior to an echocardiogram Mitral Valve prolapse and Aortic dilation Ischemic Heart Disease 3 mm 4 infiltrative Diastolic VSD Positioning the tdx in too high an intercostal space rheumatic mitral stenosis bovine, equine, or porcine valve pericardial effusion may not be present less than 0.06 seconds after MV closure coronary artery aneurysm pulsed doppler fossa ovalis region of the atrial septum apical 5 and apical long axis view constrictive pericarditis low CO pressure half-time apical 4 Aortic Insufficiency be higher following long R-R intervals reversal in color aortic insuffiency MV prolapse ASD and bicuspid AV an infected MV Aneurysm formation damped TV subcostal 4 chamber be continuous wave LA enlargement and signs of pulmonary hypertension LVH left ventricular dimension changes abnormal wall motion myocardial infarction T wave Tricuspid regurgitation Aortic insufficiency Calcified mitral annulus Mitral stenosis narfans check LV size post valvuloplasty Right ventricular systolic pressure severe MR pulmonary venous flow Carcinoid causing restrictive diastolic filling AI because of the coronary arteries atrioventricular sulcus Tricuspid Regurgitation sit them up pulmonic Valvular areas gender apical infarction AI high MI 40 cc hypovolemia (pulmonary hypertension, caridac tamponade, TS all do) Right ventricular increase pleural effusion (pericardial effusion, AS, hypertrophic can) 4th fusiform apical infarction MV close AV closure AV open MV open retrograde Eustachian R to L tricuspid Trabiculation irregularly upstream pericardium and epicardium Blood stasis TTE True low LVEF TEE True 0.5-2.0 cm Systole subcostal With inspiration, RV filling velocities are _ while LV filling velocities are _<\/strong><\/p>\n\n\n\n true Severity of tamponade is detrmined by<\/p>\n\n\n\n chaotic 3\/4 true renal cell carcinoma true true lipoidoma papillary fibroelastoma myxoma Angiosarcoma, Mesothelimas, Myxoma pericarditis true Large E, small A RA 25mm\/sec true LV thrombus true true 1-2 beats true true Constrictive Pericarditis true False Age and pannus growth true PLAX midsystolic click and\/or late systolic murmur ischemic heart disease 3 mm akinetic Infiltrative VSD Ostium secundum RCA Which Aortic leaflet is the superior one in the PSLA Name the tricuspid leaflets The coronary arteries come off of the.. Name the vessels coming off the arch and the most proximal or distal. What cardiac pathology is associated with bicuspid aortic valves? Where do the most aortic Coarctation occur? Where are the pulmonary veins loca? Which ones are seen in this view? Where is the coronary sinus located? To visualize the coronary sinus in the apical 4 chamber view you should tilt the transducer.. During which phase do the coronaries fill? Where is the chiari network located? What portion of the pulmonary venous PW Doppler represents atrial systole? Know frequency for TEE probes versus TTE At what temperature is it unsafe to use a TEE probe? Know TEE views by esophageal level (know mid esophageal- ME and transgastric) and degrees. Why is the SA node the primary pacemaker? The save of contraction (depolarization) moves from the endocardium to the epicardium. What is the absolute refractory state? Know what P wave, P-R interval, T wave represents What is the normal duration for the QRS complex? Frank-Sterling Law Acute AI is hypercontractile because we shift up the Starling curve Does a PDA (patent ductus arteriosus) increase LV preload? Echo finding for preload vs. afterload\u2026 Which study does not allows for the calculations of ejection fraction? Does venous return increase or decrease with inspiration? Mitral valve velocity during inspiration increases or decreases? Hepatic venous flow reveral indicates _<\/em><\/strong> TR. Given a TR velocity of 4.0m\/sec what is the RVSP? A patient has a RVSP of 60mmHg. One year later the RVSP is 30mmHg. What happened to the pt? Coanda Effect- Define. Pulmonary venous systolic flow reversal is.. Which of the following is used in echo to measure dP\/dt? dP\/dt measurement of mitral regurgitation assesses what? __<\/strong> is the rate of rise of LV pressure? LAP= Know pressure waveforms for MR (late systolic jump in LA pressure) pg. 97 Know about Marfan’s syndrome.. define In Marfan syndrome, why does aortic dissection and MVP occue? Know Ehlers-Danlos. Another connecative tissue disorder Severe Ao aneurysms are greater than: Know libman-sachs= St. Jude is a __<\/em><\/strong> valve Autografts Pannus What are all the cardiomyopathies? Which cardiomyopathy is autosomal dominant? Apical Hypertrophic Cardiomyopathy (AHCM) Ratio for assessing asymmetric hypertrophy. LVOT obstruction cuases the aortic valve to\u2026 Pts with a history of IV drug abuse may present with\u2026 The Venturi Effect can be associated with which cardiomyopathy? Dos Inderal (beta blocker) increase SAM? Chaga’s disease (Dilated CM)? Know the echo signs of congestive cardiomyopathies: What type of CM might you see in a pt with AIDS? Know post-transplant 2-D appearance.. Amyloid and sarcoid are what type of cardiac abnormalities? Hemochromatosis is\u2026 “Ground glass” appearance is related to\u2026 (pg. 123) Amyloid LAX- PV inflow will have _<\/strong> systolic velocity A restrictive CM has which of the following? A typical ejection fraction in a dilated MC pt might be (for a HCM pt) The majority of ventricular filling occurs during\u2026 If a pt has a normal MV inflow but Pulm veins showed a decreased S-wave and D-wave, consider that they might have a _<\/strong><\/em><\/strong> pattern. A pericardial effusion can often be seen in patients with\u2026 Pericardial Effusion Grading Criteria: Small? Med? Large? Where does the oblique sinus of the pericardium lie? Beck’s Triad? 3 options: The most sensitive way to diagnose cardiac tamponade is: What cardiac condition would prevent diastolic right ventricular collapse? Patients in tamponade cannot _<\/em><\/strong> flow variation in tamponade can get a false positive if: What other pericardial abnormality also causes impaired ventriular filling? A huge, dilated PA, severe TR and RV enlargement best describes: What is represented with a decreased “a” wave and a flying W? Decreased ‘a’ wave means.. Your pt has PHTN with a dilated IVC (3cm) which collapsed 50% with sniff. Estimated the RA pressure: What is the most common (mechanical) complication of an MI. Which occurs first in the setting of severe mitral regurgitation due to a flail leaflet? What type of MI causes a muscle rupture? Definition of Ischemia The most common location for speudoaneurysm is.. does the wall of a pseudoaneurysm contain endocardium? What information do you need pre-op in a patient with LV aneurysm? Color Doppler in ischemic disease can be good for? What do you look for in a pt with Kawasaki Disease? Which of the following terms refers to a decrease in wall motion? What is the IVS motion in a patient with LBBB? From where do the coronaries originate? What is meant by “right dominance”? Which coronaries supply the interatrial septum? Which coronary artery feeds the inferoseptal wall? Which drug is used in Nuclear Stress Test? What would be a containdication to performing a stress test on an athlete with chest pain? Dobutamine provides all the following except responses EXCEPT increasing: What is the most common type of ASD? Partial anomalous pulmonary venous return is seen in with what type of ASD? Which is the best view to diagnose a sinus venoses ASD? Best view to demonstran an ASD? If you see an anechoic dropout of the interatrial septum in the aprical 4ch view what should you do? What is the standard echo view for contrast studies of an ASD? How many beats to see contrast on the L side in a patient with an ASD? (with a pulmonary shunt) Where should contrast be injected in order to diagnose a persistent left superior vena cava? Endocardial cushion defects (AV septal) are associated with: Supracristal location is: Inlet location Which is the most common type of VSD? Calculate the RVSP in a patient with 5m\/sec VSD jet and BP of 130\/80 (beware of distractors like RA pressure!) What congenital abnormality has a displaced TV? If a large PDA is not corrected what might develop? Patent Ductus Arteriosus: Which is the following is NOT a TET defect? Blood follows the path of less resistance. _ reverses the __<\/em><\/strong>. What part of the heart is most likely to be affected by cardiac contusion? What might be the first indication of metastatic cardiac disease? Which cardiac chamber is most likely involved with metastatic tumors? The most common benign tumor on the aortic valve is: Myxoma Where are most fibroelastoma found? __<\/em><\/strong> is the most common benign tumor in children (slow growing) Symptoms mimic mitral stenosis LA Myxoma are usually attached where Which triculspid leaflets are seen? Where is the LAA on TTE? What cardiac pathology is an associated with bicuspid aortic valve? In PLAX, which TV leaflets are seen? \\n The coronary Arteries come off the? \\n What is the structure under the arch? \\n The formula for calculating EF is: \\n Stroke Volume \\n The LA dimension is measured on M=mode during? \\n Where are the pulmonary veins located? \\n How do you