Podcast
Questions and Answers
Which of the following best describes the hemodynamic response to aortic insufficiency (AI)?
Which of the following best describes the hemodynamic response to aortic insufficiency (AI)?
- Decreased preload, leading to increased contractility.
- Decreased afterload, leading to decreased ventricular end-diastolic pressure.
- Increased preload, leading to ventricular volume overload. (correct)
- Increased afterload, leading to decreased stroke volume.
What is the significance of identifying an eccentric diastolic closure line on M-mode echocardiography in the context of aortic valve pathology?
What is the significance of identifying an eccentric diastolic closure line on M-mode echocardiography in the context of aortic valve pathology?
- It confirms the presence of a bicuspid aortic valve.
- It suggests the presence of aortic valve regurgitation. (correct)
- It is a normal finding and of no clinical significance.
- It indicates the severity of aortic valve stenosis.
Which of the following best describes the utility of performing a Dobutamine stress echo in the evaluation of aortic stenosis?
Which of the following best describes the utility of performing a Dobutamine stress echo in the evaluation of aortic stenosis?
- To evaluate for inducible myocardial ischemia.
- To identify the presence of a bicuspid aortic valve.
- To measure pulmonary artery pressure.
- To assess the severity of aortic stenosis in patients with low ejection fraction. (correct)
A patient is diagnosed with Takotsubo cardiomyopathy (TTC). Angiography reveals no coronary artery disease. Which of the following is the most likely trigger for this condition?
A patient is diagnosed with Takotsubo cardiomyopathy (TTC). Angiography reveals no coronary artery disease. Which of the following is the most likely trigger for this condition?
Which of the following best explains the 'pressure cascade' or 'domino effect' in the context of aortic stenosis?
Which of the following best explains the 'pressure cascade' or 'domino effect' in the context of aortic stenosis?
A patient with known aortic stenosis presents with pulsus parvus et tardus. What does this clinical finding suggest about their condition?
A patient with known aortic stenosis presents with pulsus parvus et tardus. What does this clinical finding suggest about their condition?
What is the primary advantage of surgical aortic valve replacement (SAVR) compared to transcatheter aortic valve replacement (TAVR) in younger patients?
What is the primary advantage of surgical aortic valve replacement (SAVR) compared to transcatheter aortic valve replacement (TAVR) in younger patients?
Which echocardiographic method is most suitable for assessing AS Doppler measurements in patients with irregular heart rhythms, such as atrial fibrillation?
Which echocardiographic method is most suitable for assessing AS Doppler measurements in patients with irregular heart rhythms, such as atrial fibrillation?
A patient with dilated cardiomyopathy (DCM) has a left ventricular ejection fraction (LVEF) of less than 40%. Which of the following is a potential long-term consequence of this condition?
A patient with dilated cardiomyopathy (DCM) has a left ventricular ejection fraction (LVEF) of less than 40%. Which of the following is a potential long-term consequence of this condition?
Which of the following is the correct method for calculating aortic valve area (AVA) using the continuity equation?
Which of the following is the correct method for calculating aortic valve area (AVA) using the continuity equation?
Flashcards
Atrophy
Atrophy
Decrease in cell size
Hypertrophy
Hypertrophy
Increase in cell size
Hyperplasia
Hyperplasia
Increase in cell number
Metaplasia
Metaplasia
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Dysplasia
Dysplasia
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Apoptosis
Apoptosis
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Stenosis
Stenosis
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Regurgitation
Regurgitation
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Aortic Valve Stenosis
Aortic Valve Stenosis
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Angiotensin Converting Enzyme (ACE) - "pril"
Angiotensin Converting Enzyme (ACE) - "pril"
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Study Notes
- Atrophy: The wasting away or decrease in size of a body part, tissue, or organ.
- Hypertrophy: The enlargement of an organ or tissue from the increase in size of its cells.
- Hyperplasia: The enlargement of an organ or tissue caused by an increase in the reproduction rate of its cells.
- Metaplasia: The abnormal change in the nature of a tissue.
- Dysplasia: The presence of cells of an abnormal type within a tissue, which may signify a stage preceding the development of cancer.
- Apoptosis: The process of programmed cell death.
- Left Ventricular Hypertrophy: Thickening of the heart's left ventricle.
- Stenosis: The abnormal narrowing of a passage in the body.
- Ventricular Torsion & Twisting: The wringing motion of the ventricles during the cardiac cycle.
- Regurgitation: The backward flowing of blood.
- Aortic Valve Stenosis: Narrowing of the aortic valve opening.
- Degenerative: Resulting from or characterized by degeneration.
- Congenital: Present from birth.
- Rheumatic Fever: An inflammatory disease that can develop as a complication of inadequately treated strep throat or scarlet fever.
- Bicuspid Aortic Valve: A type of aortic valve that only has two leaflets, instead of the normal three.
- Unicuspid Aortic Valve: A rare congenital heart defect in which the aortic valve has only one leaflet.
- Quadracuspid Aortic Valve: A rare congenital heart defect in which the aortic valve has four leaflets.