bring in the RVIT in PLAX? \\n How do you bring in the RVOT in PLAX? \\n Where is the Chiari Network located? \\n Where is the aortic isthmus located? \\n The __<\/em> is the most anterior chamber of the heart? \\n Pulmonary artery is ,<\/strong><\/em><\/strong> \\n The Eustachian valve is located in the? \\n Can you see the moderator band in the PLAX? \\n Where does the moderator band extend? \\n Spontaneous chordal rupture more often occurs on which leaflet of the Mitral Valve? \\n The heart tube normally loops? \\n Where is the coronary sinus located in relation to the descending aorta \\n How would you angle to view the coronary sinus in the apical four chamber view? \\n Why is it important to know the location of the coronary sinus and the descending aorta? \\n What is another name for the RVOT? \\n Where is the coronary sinus located in the parasternal long axis view? \\n What would cause the coronary sinus to become dilated? \\n Describe the anatomy of the tricuspid valve, including the name and location if each leaflet. \\n Name and describe two main layers of the pericardium? \\n Name the three major coronary arteries. \\n The heart tube loops at day ___<\/em> \\n The AV canal is a large communication between the __<\/strong><\/em> and<\/strong> \\n The __<\/em><\/strong> divides the AV canal into right and left AV orifices \\n The ductus arteriosus closes after birth due to increased systemic pressure and becomes the _<\/em><\/strong> \\n What are the two Right to Left shunts in the normal fetal circulation? \\n Following electrical depolarization of the myocardial cell membrane, which ion rushes in first and which ion rushes in later? \\nWhere is a subaortic membrane (DSS) located? Tricuspid Valve leaflets seen in the PSAX-Aortic valve Name the cardiac walls supplied by each of the coronary arteries. Left anterior descending artery – LAD Circumflex artery What walls do the LAD supply? What walls do the CX supply? \\n\\nWhat walls do the Posterior descending artery supply? The LAD lies in the _<\/em><\/strong> interventricular sulcus? walls and coronary artery circulation on PLAX?.<\/p>\n\n\n\n walls and coronary artery circulation on PSAX?<\/p>\n\n\n\n walls and coronary artery circulation A4?<\/p>\n\n\n\n walls and coronary artery circulation Apical 2 Ch?<\/p>\n\n\n\n The circumflex artery supplies? The Posterior descending artery ( of the right coronary artery) supplies? The anterior septum and anterior wall of the Left Ventricle is supplied by the? \\n\\nThe anterolateral, lateral and inferolateral walls of the Left Ventricle are supplied by the? The inferior wall of the Left Ventricle and inferior septum are supplied by the? The cardiac apex is supplied by the? Which coronary artery provides blood to the Right Ventricle? Which coronary artery provides blood to the inferior septal walls in right dominant? Which walls of the left ventricle are seen in the parasternal and apical long axis views Which two aortic valve leaflets are seen in these views? Where are the coronary arteries located on the surface of the heart? Complications with MI?<\/p>\n\n\n\n While scanning a 43 old man with history of an old myocardial infarction, you notice at the anterior cardiac wall is akinetic. Which coronary artery is most likely to have been involved in the infarction? In the apical 4 ch view of another patient, the distal ventricular septum and left ventricular apex are hypo-contractile. Which coronary artery is most likely to be diseased? To visualize the inferior lateral wall the left ventricle, which 2D view would you use? The normal intracardiac pressure for the Right Atrium is? The normal intracardiac pressure for the Right Ventricle is? The normal intracardiac pressure for the PA is? The normal intracardiac pressure for the Left Atrium is? The normal intracardiac pressure for the Left Ventricle is? The normal intracardiac pressure for the Aorta is? Describe the normal mitral valve anatomy Which aortic leaflet is the superior one in the parasternal long axis view? During which phase do the coronaries fill? Inhalation of amyl nitrite causes? When is Left Ventricle pressure the lowest? Which type of mitral deformity occurs where there is only ONE PAPILLARY MUSCLE into which both chordae insert\\nOR insertion of mitral chord into a single papillary muscle? Which is the most common chamber for a sinus of Valsalva aneurysm to rupture into? Systolic flow reversal of bubbles in the IVC is indicated of Tricuspid Regurgitation or tamponade? Which of the following is used in echo to measure dp\/dt? What is beck’s triad? A huge, dilated PA, severe Tricuspid Regurgitation and Right Ventricle enlargement best describes? The size of aneurysms during systole: What is the most common (mechanical) complication of an MI. Which of the following occurs first in the setting of severe mitral regurgitation due to a flail leaflet? What type of MI causes papillary muscle rupture? From where do the coronaries originate? Which coronary supplies the Interatrial septum? Which coronary artery feeds the inferoseptal wall? What would be a contraindication to performing a stress test on an athlete with chest pain? Know that Atropine may be given at peak dose if the target heart rate is not reached. Calculate the RVSP in a patient with 5m\/sec VSD jet and BP of 130\/80 If your patient has a dilated Left Ventricle and thin septum what might be going on with this patient? Which view shows the coronary sinus in long axis? Where does the left anterior descending coronary artery originate? Are right-sided pressures elevated with a Valsalva maneuver? Which clinical finding is associated with a friction rub? What does the sinus venous turn into? In normal development which is the last to close? What is Qp\/Qs? What are the Qp\/Qs for an ASD?<\/p>\n\n\n\n 1 for left to right shunt \\n< 1 for right to left shunt<\/p>\n<\/blockquote>\n\n\n\n In patients with A-fib which heart sound would be missing? How do you position a patient for using a Pedoff probe along the right sternal border? A 52 year old woman develops a murmur after a myocardial infarction. What is the most likely etiology? When Transporting a Patient with a Urinary Catheter the bag should always be ? A 52 year old women developes a murmur after a myocardial infarction. What is the most likely etiology? Which of the following choices would not be used to correct for pulced wave doppler aliasing? How do you position a patient for using a Pedoff probe along the right sternal border? A patient with down syndrome is referred to your lab for an echo. Which of the following cardiac defects would you likely find? During a pharmacological echo stress test using Dobutamine which drug is given if the patient dosnt reach target heart rate? How do you position a patient for a TEE exam? If you measure the LVOT too big how will this affect your measurement for the aortic area? A patient with AIDS ( acquired Immune Deficiency Syndrome) might present with what type of cardiomyopathy? A 3 year old patient comes to the lab with a systolic murmur. what is the most likely etiology? In a patient with COPD which frequency transducer would most likely result in the best images? Which is the best stress echo technique for revealing hibernating or stunned myocardium? You are in the emergency department and a patient presents with the signs and symptoms of aortic dissection. which modality would give you the most rapid diagnosis? which is the proper term when the pulmonic valve is removed and put in place of the aortic valve in the same patient? Know that pericarditis (pericardial Effusion) can present with positional chest pain. what is the 1st structure seen when imaging from the suprasternal notch? which of the following drugs is used in Nuclear stress test? which of the following is the most important echo to do? At what time during fetal growth is the heart first fully developed? on the 3oth day, the trunks normally divides. what anomaly occurs if the truncus does not divide? The sinus venosus forms all of the following except: The truncus ateriosus forms all of the following except: what are the two right to left saints in the normal fetal circulation? which of the following left to right shunts is the last to close in the normal post partum period? when does it close ? in the normal fetal circulation, which of the following has the least amount of blood flow? all of the following hemodynamic events occur post delivery except: The fetal ductus arteriosus closes soon after birth. what structure does it become? The ductus arteriosus connects the pulmonary artery and aorta in the fetus. at what site does the ductus attach to the aorta? the following five structures are activated during a single cardiac cycle. Rank them in the normal order of activation. which of the following structures is the primary pacemaker of the heart? During the resting state, which of the following ions are pumped out of the cells of the myocardium? Following electrical depolarization of the myocardial cell membrane, which ion rushes in first, and which ion rushes in later? which of the following helps slow heart muscle contraction? in the cardiac cell action potential, what phases are included in the absolute refractory period? when contraction against which of the following pressures will the velocity of muscle cell contraction be more rapid? what happens to the beat following a premature ventricular depolarization ? what is the Frank sterling Law? which of the following best describes preload? all of the following tend to increase preload except: what best describes afterload? all of the following tend to increase after load except? what is the predominant echo findings associated with increased after load? what is the predominant echo finding associated with increased preload? Afterload equals : Preload equals : a patients blood pressure is 120\/80mmHg, stroke volume is 80mL,R-R interval is .86, heart rate is 70 beats\/min, and age is 42 years. what is the patients cardiac output? Cardiac output= In the normal circulation, what is the value of the Qp\/Qs ratio? In a patient with a VSD, which of the following sites will provide a measure of pulmonic flow? which of the following best describes a patient with sever MR? Heart muscle beats automatically, without outside stimulation, the rate that the heart naturally contracts is called the inherent rate. which of the following terms has the same meaning as inherent? At what time during fetal growth is the heart fully developed? on the 30th day, the truncus normally divides. what anomaly occurs if the truncus does not divid ? The Sinus venosus formal all of the following except The truncus arteriosus forms all of the following except What are the two right to left shunts in the normal fetal circulation? In the normal fetal circulation, which of the following has the least amount of blood flow? fetal ductus arterioles closes soon after birth. what structure does it become? which of the following is the primary pacemaker of the heart All of the following are cardiac responses to increase sympathetic stimulation except: Stimulation of the vagus never will result in during the cardiac cycle, which valve event most closely follows the p-wave on the EKG? what hemodynamic event follows the p-wave on the EKG? What hemodynamic event follows the R-wave on the EKG? During the cardiac cycle, which valve event most closely follows the R-Wave on the EKG? During the cardiac cycle, which valve event most closely follows the T-wave on the EKG? What hemodynamic event follows the T-wave on the EKG? Which TWO of the following pressures allows for the evaluation of AS? Which TWO of the following allows for the evaluation of mitral stenosis? Which TWO of the following pressures allows for the evaluation of pulmonic stenosis? Which TWO of the following pressures allows for the evaluation of tricuspid stenosis? T or F: The hemodynamic evaluation of MR is performed during diastole T or F: The hemodynamic evaluation of aortic stenosis is performed during diastole? T or F: The hemodynamic evaluation of tricuspid stenosis is performed during diastole T or F: The hemodynamic evaluation of pulmonic regurgitation is performed during diastole Which of the following flow patterns is most likely to be longest? What valve closures are associated with the first heart sound ? what valve even is associated with the second heart sound? Which of the following grades represents a murmur that is most faint? A thrill is most like associated with which of the following murmurs? T or F: A crescendo-decrescendo murmur is quite often associated with a stenosis What is a typical or normal value for hematocrit? T or F: Mean right Atrial pressure is less than mean left atrial pressure what is a typical value for mean left atrial pressure what is a typical value for mean right atrial pressure? What is the normal O2 saturation of the blood in the pulmonary artery? what is the normal O2 saturation of the blood in the pulmonary vein? where is the oxygen saturation of blood the lowest ? T or F: the size of a color flow jet is always related to the volume of blood creating the jet. During systole, the aortic and LV pressure are quite different. what is this fin find indication of? During diastole, the RA pressure is much higher then RV pressure, what does this indicate? Sinus bradycardia is defined as a heart rate less then 60bpm. How do the R-waves appear on the EKG? Sinus tachycardia is defined as a HR more then 100bpm. How do the R-waves appear on the EKG? A patient has an EKG with five premature ventricular contractions in succssion. what is this called? Three vessels branch off of the aortic arch. Put them in order, closest to the aortic valve first. Most coarctations of the aorta occur after the take off of which of the following vessels? what is the minimum length of time that echo records need to be kept ? Normally, how much fluid is found in the pericardial sac? Which is key EKG feature of Wenckebach What do the Coronary Arteries arise from? During which phase do the coronaries fill? What Cardiac pathology is associated with bicuspid aortic valve ? which window do you use to look for the secondary finding in bicuspid valves? where do most aortic carctations occur? From an apical 4ch view how do you rotate the transducer to obtain an A3? What two walls are you seeing of the LV in the apical 2 chamber view? Where is the coronary Sinus located? To visualize the coronary sinus in the apical 4 chamber view you should tilt your transducer \u2026. which valve sits at the opening of the coronary sinus? What portion of the pulmonary venous PW Doppler represents atrial systole? At what temperature is it unsafe to use a TEE probe? AV Node Which has the fastest intrinsic rate? What is the absolute refractory state? P wave P-R interval QRS complex T wave what is the normal duration for the QRS complex Frank-Starling Law ( length- tension relationship) Increase volume (preload) Increase myocardial fiber length (after load) Increased preload Preload = after load = EF= (normal >55%) CO= (normal 4-6L\/min) How do you eliminate aliasing on PW spectral Doppler? When does aliasing occur? The Nyqvist Limit= How is VTI calculated ? Normal VTI for MV and AOV What does VTIxCSA equal ? Does venous return increase or decrease with inspiration? Inhalation of amyl nitrite causes? Mitral valve velocity during inspiration? Cardiac cycle Isovolumic contraction isovolumic relaxation On the wiggers diagram when is the MV open What is the duration of IVRT and IVCT COCO when the Aortic valve is open: Pulmonary Hemodynamics Systemic Hemodynamics blood components What is the normal pressure in the pulmonary artery? Normal pressure in the RA Normal pressure in the LA Where is the O2 saturation the lowest ? O2 saturation of the pulmonary veins O2 saturation of the pulmonary arteries Best cath technique for Left Ventricle function? What is PCW(pulmonary capillary wedge) measuring ? SEP (systolic ejection period) To determine AS where are catheters placed ?<\/p>\n\n\n\n High gain destroys: low frequency high frequency Fundamental Imagining Harmonic imaging Tissue harmonic imaging Apical swirling of echo contrast for LVO is caused by Attenuation of contrast A secondary finding in aortic stenosis is? In Aortic stenosis is pulse pressure wide or narrow ? Aortic jet velocity Aortic mean gradient AVA The best view to diagnosis a bicuspid aortic valve is the parasternal: What is a common symptom for aortic coarctation What is the best view for detection subvalvular membranes What is Takayasu arteritis? Normal Aortic valve area When does VTI Work better ? Using the continuity equation when would the severity of Aortic Stenosis be underestimated? When do you measure LVOT Which pressure is obtained during Doppler? Know that echo gradients are usually higher than cath gradients. Noonan Syndrome Does PS cause Pulmonary hypertension? Asked if unable to obtain PS gradient from the parasternal window where else can you go? MS murmur= Which cardiac valve is the second most common to be affected by rheumatic heart disease Patients with mitral stenosis often develop: Patients with MS and A fib might: Normal MV area With atrial fibrillation mitral stenosis velocity calculations are best performed: In the PSAX view which method is used to asses the MV area Given a mitral pressure half-time of 400 m\/sec what would the area be? how to calculate MVA Carcinoid-vs-Rheumatic: Which anomaly goes with aortic dissection? classification for aortic regurgitation murmur What kind of murmur would you hear in a patient with a rupture of a sinus of Valsalva aneurysm? What causes MV preclosure? Mild aortic regurgitation has an _<\/strong><\/em><\/strong> spectral trace. How would you calculate pulmonary artery end diastolic pressure ? how to calculate PAEDP IS systolic flow reversal of bubble in the IVC TR or Tamponade what is the most common valvular problem associated with carcinoid syndrome? What does central venous pressure refer to Hepatic venous flow reversal indicates_______ TR Given a TR velocity of 4.0m\/sec what is the RVSP RVSP= RVSP= A vena contracta might be seen in wha type of cardiomyopathy? Coanda effect If you suspect sever MR where els should you look? The greatest source of error in measuring PISA is with: What does PISA stand for Which of the following is used in echo to measure dP\/dt? dP\/dt measurement of mitral regurgitation assesses what? normal LV dP\/dt is<\/p>\n\n\n\n 1200 mmHg\/sec<\/p>\n<\/blockquote>\n\n\n\n Know pressure waveforms from MR Marfan’s Disease In Marfans syndrome why does aortic dissection and MVP occur? Ehlers-Danlos syndrome Sever aortic aneurysms are greater then: Libman-Sachs: endocarditis Marantic endocarditis Patients with a history of IV drug abuse may present with: Can you tell the difference between and old or new Vegetation? In order to be seen by 2-D, vegetation’s need to be at least: Ball and cage mechanical valves are made by? st. jude bi leaflet valve<\/p>\n\n\n\n Homografts or allograft heterograft autograph what is the name of the dual valve surgery for congenital AS Pannus= When will you see acoustical shadowing ? Which cardiomyopathy is autosomal dominant? the ratio 1. 