- Raphe: A ridge or seam-like structure.
- Acquired bicuspid aortic valve: Bicuspid aortic valve that develops later in life.
- Aortic Stenosis as seen on M-Mode echocardiography is a diagnostic tool using motion mode.
- Eccentric diastolic closure line: An abnormal M-mode finding in aortic stenosis.
- Raphe Types: Categorized as Type O, Type I, or Type II, describing the extent and location of the raphe on bicuspid aortic valves.
- Symptoms related to aortic stenosis
- Aortic Stenosis Clinical Findings/Presentation
- Complications of Aortic Stenosis: Potential adverse outcomes resulting from the condition.
- Chamber Pressures resulting from Aortic Stenosis
- Pressure Cascade/Domino Effect due to AS
- Crescendo-Decrescendo: The characteristic shape of the systolic murmur in aortic stenosis.
- Pulsus Parvus et Tardus: A weak and delayed arterial pulse associated with aortic stenosis.
- Complimentary testing/modalities for Aortic Stenosis
- Cardiac Catheterization: An invasive diagnostic procedure used to assess the severity of aortic stenosis.
- Gorlin Formula: Used to calculate aortic valve area.
- M-Mode in AS, appearance on M-Mode imaging.
- Wigger's Diagram in AS: A graphical representation of the cardiac cycle in aortic stenosis.
- Systolic "doming": The upward bowing of the aortic valve during systole, seen in aortic stenosis.
- Post stenotic dilatation: Enlargement of the aorta beyond the point of stenosis.
- Left atrial enlargement can be caused by Aortic Stenosis
- Aortic Stenosis in late course, leading to decreased LV systolic function
- AS - Peak Velocity: The highest velocity of blood flow through the stenotic aortic valve.
- AS - Maximum Instantaneous Pressure Gradient: The peak difference in pressure across the aortic valve.
- AS - Mean Transvalvular Pressure Gradient: Average pressure difference across the aortic valve during systole.
- Aortic Valve Area (AVA): The calculated area of the aortic valve opening.
- Aortic Stenosis Velocity Ratio
- Bernoulli Principle: Used to estimate pressure gradients across the aortic valve.
- Aortic Stenosis can cause aortic insufficiency/regurgitation
- Doppler in Aortic Stenosis versus Mitral Regurgitation
- Continuity Equation: Formula used to calculate valve area based on flow velocities.
- Common Errors in Flow Angle
- AS Doppler Measurement in Irregular Rhythm(s)
- Dimensionless Measurements
- Aortic Valve Prolapse
- Aortic Stenosis
- Aortic Valve Perforation
- Aortic Annular Dilatation/Aortic Root Dilatation
- Aortic Insufficiency (AI) / Aortic Regurgitation (AR)
- Hemodynamic LV Response to AI
- AI Pressure Half-Time (P1/2t)
- Descending Aorta - Diastolic Reversal = blood flows in opposite direction during diastole in the descending aorta
- Abdominal Aorta - Diastolic Reversal = blood flows in opposite direction during diastole in the abdominal aorta
- Color Doppler: extent, occupancy, and aliasing properties
- AI Spectral Doppler: Spectral Broadening strength
- AI - Proximal Isovelocity Surface Area (PISA)
- AI - Vena Contracta
- Emphasis on pathology relating to heart conditions and disease.
- Echo/ultrasound usage in descriptive language
- Pedoff probe windows/positions
- Aortic stenosis with low ejection fraction
- Dobutamine/Dobutamine stress echo: Stress test using dobutamine to assess aortic stenosis.
- False positive for Aortic Stenosis
- Angiotensin Converting Enzyme (ACE) Inhibitors which typically end in "pril"
- Beta Blockers typically end in "olol"
- Selective versus non-selective beta blockers
- Preload: The amount of ventricular stretch at the end of diastole.
- Afterload: The resistance the left ventricle must overcome to circulate blood.
- Prosthetic valves use in valve replacement surgery
- Mechanical Valve Types
- Bioprosthetic Valves
- Allograft or Homograft: A tissue graft from a donor of the same species.
- Porcine Heterograft: A xenograft from a pig.
- Bovine Heterograft: A xenograft from a cow.
- Aortic Stenosis Symptoms include
- Mechanical Versus Bioprosthetic Longevity
- Surgical Aortic Valve Replacement (SAVR): Traditional open-heart surgery for valve replacement.
- Transcatheter Aortic Valve Replacement (TAVR): Minimally invasive procedure for valve replacement.
- Valve-in-Valve TAVR: Placement of a new valve inside a failed TAVR valve.
- Normal mean valve gradient for prosthetic valve
- Cardiomyopathies: Diseases of the heart muscle.
- Dilated Cardiomyopathy (DCM): Enlargement and weakening of the left ventricle.
- Genetic CM: Cardiomyopathy caused by genetic factors.
- Acquired CM: Cardiomyopathy caused by external factors. -LVEF <40%: Indicates reduced left ventricular ejection fraction, indicative of heart failure.
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