3: 1 is for assessing ? LVOT obstruction causes the aortic valve to: MV inflow shows A wave greater then E wave Does Inderal (beta blocker) increase SAM? NOTE: SAM is increased with increase in HR. ( amyl nitrate and Valsalva will increase SAM ).<\/p>\n\n\n\n Global Longitudinal Strain in patients with HOCM is typically Average GLS Chagas’ disease Echo signs of congestive cardiomyopathy What is the cause of B-notch Post transplant 2-D appearance What is the most common restrictive cardiomyopathy Amyloid and sarcoid are what type of cardiac abnormalities? Hemochromatosis What does the term ” ground class appearance” refer to A restrictive cardiomyopathy has which of the following? what are the 4 types of cardiomyopathies A typical ejection fraction in a dilated cardiomyopathy patient may be ? The majority of ventricular filling occurs during: If a patient has a normal MV inflow but pulmonary veins show a decreased S wave and D wave you should consider: diastolic phases Normal doppler waveforms at the mitral annulus differs from the flow at the mitral leaflet tips. In Constrictive pericarditis does the E wave increase or decrease with inspiration? How would you determine if a patient has constrictive versus restrictive disease? Three layers of the pericardium A pericardial effusion can often be seen in patients with what is the murmur of a pericardial effusion Pericardial Effusion Grading Criterial: Identify the CS vs the descending Ao and its importance: Where does the oblique sinus lie What to do if tamponade is suspected? Beck’s triad The most sensitive way to diagnosis cardiac tamponade is: Cardiac tamponade Doppler what cardiac conditions would prevent diastolic RV collapse? What other pericardial abnormality also causes impaired ventricular filling? A huge, dilated PA, Severe TR and RV enlargement best describes? Eisenmenger syndrome what is represented with a decrease “a” wave and the flying W? given TR with 60mmHg gradient grade the severity of pulmonary hypertension Pulmonary artery pressure your patient has PHTN with dilated ivc (3cm) which collapsed 50% with sniff. Estimate the RA pressure: The size of aneurysms during systole: What is the most common complication of MI What type of MI causes pap. muscle rupture? what occurs first in the setting of sever MR due to a flail leaflet? True Aneurysm (fusiform, saccular) Pseudoaneurysm What is the most common location for pseudo aneurysms ? Does the wall of a pseudoaneurysm contain endocardium? What information do you need to pre-op in a patient with a LV aneurysm? Color Doppler in ischemic disease can be good for? What is secondary to pap muscle dysfunction What do you look for in a patient with Kawasaki disease? Decrease in wall motion Akinesia wall motion Dyskinesia What is the IVS motion in a patient with LBBB What does the LAD supply? what does the Left circumflex supply What does the RCA supply? From where do the coronaries originate? What is meant by “right dominance” which coronary supplies the interatrial septum Which coronary artery supplies the inferoseptal wall? Is a multivessel disease stress echo better then a nuclear stress echo ? What are the indications for a stress echo? what would be a contraindication to preforming a stress echo on an athlete with chest pain? What is given if peak dose is given and still not at target heart rate? When the 2D image appears to have three atria. It might mean that the patient has a Cor Triatrium What is the most common type of ASD Partial anomalous pulmonary venous return is seen with which type of ASD? which is the best view to diagnosis a sinus venous ASD? what is the best view to demonstrate an ASD What is the standard echo view for contrast studies of an ASD How many beats to see contrast on the left side in a patient with an ASD? Where should contrast be injected in order to diagnosis a persistent left superior vena cava? endocardial cushion defect ( AV septal) Which is the most common type of VSD Supracristal location Inlet location classic VSD murmur What congenital abnormality has a displaced TV? If a large PDA( patent ductus arterioles) is not corrected what might develop? What is NOT a TET defect Tetralogy of Fallot Should you use x-ray and off axis views for evaluation of myxomas What part of the heart is most likely to be affected by cardiac contusion? What might be the 1st indication of metastatic cardiac disease? which cardiac chamber is most likely involved with metastatic tumors? What is the most benign tumor on the aortic valve ? Myxomas Where are myxomas mainly seen? LA myxomas are usually attached where? <\/p>\n","protected":false},"excerpt":{"rendered":" which of the following is critical for a proper acquisition of complete cardiac cycles in digital imaginga high quality EKG signal a patient presents with a clinical history of stable angina.what medication is most likely to be listed in her chart that is related to this clinical historynitroglycerin a three lead EKG is used for […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[],"tags":[],"class_list":["post-111054","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/111054","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=111054"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/111054\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=111054"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=111054"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=111054"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
semi-critical high level disinfectant<\/p>\n\n\n\n
30\/2<\/p>\n\n\n\n
constructive pericarditis<\/p>\n\n\n\n
to roll out thrombus formation in the left atrium and appendage<\/p>\n\n\n\n
percentage of patients that have experienced complications after the same procedure at the facility<\/p>\n\n\n\n
minimum sensitivity<\/p>\n\n\n\n
it causes an increased risk of electrical shock to the patient<\/p>\n\n\n\n
the patient is most likely experiencing an anaphylactic reaction to the contrast<\/p>\n\n\n\n
when the suspected diagnosis is not able to be evaluated by the exam that is ordered<\/p>\n\n\n\n
patient has unstable angina<\/p>\n\n\n\n
more than one of the above<\/p>\n\n\n\n
use the patient’s wristband provided by the hospital to verify the patient’s name and medical record number<\/p>\n\n\n\n
protective environment precautions<\/p>\n\n\n\n
the exam should be rescheduled<\/p>\n\n\n\n
left lateral decubitus with head elevated about 30\u00b0<\/p>\n\n\n\n
three to five inches below the pacemaker<\/p>\n\n\n\n
left lateral decube or suspine with the head elevated and neck extended<\/p>\n\n\n\n
calculate the body surface area<\/p>\n\n\n\n
chest thrust are performed instead of abdominal thrust<\/p>\n\n\n\n
obtain information on treatment options<\/p>\n\n\n\n
soaking the probe too long in a disinfectant solution can damage the bonding effect of the glue used to assemble the probes<\/p>\n\n\n\n
review the diastolic LV size on the last study to compare to today’s measurement<\/p>\n\n\n\n
at the fourth intercostal space on either side of the sternum<\/p>\n\n\n\n
to aid an electrode adhesion for EKG<\/p>\n\n\n\n
history of chemotherapy for liver carcinoma<\/p>\n\n\n\n
social security number<\/p>\n\n\n\n
to deliver a single shock and reassess the patient<\/p>\n\n\n\n
PT and INR<\/p>\n\n\n\n
betadine and filtration of the matching layer<\/p>\n\n\n\n
at the interior electric line between the last rib and the illiac crest<\/p>\n\n\n\n
record the pressure level at the last sound heard before the pulsation disappear<\/p>\n\n\n\n
instruct the patient breathing techniques necessary during the procedure<\/p>\n\n\n\n
standard precautions<\/p>\n\n\n\n
tachycardia<\/p>\n\n\n\n
2MHz<\/p>\n\n\n\n
place a service call for the probe and reschedule all appointments until it is repaired<\/p>\n\n\n\n
chest trauma severe pulmonary HTN TEE for pre-op suspected CHF<\/p>\n\n\n\n
epinephrine<\/p>\n\n\n\n
eosinophil level on complete blood count<\/p>\n\n\n\n
dyspnea<\/p>\n\n\n\n
should be NPO 4 to 6 hours prior to the exam<\/p>\n\n\n\n
our wave and t-wave on the EKG<\/p>\n\n\n\n
the window used to obtain the highest aortic velocity<\/p>\n\n\n\n
contact precautions<\/p>\n\n\n\n
if the probe is heated above the curry temperature the piezoelectric properties will be lost<\/p>\n\n\n\n
normal use of disinfecting agents can lead to damage of the coding which will cause a risk of electrical hazard<\/p>\n\n\n\n
St Jude ave with suspected stenosis<\/p>\n\n\n\n
prothrombin time<\/p>\n\n\n\n
the patient will need to be scanned in the spine or semi-erect position<\/p>\n\n\n\n
2 cm below the left clavicle<\/p>\n\n\n\n
hands should be always be washed before and after assisting with any type of interconventional procedure<\/p>\n\n\n\n
severe Arctic stenosis<\/p>\n\n\n\n
electroencephalogram report<\/p>\n\n\n\n
Which abnormalities commonly go with Marfan’s?<\/p>\n\n\n\n
Papillary muscle dysfunction usually results from<\/p>\n\n\n\n
In order to record the veg of endocarditis by echo, it must be<\/p>\n\n\n\n
How many veins connect the pulmonary vascular bed with the LA?<\/p>\n\n\n\n
Which cardiomyopathy is associated with amyloidosis?<\/p>\n\n\n\n
Which m-mode finding is considered to be a specific indicator of a fenestrated AV?<\/p>\n\n\n\n
Pulmonic stenosis in uncommon as an isolated defect and is usually accompanied with a<\/p>\n\n\n\n
false overriding of the aorta may be produced on the m-mode echo by<\/p>\n\n\n\n
A fib is most common with what valvular disease<\/p>\n\n\n\n
Example of a bioprosthetic<\/p>\n\n\n\n
When a patient has a clinical diagnosis of pericarditis<\/p>\n\n\n\n
TV closure usually occurs<\/p>\n\n\n\n
Kawasaki’s disease may lead to<\/p>\n\n\n\n
which echo technique is best for the detection of MR<\/p>\n\n\n\n
atrial myxomas are usually attached to the<\/p>\n\n\n\n
which 2d views are best for direct imaging of a discrete subaortic membrane<\/p>\n\n\n\n
premature opening of the pulmonary valve may be seen in<\/p>\n\n\n\n
an underestimation of AS may occur because of<\/p>\n\n\n\n
Estimation of MV area from doppler is calculated by the<\/p>\n\n\n\n
What is the standard view for contrast study with an ASD?<\/p>\n\n\n\n
The doppler jet of MS obtained at the apex is sometimes confused with<\/p>\n\n\n\n
For patients with AS and A fib, peak systolic aortic velocity will<\/p>\n\n\n\n
Aliasing on color flow doppler is shown by a<\/p>\n\n\n\n
Premature MV closure on mmode is a sign of high LV diastolic pressure in<\/p>\n\n\n\n
Midsystolic clicks and or late systolic murmurs are most characteristic of<\/p>\n\n\n\n
The two most frequently encountered congenital heart lesions in adults are<\/p>\n\n\n\n
On m-mose a flail MV may have a similar appearance to<\/p>\n\n\n\n
One of the most common complications of a myocardial infarction is<\/p>\n\n\n\n
in pericardial effusion the motion of the pericardium may be<\/p>\n\n\n\n
On 2D Echo, a cleft MV may be confused with an anatomic<\/p>\n\n\n\n
In which view is the ultrasound beam most perpendicular to the IAS<\/p>\n\n\n\n
To determine peak AS velocity the tdx should be<\/p>\n\n\n\n
secondary findings in mitral stenosis<\/p>\n\n\n\n
patients with longstanding AS will have<\/p>\n\n\n\n
Patients with AI may have serial echos for<\/p>\n\n\n\n
A left ventricular thrombus is usually in an area of<\/p>\n\n\n\n
Rupture of the IVS is most commonly a complication of<\/p>\n\n\n\n
Ventricular repolarization<\/p>\n\n\n\n
A common cause for right ventricular volume overload<\/p>\n\n\n\n
Premature closure of the MV can be seen in patients with<\/p>\n\n\n\n
Most common cause of MR in elderly patients<\/p>\n\n\n\n
LV mass (weight) remains normal in chronic<\/p>\n\n\n\n
What syndromes fit with AI, Aortic dilation, dissection?<\/p>\n\n\n\n
Why follow chronic AI?<\/p>\n\n\n\n
When is mitral pressure half-time NOT accurate?<\/p>\n\n\n\n
Given TR and RA pressure, what can you calculate?<\/p>\n\n\n\n
If a pt has a dilated LV and thin septum what might be going on with this patient?<\/p>\n\n\n\n
What is the best way to determine severity of Mitral regurgitation?<\/p>\n\n\n\n
Which cardiac pathology affects valves?<\/p>\n\n\n\n
Cardiac tamponade is rapid filling fluid<\/p>\n\n\n\n
Peripheral contrast is NOT useful in<\/p>\n\n\n\n
Why are the RCC, LCC, and NCC called what they are?<\/p>\n\n\n\n
Where does the left anterior descending artery originate?<\/p>\n\n\n\n
A systolic rumble could be<\/p>\n\n\n\n
if you are doing an echo on a supine patient who becomes SOB<\/p>\n\n\n\n
Which valve is least likely to be affected by rheumatic disease?<\/p>\n\n\n\n
Gorlin Formula in cath lab is used to calculate<\/p>\n\n\n\n
MV inflow velocity should not be affected by<\/p>\n\n\n\n
With what disease should you not rely on mmode for quantifying LVEF?<\/p>\n\n\n\n
patients with ankylosing spondylitis may develop<\/p>\n\n\n\n
What can cause contrast to disipate too quickly?<\/p>\n\n\n\n
Normally how much pericardial fluid is present?<\/p>\n\n\n\n
All of the following may result in JVD except<\/p>\n\n\n\n
If a patient has Cor Pulmonale which of the following conditions are most likely to exist?<\/p>\n\n\n\n
An enlarged heart on xray could be all of the following except?<\/p>\n\n\n\n
Which embryonic arch develops into the trasverse arch?<\/p>\n\n\n\n
If you have a uniformly dilated Aortic root the term<\/p>\n\n\n\n
The primary cause for papillary muscle dysfunction is<\/p>\n\n\n\n
Which valve event starts isovolumic contraction?<\/p>\n\n\n\n
Which valve event starts isovolumic relaxation?<\/p>\n\n\n\n
Which valve event ends isovolumic contraction?<\/p>\n\n\n\n
Which valve event ends isovolumic relaxation?<\/p>\n\n\n\n
Systolic reversal of flow is called<\/p>\n\n\n\n
What is the valve of the IVC?<\/p>\n\n\n\n
Which shunt causes cyanosis in newborns?<\/p>\n\n\n\n
Which valve is most likely to have regurgitation?<\/p>\n\n\n\n
What is not a normal type of mass in the heart<\/p>\n\n\n\n
Vegetations are usually shaped<\/p>\n\n\n\n
Vegetations are usually attached<\/p>\n\n\n\n
Most nonprimary cardiac tumors involve the<\/p>\n\n\n\n
Main cause of thrombus formation in the LV<\/p>\n\n\n\n
Which modality is best for identifying LV thrombus<\/p>\n\n\n\n
Contrast may help with the diagnosis of an apical thrombus<\/p>\n\n\n\n
What does not cause LA thrombus<\/p>\n\n\n\n
Best modality to diagnose LA thrombus<\/p>\n\n\n\n
Pulsus Paradoxus is an inspiratory decline of >10mmHg in systemic blood pressure<\/p>\n\n\n\n
Moderate effusion<\/p>\n\n\n\n
Increased intrapericardial pressure results in collapse of RA free wall<\/p>\n\n\n\n
Best view to image pericardial effusion<\/p>\n\n\n\n
Pericardial effusion is recognized as an echolucent space around the heart<\/p>\n\n\n\n
Vegetations have a _<\/strong> movement<\/p>\n\n\n\n
Almost _<\/em> of cardiac metastases are due to lung, breast, or hematologic malignancies<\/p>\n\n\n\n
PE in a pt with known malignancy should alert the clinician of cardiac involvemtne<\/p>\n\n\n\n
fingerlike projection protruding into RA from IVC<\/p>\n\n\n\n
LV thrombus is uncommon if there is no wall abnormality<\/p>\n\n\n\n
regurgitation is a common finding with veg and masses<\/p>\n\n\n\n
Involved superior and inferior fatty portions of IAS paraing fossa ovalis region<\/p>\n\n\n\n
Found more often on downstream side of valve<\/p>\n\n\n\n
Most often are single, protrude into LA from IAS<\/p>\n\n\n\n
Malignant primary cardiac tumor<\/p>\n\n\n\n
Causes a plop heard on auscultation<\/p>\n\n\n\n
inflammation of pericardium<\/p>\n\n\n\n
Left pleural effusion extends posterior to the descending aorta<\/p>\n\n\n\n
Constrictive pericarditis MV inflow doppler<\/p>\n\n\n\n
pericaridal effusions typically originate near the<\/p>\n\n\n\n
Sweep speed to evaluate for respiratory variation in effusion<\/p>\n\n\n\n
Malignant primary cardiac tumors are rare<\/p>\n\n\n\n
strong predictor of subsequent embolic events<\/p>\n\n\n\n
Prstheitc valves can be source of emnolic event<\/p>\n\n\n\n
PFO is in 25-30% of people<\/p>\n\n\n\n
In a bubble study, bubbles should be present on the left side in<\/p>\n\n\n\n
At least 2 injections should be performed with a bubble (one with valsalva, one without)<\/p>\n\n\n\n
Pericardial adipose tissue can be mistaken for an effusion<\/p>\n\n\n\n
Adherent, thickened, and fibrotic pericardium<\/p>\n\n\n\n
Bioprosthtic valves are used for catheter implantation and are mounted on a compressible stent<\/p>\n\n\n\n
Ball and Cage valves are still in use<\/p>\n\n\n\n
Mechanical valve stenosis or regurg is due to<\/p>\n\n\n\n
Mechanical valves are prone to thrombus formation<\/p>\n\n\n\n
Standard __<\/em> plane provides optimal visualization of valve leaflet anatomy\/movement with mechanical valves<\/p>\n\n\n\n
Clinically, prolapse of the MV is associated with<\/p>\n\n\n\n
papillary muscle dysfunction usually results from<\/p>\n\n\n\n
In order to see a veg it must be<\/p>\n\n\n\n
When a wall exhibits no motion it is called<\/p>\n\n\n\n
What cardiomyopathy is associated with amyloidosis?<\/p>\n\n\n\n
Infundibular pulmonary stenosis is uncommon as an isolated lesion and usually goes with a<\/p>\n\n\n\n
Most common type of ASD is<\/p>\n\n\n\n
What coronary artery supplies the AV node and SA node?<\/p>\n\n\n\n
Right Leaflet<\/p>\n\n\n\n
Posterior and Anterior<\/p>\n\n\n\n
Sinus of Valsalva<\/p>\n\n\n\n
Innominate (proximal), left carotid, and the left subclavian (distal)<\/p>\n\n\n\n
Coarctation of the Aorta<\/p>\n\n\n\n
After the take-off of the left subclavian artery, or within the aortic isthmus<\/p>\n\n\n\n
Rights and left superior (upper) pulmonary veins<\/p>\n\n\n\n
Posterior AV groove<\/p>\n\n\n\n
Posterior<\/p>\n\n\n\n
early diastole<\/p>\n\n\n\n
RA<\/p>\n\n\n\n
A wave<\/p>\n\n\n\n
TTE probes are usually higher 5-7MGz, while TTE probes are 2-7MHz<\/p>\n\n\n\n
40-45C<\/p>\n\n\n\n
4ch- 0 degrees
2ch- 90 degrees
LAX- 120 degrees<\/p>\n\n\n\n
The SA node has the highest intrinsic rate of any cardiac tissue.<\/p>\n\n\n\n
Inside to outside. Look at the purkinje fibers above.<\/p>\n\n\n\n
That period when a muscle cell is not excitable- from phase 1 into phase 3; the ‘relative refractory period’ is during phase 3 and the muscle cell might contract if the stimulus is strong.<\/p>\n\n\n\n
P wave- atrial systole
P-R interval- includes P-R segment (from atrial to ventricular depolarization)
QRS complex- ventricular diastole (repolarization)<\/p>\n\n\n\n
0.10 sec<\/p>\n\n\n\n
Increased volume= increased contractility
RUBBER BAND THEORY<\/p>\n\n\n\n
Chronic AI is failure when we drop off the end<\/p>\n\n\n\n
yes (when shunt L-R)<\/p>\n\n\n\n
Preload= dilatation
Afterload= hypertrophy<\/p>\n\n\n\n
CXR<\/p>\n\n\n\n
Increase<\/p>\n\n\n\n
Increases<\/p>\n\n\n\n
Severe<\/p>\n\n\n\n
70mmHg<\/p>\n\n\n\n
Coanda effect?<\/p>\n\n\n\n
Wall hugging effect<\/p>\n\n\n\n
Severe MR<\/p>\n\n\n\n
Mitral regurgitation<\/p>\n\n\n\n
LV systolic dysfunction<\/p>\n\n\n\n
dP\/dt<\/p>\n\n\n\n
systolic BP- MR gradient<\/p>\n\n\n\n
\u2026<\/p>\n\n\n\n
Congenital connective tissue disease causing aortic dilatation of MVP<\/p>\n\n\n\n
Connective tissue disorder<\/p>\n\n\n\n
like Marfan’s pts, you look for MVP dilated Ao dissection<\/p>\n\n\n\n
5.0cm<\/p>\n\n\n\n
Lupus and Marantic endocarditis<\/p>\n\n\n\n
Bi-leaflet<\/p>\n\n\n\n
means using pts own tissue<\/p>\n\n\n\n
host tissue overgrowth<\/p>\n\n\n\n
Dilated, hypertrophic, restrictive, ischemic<\/p>\n\n\n\n
Hypertrophic<\/p>\n\n\n\n
Normal etiology (genetic)
Typical spectral Doppler finding (flow acceleration in mid LV)<\/p>\n\n\n\n
1.3:1<\/p>\n\n\n\n
close in mid systole<\/p>\n\n\n\n
Tricuspid endocarditis<\/p>\n\n\n\n
Hypertrophic<\/p>\n\n\n\n
No, decreases HR reduces SAM with excercise<\/p>\n\n\n\n
posterior and apical thinning septum usually normal<\/p>\n\n\n\n
-Multi chamber enlargement
-Globally impaired LV contractility
-B-Notch on MV M-Mode (increased LVEDP)
-Thrombus may be present<\/p>\n\n\n\n
Dilated CM<\/p>\n\n\n\n
Double atria<\/p>\n\n\n\n
Restrictive<\/p>\n\n\n\n
excess iron<\/p>\n\n\n\n
infiltrative myocarditis<\/p>\n\n\n\n
Low<\/p>\n\n\n\n
Decreased LV compliance<\/p>\n\n\n\n
-15-25%<\/p>\n\n\n\n
first third of diastole<\/p>\n\n\n\n
pseudonormal<\/p>\n\n\n\n
Renal Failure<\/p>\n\n\n\n
Small: posterior fluid <1cm Med: anterior and posterior <1cm Large: surrounding the heart >1cm<\/p>\n\n\n\n
Posterior to the LA in the PLAX view<\/p>\n\n\n\n
a. elevated venous pressure
b. Hypotension
c. Quiet Heart<\/p>\n\n\n\n
Respiratory variation<\/p>\n\n\n\n
Pulmonary Hypertension<\/p>\n\n\n\n
Lay flat<\/p>\n\n\n\n
a. unstable sample volume
b. COPD
c. pleural effusion<\/p>\n\n\n\n
Constrictive pericarditis<\/p>\n\n\n\n
Pulmonary Hypertension<\/p>\n\n\n\n
Pulmonary hypertention by M-Mode<\/p>\n\n\n\n
PHTN<\/p>\n\n\n\n
15mmHg<\/p>\n\n\n\n
Aneurysm formation<\/p>\n\n\n\n
Dilated RV<\/p>\n\n\n\n
inferior MI<\/p>\n\n\n\n
Lack of oxygen<\/p>\n\n\n\n
Inferior basal- NOT apical<\/p>\n\n\n\n
No, it’s a rupture across both endo and myocardium<\/p>\n\n\n\n
Movement of other walls<\/p>\n\n\n\n
VSD<\/p>\n\n\n\n
Coronoary Artery Aneurysms
(R and L coronary artery aneurysms might be called “mickey mouse ears”)<\/p>\n\n\n\n
Hypokinesis<\/p>\n\n\n\n
Dyskinetic or paradoxical<\/p>\n\n\n\n
In the L and R aortic sinus of Valsalva<\/p>\n\n\n\n
When the right coronary gives rise to the “posterior descending artery” (85% of the time)<\/p>\n\n\n\n
Right (also ususally supplies the SA and AV nodes)<\/p>\n\n\n\n
Right coronary artery<\/p>\n\n\n\n
Thallium<\/p>\n\n\n\n
Unstable angina<\/p>\n\n\n\n
Myocardial perfusion<\/p>\n\n\n\n
Secundum<\/p>\n\n\n\n
Sinus Venosus<\/p>\n\n\n\n
Modified subcostal four chamber<\/p>\n\n\n\n
Subcostal 4ch<\/p>\n\n\n\n
Look in the subcostal 4ch view<\/p>\n\n\n\n
Apical 4ch<\/p>\n\n\n\n
1-2 beats for an ASD. 3-5 beats for a Pulm. shunt<\/p>\n\n\n\n
Left arm<\/p>\n\n\n\n
Down syndrome or trisomy 21<\/p>\n\n\n\n
Subpulmonic region<\/p>\n\n\n\n
subvalvular low near the mitral and tricuspid valves<\/p>\n\n\n\n
perimembraneous<\/p>\n\n\n\n
VSD jet= 5m\/sec
SBP= 130mmHg<\/p>\n\n\n\n
Ebstein’s anomaly<\/p>\n\n\n\n
Eisenmenger Syndrome<\/p>\n\n\n\n
Failure of the fetal ductus arteriosus (between the pulmonary artery and descending aorta) to close after birth.<\/p>\n\n\n\n
a. Large
b. Pulmonic stenosis
c. RVH
d. ASD
ASD<\/p>\n\n\n\n
Squatting, shunt<\/p>\n\n\n\n
RV (most anterior)<\/p>\n\n\n\n
Pericardial effusion<\/p>\n\n\n\n
RA<\/p>\n\n\n\n
Papillary fibroelastoma<\/p>\n\n\n\n
Benign tumor (most common in adults)<\/p>\n\n\n\n
Heart valves, mostly mitral and aortic (frond-like)<\/p>\n\n\n\n
Rhabdomyoma<\/p>\n\n\n\n
Myxoma<\/p>\n\n\n\n
interatrial septum<\/p>\n\n\n\n
Medial and anterior<\/p>\n\n\n\n
PSAX Ao valve level<\/p>\n\n\n\n
Coarctation of the aorta<\/p>\n\n\n\n
Anterior and medial\/ septal\\nPosterior can only be seen in RVIT plax<\/p>\n\n\n\n
Sinuses of Valsalva<\/p>\n\n\n\n
Right Pulmonary Artery<\/p>\n\n\n\n
EDV-ESV \/ EDV x 100<\/p>\n\n\n\n
EDV-ESV<\/p>\n\n\n\n
End -systole<\/p>\n\n\n\n
Can be seen in Apical 4 chamber w\/inferior angulation.<\/p>\n\n\n\n
Angle Medial and Inferior from Aortic Root. TV<\/p>\n\n\n\n
Angle Lateral and Superior from Aortic root. PV<\/p>\n\n\n\n
RA<\/p>\n\n\n\n
Area between the left subclavian and the ductus arteriosus(where most coarctations occur)Sinus of Valsalva is the most common area of dissections).<\/p>\n\n\n\n
RV<\/p>\n\n\n\n
anterior, superior<\/p>\n\n\n\n
IVC<\/p>\n\n\n\n
No- Moderator band is located in the RV<\/p>\n\n\n\n
From the lower intraventricular septum to the anterior wall where it joins the papillary muscle.<\/p>\n\n\n\n
Posterior \\nAlso psterior medial papillary muscle \\nSingle blood supply to posterior wall<\/p>\n\n\n\n
Anterior and to the right<\/p>\n\n\n\n
The coronary sinus is located anterior to the descending aorta. If the coronary sinus is dilated, it can be mistaken for the descending aorta.<\/p>\n\n\n\n
From the apical four chamber you you would angle inferior in order to visualize the coronary sinus, which is located posterior to the mitral annulus.<\/p>\n\n\n\n
Pericardial Effusions lie posterior to the coronary sinus and anterior to the descending aorta. \\nPleural effusions lie posterior to the descending aorta.<\/p>\n\n\n\n
Infundibulum<\/p>\n\n\n\n
The coronary sinus lies in the posterior AV groove. This groove is located between the LA and LV walls and lies posterior to be MV. In the parasternal long axis view, the coronary sinus can sometimes be seen as a small echo free circle.<\/p>\n\n\n\n
The coronary sinus dialates due to increased pressure in the RA, increased flow to coronary sinus.<\/p>\n\n\n\n
Location is between the Right atria and right ventricle. It has three leaflets: anterior, posterior, and medial or (septal) leaflets. \\nThe names reflect the anatomical relationship to the right ventricle. The medial leaflet is connected to the septal wall. It’s insertion is located closer to the cardiac apex than that of the anterior mitral valve leaflet.<\/p>\n\n\n\n
Often referred to as 2 main layers as visceral and parietal. This visceral layer lies directly upon external surface of the heart and is commonly referred as the epicardium. The parietal or fibrous pericardium is the thick outer sac. Pericardial cavity lies between the two layers.Anatomically 3 layers are: serous visceral, serous parietal, fibrous pericardium.<\/p>\n\n\n\n
The three major coronary arteries are the right, left ant descending (LAD), and the circumflex arteries<\/p>\n\n\n\n
The heart tube loops ANTERIORLY and RIGHTWARD at day 22<\/p>\n\n\n\n
Primitive atria and primitive ventricle<\/p>\n\n\n\n
Endocardial cushions<\/p>\n\n\n\n
Ligamentum arteriosum<\/p>\n\n\n\n
Foreman ovale\\nDuctus arteriosus<\/p>\n\n\n\n
Sodium is a rest \\n\\n* Calcium is 2nd and responsible for contraction<\/p>\n\n\n\n
just below the Aortic Valve<\/p>\n\n\n\n
Medial (septal)\\nAnterior<\/p>\n\n\n\n
right coronary artery \\na) inferior wall \\nb) inferoseptal \\nc) right ventricular apex \\nd) right ventricular free wall. \\n**RIGHT= inferior, septals, right<\/p>\n\n\n\n
a) anterior wall \\nb) anteroseptal \\nc) left ventricular apex \\n**LEFT = anterior, apical, left<\/p>\n\n\n\n
a) anterior lateral wall \\nb) inferolateral wall\\nCIRC = laterals<\/p>\n\n\n\n
Anterior IVS, Anterior Left Ventricle and Apex<\/p>\n\n\n\n
Anterolateral and inferolateral<\/p>\n\n\n\n
Inferior Left Ventricle, Inferior Right Ventricle and Inferior IVS<\/p>\n\n\n\n
anterior<\/p>\n\n\n\n\n
\n
\n
\n
anterolateral and inferolateral walls<\/p>\n\n\n\n
inferior Left Ventricle, inferior Right Ventricle and inferior IVS<\/p>\n\n\n\n
LAD<\/p>\n\n\n\n
Circumflex<\/p>\n\n\n\n
Posterior descending artery<\/p>\n\n\n\n
LAD<\/p>\n\n\n\n
RCA<\/p>\n\n\n\n
Posterior descending artery<\/p>\n\n\n\n
The anterior septal and the inferolateral walls of the LV are seen in the parasternal apical long axis Views.<\/p>\n\n\n\n
The right & non coronary leaflets are seen in these views. The right leaflet is on top (superior) and the non-coronary is on the bottom (inferior)<\/p>\n\n\n\n
The coronary arteries are located on the outer, epicardial surface of the heart as follows: \\nthe right coronary artery (RCA) arises from the right aortic root sinus, follows the right atrioventricular junction, and to descends along the posterior interventricular groove. \\nThe left anterior descending coronary artery (LAD) follows the Anterior interventricular groove. \\nThe circumflex coronary artery’s or courses along the left AV junction.<\/p>\n\n\n\n\n
The left anterior descending (LAD) coronary artery, which supplies blood to the inferior cardiac wall, is most likely to have been involved. This artery also supplies the inferior portion of ventricular septum and the left ventricular apex. \\n**LEFT = anterior, apical, left<\/p>\n\n\n\n
Again, the left Anterior descending (LAD) coronary artery is the most likely choice. Some patients with distal septal hypocontractility, the proximal portion of the septum moves normally because it is supplied by the RCA. \\nNOTE: LEFT= left, ant, apicals<\/p>\n\n\n\n
The anteriolateral wall of the left ventricle is best visualized in the apical four chamber view.( The lateral wall can also be seen in the short axis views, but the four chamber view is the best.)\\nNOTE: 2 CH is anterior & inferior<\/p>\n\n\n\n
5mmHG\\nNOTE: RIGHT SIDED PULMONARY PRESSURES ARE LOWER THAN THE LEFT\\n\\nRight Atrium=5, Right Ventricle=25, PA=25 5-25-25\\nLeft Atrium=10, Left Ventricle=120, Aorta =120. 10-130-120<\/p>\n\n\n\n
25\/5mmHg<\/p>\n\n\n\n
25\/10mmHg<\/p>\n\n\n\n
10mmHg<\/p>\n\n\n\n
120\/10mmHg<\/p>\n\n\n\n
120\/80mmHg<\/p>\n\n\n\n
The mitral valve is a bi-leaflet valve situated between the left atrium on the left ventricle. The valves anterior leaflet is relatively long, lies close to the aorta, and comprises one third of the valves circumference. The posterior leaflet is shorter and is usually divided into three sections (scallops). Both the anterior and the posterior leaflets are attached to the ventricular Papillary muscle by multiple cordae tendonae<\/p>\n\n\n\n
Right leaflet (the posterior leaflet is the non coronary)<\/p>\n\n\n\n
Early diastole<\/p>\n\n\n\n
Decreased after load\\n-Vasodilator\\n-BP drops\\n-less blood comes back\\n-HR increases\\n\\nDecreases vascular resistance. Increases forward flow murmurs decreases AR\/MR ( retro flow murmurs)<\/p>\n\n\n\n
Early diastole<\/p>\n\n\n\n
Parachute mitral valve\\nNOTE: MOST COMMON FORM OF CONGENITAL MITRAL STENOSIS–it is a rare cause of mitral stenosis<\/p>\n\n\n\n
Right Atrium \\nNOTE: SINUS OF VALSALVA IS MOST COMMON AREA OF ANEURYSM IN MITRAL STENOSIS<\/p>\n\n\n\n
Tricuspid Regurgitation\\n\\nSevere grade TR\\n\\nRegurgitation is a preload= volume = Dilitation\\nIt affects the chamber behind it. ( which is Left atria and the Ivc)<\/p>\n\n\n\n
Mitral Regurgitation\\n\\nNOTE: \\nThe rate (dP\/dt max) of left ventricle (LV) pressure rise in early systole measures LV SYSTOLIC FUNCTION.<\/p>\n\n\n\n
-elevated venous pressure\\n-hypotension\\n-quiet heart\\nassociated with acute tamponade\\n* IT IS THE CLINICAL DIAGNOSIS OF CARDIAC TAMPONADE\\n\\nBecks triad ( cardiac tamponade ) 3 Ds\\nDistant heart sounds\\nDistended jugular veins \\nDecreased arterial pressure<\/p>\n\n\n\n
Pulmonary hypertension\\n\\nTricuspid reguritation. Is a preload, volume overload affects chambers ahead of it.<\/p>\n\n\n\n
Increase<\/p>\n\n\n\n
Aneurysm formation<\/p>\n\n\n\n
Dilated Right Ventricle\\n\\nFLAIL LEAFLET WILL CAUSE MITRAL REGURGITATION\\n\\nThis is a sudden onset (acute) and the heart does not have time to adjust yo the pressure difference.<\/p>\n\n\n\n
inferior MI\\n-Inferior pap muscle has a single blood supply (Medial papillary muscles receives dual blood supply and is less likely to rupture)\\n\\n* posterior papillary muscle single blood supply is most likely to rupture<\/p>\n\n\n\n
In the LEFT and RIGHT aortic sinus of Valsalva<\/p>\n\n\n\n
Right (also usually supplies the SA and AV nodes)<\/p>\n\n\n\n
Right coronary artery<\/p>\n\n\n\n
Unstable angina<\/p>\n\n\n\n
Peak HR is 80%<\/p>\n\n\n\n
RVSP=SBP-4(V)2 \\n =130-4(5)2 \\n =130-4(25)2\\n =130-100\\n =30 mm Hg<\/p>\n\n\n\n
Severe mitral regurgitation.\\n\\nOn M mode anterior motion of the posterior leaflet<\/p>\n\n\n\n
Apical 4 chamber with posterior angulation\\nNOTE: PLSVC, CHF, PHTN = dialated CS<\/p>\n\n\n\n
anterior intraventricular sulcus<\/p>\n\n\n\n
During the strain phase=No \\nDuring the release phase=Yes<\/p>\n\n\n\n
pericardial effusion- \\nconstrictive pericarditis (which leads to PE)- friction rub. \\nConstrictive pericarditis impaired ventricular filling\\nPericardial knock Similar in timing to a very loud S3. It’s caused by an abrupt cessation of early diastolic inflow.\\n – respiratory variations of MV and TV<\/p>\n\n\n\n
Atrial connections (IVC, SVC, pulmonary veins, CS and part of the atria<\/p>\n\n\n\n
patent foramen ovale \\nFirst to close is. ASD<\/p>\n\n\n\n
Qp pulmonary circulatory flow\\nQs = systemic circulatory flow\\nASD surgery is mainly considered when the Qp\/Qs exceed?\\n1:5\\nNormal ratio 1:1<\/p>\n\n\n\n\n
Fourth (occurs during atrial contraction)<\/p>\n\n\n\n
right lateral decubitus<\/p>\n\n\n\n
ventricular septal defect<\/p>\n\n\n\n
-Below the patients bladder<\/p>\n\n\n\n
Ventricular septal defect VSD<\/p>\n\n\n\n
Use of higher frequency probe<\/p>\n\n\n\n
Right lateral decubitus.<\/p>\n\n\n\n
Atrioventricular Canal defect.<\/p>\n\n\n\n
Atropine<\/p>\n\n\n\n
Left lateral decubitus<\/p>\n\n\n\n
Area is to large<\/p>\n\n\n\n
Dilated<\/p>\n\n\n\n
Ventricular septal defect.<\/p>\n\n\n\n
2.25MHz<\/p>\n\n\n\n
Dobutamine<\/p>\n\n\n\n
TEE<\/p>\n\n\n\n
autograft<\/p>\n\n\n\n
Hurts more in certain positions or when changing positions.<\/p>\n\n\n\n
Aortic arch<\/p>\n\n\n\n
Thallium<\/p>\n\n\n\n
Murmur Post MI<\/p>\n\n\n\n
40 days<\/p>\n\n\n\n
Truncus ateriosus<\/p>\n\n\n\n
Pulmonary arteries<\/p>\n\n\n\n
Pulmonary veins<\/p>\n\n\n\n
Foramen oval and ductus arteriosus<\/p>\n\n\n\n
patent foramen ovale, closes at the end of the first week.<\/p>\n\n\n\n
pulmonary veins<\/p>\n\n\n\n
Left atrial pressure decreases<\/p>\n\n\n\n
ligamentum arteriosum<\/p>\n\n\n\n
aortic isthmus<\/p>\n\n\n\n
SA node
AV node
Bundle of His
left bundle branch
purkinje fibers<\/p>\n\n\n\n
SA node<\/p>\n\n\n\n
Sodium<\/p>\n\n\n\n
sodium followed by calcium<\/p>\n\n\n\n
potassium<\/p>\n\n\n\n
phases 1 into phase 3<\/p>\n\n\n\n
75 mmHg<\/p>\n\n\n\n
the beat is stronger than a typical beat<\/p>\n\n\n\n
the more the heart muscle is stretched, the more forcefully it contracts.<\/p>\n\n\n\n
LV filling<\/p>\n\n\n\n
AS<\/p>\n\n\n\n
aortic pressure<\/p>\n\n\n\n
MR<\/p>\n\n\n\n
LV hypertrophy<\/p>\n\n\n\n
LV Dilation<\/p>\n\n\n\n
hypertrophy<\/p>\n\n\n\n
Dilation<\/p>\n\n\n\n
5.5L\/min<\/p>\n\n\n\n
heart rate x stroke volume<\/p>\n\n\n\n
1<\/p>\n\n\n\n
Mitral Valve<\/p>\n\n\n\n
RF=50%<\/p>\n\n\n\n
intrinsic<\/p>\n\n\n\n
40 days<\/p>\n\n\n\n
Truncus arteriosus<\/p>\n\n\n\n
pulmonary arteries<\/p>\n\n\n\n
Pulmonary veins<\/p>\n\n\n\n
Foramen ovale and ductus arteriosus<\/p>\n\n\n\n
Pulmonary veins<\/p>\n\n\n\n
ligamantum arteriosum<\/p>\n\n\n\n
SA node<\/p>\n\n\n\n
Increased R-R interval<\/p>\n\n\n\n
Increased R-R interval<\/p>\n\n\n\n
TV closure<\/p>\n\n\n\n
Atrial systole<\/p>\n\n\n\n
isovolumic contraction<\/p>\n\n\n\n
Pulmonic valve opening<\/p>\n\n\n\n
Aortic valve closure<\/p>\n\n\n\n
isovolumic relaxation<\/p>\n\n\n\n
LV pressure
Aortic pressure<\/p>\n\n\n\n
LV pressure
LA pressure<\/p>\n\n\n\n
RV pressure
PA Pressure<\/p>\n\n\n\n
RA pressure
RV pressure<\/p>\n\n\n\n
False<\/p>\n\n\n\n
False<\/p>\n\n\n\n
True<\/p>\n\n\n\n
True<\/p>\n\n\n\n
Pulmonic insufficiency<\/p>\n\n\n\n
Mitral & tricuspid<\/p>\n\n\n\n
Aortic Closure<\/p>\n\n\n\n
2 of 6<\/p>\n\n\n\n
grade 5 to 6<\/p>\n\n\n\n
True<\/p>\n\n\n\n
40%<\/p>\n\n\n\n
True<\/p>\n\n\n\n
10mmHg<\/p>\n\n\n\n
5mmHg<\/p>\n\n\n\n
75%<\/p>\n\n\n\n
100%<\/p>\n\n\n\n
Coronary sinus<\/p>\n\n\n\n
False<\/p>\n\n\n\n
Aortic stenosis<\/p>\n\n\n\n
Tricuspid stenosis<\/p>\n\n\n\n
more then 5 big boxes apart<\/p>\n\n\n\n
Less then 3 big boxes apart.<\/p>\n\n\n\n
ventricular tachycardia<\/p>\n\n\n\n
Innominate
Left carotid
Left subclavian A<\/p>\n\n\n\n
Left Subclavian artery<\/p>\n\n\n\n
7 years<\/p>\n\n\n\n
40cc<\/p>\n\n\n\n
Progressive lengthening of the PR interval<\/p>\n\n\n\n
Sinus of Valsalva<\/p>\n\n\n\n
Early diastole<\/p>\n\n\n\n
Coarctation of the aorta<\/p>\n\n\n\n
suprasternal notch<\/p>\n\n\n\n
The aortic isthmus ( after the take off of the left subclavian artery)<\/p>\n\n\n\n
counterclockwise 120 degrees<\/p>\n\n\n\n
Inferior & Anterior<\/p>\n\n\n\n
Posterior to the AV groove<\/p>\n\n\n\n
posterior<\/p>\n\n\n\n
Thebesian<\/p>\n\n\n\n
A wave ( Atrial contraction)<\/p>\n\n\n\n
40-45 degrees C<\/p>\n\n\n\n
electrical impulses passes to prevent simultaneous contraction of the atrias and ventricles<\/p>\n\n\n\n
SA node<\/p>\n\n\n\n
That period when a muscle cell is not excitable- from phase I until into phase 3 the “relative refractory period” is during phase 3 and the muscle cell might contract if the stimulus is strong.<\/p>\n\n\n\n
atrial systole<\/p>\n\n\n\n
from atrial depolarization to ventricle depolarization<\/p>\n\n\n\n
ventricular systole (depolarization)<\/p>\n\n\n\n
ventricular diastole (repolarization)<\/p>\n\n\n\n
0.10 sec<\/p>\n\n\n\n
The greater the load the greater the force of contraction.<\/p>\n\n\n\n
Increase contractility<\/p>\n\n\n\n
increase tension<\/p>\n\n\n\n
Regurgitation<\/p>\n\n\n\n
Dilation<\/p>\n\n\n\n
hypertrophy<\/p>\n\n\n\n
SV\/EDV x 100<\/p>\n\n\n\n
SV x HR<\/p>\n\n\n\n
Switch to a lower frequency transducer<\/p>\n\n\n\n
when nyquist limit is exceeded<\/p>\n\n\n\n
1\/2 of the PRF<\/p>\n\n\n\n
tracing the doppler spectral display<\/p>\n\n\n\n
MV-12cm
AOV-20cm<\/p>\n\n\n\n
Doppler stroke volume<\/p>\n\n\n\n
increase<\/p>\n\n\n\n
Decreased after load<\/p>\n\n\n\n
decreases<\/p>\n\n\n\n
Isovolumic contraction
ejection
isovolumic relaxation
rapid infow
diastasis
atrial systole<\/p>\n\n\n\n
After R wave<\/p>\n\n\n\n
After T wave<\/p>\n\n\n\n
2-3<\/p>\n\n\n\n
70msec<\/p>\n\n\n\n
Close , open, close , open<\/p>\n\n\n\n
the LV and aortic pressure are nearly identical<\/p>\n\n\n\n
Low pressure
Low resistance
RV wall is thin
Low O2 content in the artery<\/p>\n\n\n\n
High pressure
High resistance
LV wall is thick
High O2 content in the artery<\/p>\n\n\n\n
54% is plasma
45% red blood cells (erythrocytes)
1% white blood cells (leukocytes)<\/p>\n\n\n\n
25\/10<\/p>\n\n\n\n
5 mmHg (6mmHg)<\/p>\n\n\n\n
10mmHG<\/p>\n\n\n\n
coronary sinus<\/p>\n\n\n\n
95%<\/p>\n\n\n\n
75%<\/p>\n\n\n\n
LV angiogram<\/p>\n\n\n\n
LA pressure<\/p>\n\n\n\n
DFP(Diastolic filling period)
PCW ( from a Swan-Ganz catheter)<\/p>\n\n\n\n\n
resolution<\/p>\n\n\n\n
2.5MHz (better penetration)<\/p>\n\n\n\n
4.0MHz (Better resolution)<\/p>\n\n\n\n
Transmit and receive at the same frequency<\/p>\n\n\n\n
Transmit at one frequency and receive at the second harmonic (twice the transmit freq)<\/p>\n\n\n\n
result in thicker valve leaflets<\/p>\n\n\n\n
MI being too high or the amount of contrast injected is too low.<\/p>\n\n\n\n
caused by the amount of contrast injected is to high or was injected to fast<\/p>\n\n\n\n
left ventricular hypertrophy<\/p>\n\n\n\n
Narrow ( pulse pressure is the difference between systolic and diastolic pressure-it is wide in AI and narrow in AS)<\/p>\n\n\n\n
Mild: 2.6-2.9
Mod: 3.0-4.0
sever: >4.0<\/p>\n\n\n\n
Mild: <20 Mod: 20-40 sever: >40<\/p>\n\n\n\n
Mild:>1.5
Mod:1.0-1.5
sever: <1.0<\/p>\n\n\n\n
Short Axis<\/p>\n\n\n\n
Systemic hypertension<\/p>\n\n\n\n
A5 ( approximately 15% will grow back post surgical removal)<\/p>\n\n\n\n
-Also called aortic arch syndrome(occurs more in young women from asia)
-There is a fibrosis of the arch and descending Ao of unknown etiology.<\/p>\n\n\n\n
3-4 cm2<\/p>\n\n\n\n
In patients with poor LV function and when moderate to sever AI is present than peak velocities.<\/p>\n\n\n\n
LVOT measured to large<\/p>\n\n\n\n
Systole<\/p>\n\n\n\n
Peak to Peak instantaneous ( for AS its the high gradient anytime during systole)<\/p>\n\n\n\n
Peak instantaneous versus peak to peak<\/p>\n\n\n\n
classified as a cardiofacial syndrome with PS. HCM and ASD(30%)<\/p>\n\n\n\n
Nope<\/p>\n\n\n\n
Subcostal short- axis<\/p>\n\n\n\n
low frequency “Diastolic Rumble” with an opening snap<\/p>\n\n\n\n
AOV<\/p>\n\n\n\n
atrial fibrillation<\/p>\n\n\n\n
Lose 50% of diastolic filling since they are very dependent on atrial contraction<\/p>\n\n\n\n
4-5cm2<\/p>\n\n\n\n
averaged over 5-10 beats<\/p>\n\n\n\n
Pressure 1\/2 time<\/p>\n\n\n\n
0.5cm2<\/p>\n\n\n\n
220\/PHT<\/p>\n\n\n\n
Carcinoid=fixed body of the leaflets
Rheumatic=tethered leaflet tips<\/p>\n\n\n\n
Marfan syndrome<\/p>\n\n\n\n
diastolic “blow”<\/p>\n\n\n\n
continuous<\/p>\n\n\n\n
an elevated LVEDP (end diastolic pressure)<\/p>\n\n\n\n
incomplete<\/p>\n\n\n\n
Pulmonic insufficieny velocity<\/p>\n\n\n\n
PAEDP =RAP+EDP<\/p>\n\n\n\n
TR<\/p>\n\n\n\n
TR<\/p>\n\n\n\n
IVC pressure close the RA<\/p>\n\n\n\n
sever<\/p>\n\n\n\n
70mmHg<\/p>\n\n\n\n
TR gradient + RAP<\/p>\n\n\n\n
4(v)2+ RAP<\/p>\n\n\n\n
Dilated<\/p>\n\n\n\n
happens with wall hugging jets. May underestimate jet size<\/p>\n\n\n\n
Pulmonary vein (S, D, AR)<\/p>\n\n\n\n
Radius of the flow convergence<\/p>\n\n\n\n
proximal isovelocity surface area<\/p>\n\n\n\n
MR<\/p>\n\n\n\n
LV systolic function<\/p>\n\n\n\n\n
late systolic jump in LA pressure<\/p>\n\n\n\n
congenital connective tissue disease causing aortic dilation and MVP<\/p>\n\n\n\n
decrease fibrillin<\/p>\n\n\n\n
Connective tissue disease, like in Marfan you look for MVP, Dilated AO, dissection<\/p>\n\n\n\n
5.0cm<\/p>\n\n\n\n
systemic lupus erythematosus<\/p>\n\n\n\n
nonbacterial thrombotic endocarditis (NBTE), due to trauma. seen in patients with metastatic disease.<\/p>\n\n\n\n
Tricuspid endocarditis (vegetation’s)<\/p>\n\n\n\n
Nope<\/p>\n\n\n\n
3mm<\/p>\n\n\n\n
Starr-Edwards<\/p>\n\n\n\n
Same species<\/p>\n\n\n\n
different species<\/p>\n\n\n\n
patients own tissue<\/p>\n\n\n\n
Ross Procedure<\/p>\n\n\n\n
Host tissue overgrowth<\/p>\n\n\n\n
MV prosthesis<\/p>\n\n\n\n
hypertrophic<\/p>\n\n\n\n
asymmetric hypertrophy<\/p>\n\n\n\n
close in mid systole<\/p>\n\n\n\n
Abnormal relaxation<\/p>\n\n\n\n
No, decreases heart rate reduces SAM with exercise<\/p>\n\n\n\n
-8 to -10%<\/p>\n\n\n\n
-16to -19% or more<\/p>\n\n\n\n
Posterior and Apical thinning septum usually normal<\/p>\n\n\n\n
-multichanber enlargement
globally impaired LV contractility
B-notvh on MV M-mode<\/p>\n\n\n\n
increased LVEDP<\/p>\n\n\n\n
double atria<\/p>\n\n\n\n
Amyloidosis<\/p>\n\n\n\n
restrictive<\/p>\n\n\n\n
excess iron deposits throughout the body<\/p>\n\n\n\n
infiltrative myocarditis<\/p>\n\n\n\n
increased preload<\/p>\n\n\n\n
Normal
Dilated (congestive)
Hypertrophic
Restrictive<\/p>\n\n\n\n
30-40%
40-50%<\/p>\n\n\n\n
in the first third of diastole<\/p>\n\n\n\n
they might have a pseudonormal pattern<\/p>\n\n\n\n
Isovolumic relaxation(closure of AOV to opening of MV) early filling
diastasis
atrial contraction<\/p>\n\n\n\n
E and A are reversed at these two sample sites<\/p>\n\n\n\n
decrease<\/p>\n\n\n\n
TV inflow with respiration variation<\/p>\n\n\n\n
fibrous- thick outer sack
parietal- bound to fibrous pericardium smooth
visceral- bound to the epicardium<\/p>\n\n\n\n
Renal failure<\/p>\n\n\n\n
friction rub<\/p>\n\n\n\n
Small: <1cm Med: Anterior and posterior 1-2cm Large: surrounding the heart >2cm<\/p>\n\n\n\n
to differentiate bwetwwn pericardial and pleural effusion<\/p>\n\n\n\n
posterior to the LA in the PLAZ view- area between the two sets of palm. veins<\/p>\n\n\n\n
immediate interpretation<\/p>\n\n\n\n
Elevated venous pressure
hypotensive
quite heart<\/p>\n\n\n\n
Respiratory variations<\/p>\n\n\n\n
Flow will decrees across mitral and AOV and increase across tricuspid and pulmonic valves with inspiration<\/p>\n\n\n\n
Pulmonary hypertensive<\/p>\n\n\n\n
Constrictive pericarditis<\/p>\n\n\n\n
Pulmonary Hypertension<\/p>\n\n\n\n
Reversal of a long-standing left-to-right shunt from PHTN. Shunt is now right-to-left<\/p>\n\n\n\n
pulmonary hypertension by M-mode<\/p>\n\n\n\n
Sever<\/p>\n\n\n\n
Normal: 18-40mmHg
Mild:40-54mmHg
Mod: 55-64mmHg
sever: >65mmHg<\/p>\n\n\n\n
8mmHg<\/p>\n\n\n\n
increase<\/p>\n\n\n\n
Aneurysm formation (8-15%)<\/p>\n\n\n\n
Inferior MI<\/p>\n\n\n\n
Dilated RV<\/p>\n\n\n\n
-wide base
-walls composed of myocardium<\/p>\n\n\n\n\n
-Narrow base
-Walls composed of thrombus and pericardium
-High risk of rupture<\/p>\n\n\n\n
inferior basal<\/p>\n\n\n\n
no, its a rupture across both ends and myocardium<\/p>\n\n\n\n
Movement of other walls<\/p>\n\n\n\n
VSD, because you can use PW and CW Doppler for detecting Mitral Regurgitation<\/p>\n\n\n\n
MR<\/p>\n\n\n\n
Coronary artery aneurysm<\/p>\n\n\n\n
Hypokinesis<\/p>\n\n\n\n
no motion<\/p>\n\n\n\n
motion in opposite then normal direction<\/p>\n\n\n\n
Dyskinetic or paradoxical<\/p>\n\n\n\n
-anterior wall
-anteroseptal wall
-LV apex<\/p>\n\n\n\n
-anterolateral wall
-inferolateral wall<\/p>\n\n\n\n
-inferior wall
-inferoseptal wall
-RV apex
-RV free wall<\/p>\n\n\n\n
In the LEFT and RIGHT aortic sinus of Valsalva<\/p>\n\n\n\n
When the right coronary gives rise to the “posterior descending artery” (85% of the time)<\/p>\n\n\n\n
Right (also usually supplies the SA and AV nodes)<\/p>\n\n\n\n
RCA<\/p>\n\n\n\n
yes<\/p>\n\n\n\n
-chest pain
-severity of CAD
-guide post MI rehab
-evaluate cardiac arrhythmias<\/p>\n\n\n\n
unstable Angina<\/p>\n\n\n\n
Atropine<\/p>\n\n\n\n
a congenital malformation where there is a membrane above the level of the mitral valve. in sever cases these is supravalvular stenosis.<\/p>\n\n\n\n
Secundum ASD<\/p>\n\n\n\n
sinus venosus<\/p>\n\n\n\n
modified subcostal four chamber<\/p>\n\n\n\n
Subcostal 4 chamber<\/p>\n\n\n\n
A4<\/p>\n\n\n\n
<5 beats for an ASD (> 5 beats for pulm shunts)<\/p>\n\n\n\n
Left Arm<\/p>\n\n\n\n
Down syndrome or trisomy 21<\/p>\n\n\n\n
perimembranous<\/p>\n\n\n\n
high near the aortic and pulmonic valve<\/p>\n\n\n\n
subvalvular low near the mitral and tricuspid valves<\/p>\n\n\n\n
Loud holosystolic murmur<\/p>\n\n\n\n
Ebstein’s<\/p>\n\n\n\n
Eisenmengers syndrome<\/p>\n\n\n\n
ASD<\/p>\n\n\n\n
-perimembranous VSD
-overriding Aorta
-Pulmonary stenosis
-RV hypertrophy<\/p>\n\n\n\n
Yes<\/p>\n\n\n\n
RV<\/p>\n\n\n\n
pericardial effusion<\/p>\n\n\n\n
RA<\/p>\n\n\n\n
pap fibrolastoma<\/p>\n\n\n\n
benign muscle tumors<\/p>\n\n\n\n
LA (75%)<\/p>\n\n\n\n
interatrial septum<\/p>\n\n\n\n