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Mitral Regurge is caused by disruption of the Mitral Apparatus. How is MR categorized, explain.
Primary (disease of the MV leaflet), Secondary (Abnormalities of other components of MV apparatus). Treatment is category dependent.
True/ False: Overtime, MR causes irreversible reduced LV Myocardial Contractility.
True. MR results in volume overload of LV.
What are changes caused by hemodynamically significant MR. Name Two
LAE, LVE, Elevated LA pressures, pulmonary congestion
What are some main factors affecting Regurgitant Jet appearance? Name Two.
Gain, Scale, Frame rate, Sector Size, Transducer, Color flow algorithms, Machine
Name two factors for evaluating severity of MR.
Size of Jet, Volumetric flow by PISA, Effective Regurgitant Orifice, Volume of Regurge flow.
What does PISA stand for?
Proximal isovelocity surface area
Jet area and LA area are measured in A4C. What is the equation for percentage of total LA area?
Jet area/ LAA x100%
True/ False: Larger the Regurgitant Volume, Darker the envelope of MR flow.
True. Density is proportional to the number of blood cells within beam.
One fact while doing PISA measurement.
Must lower baseline 40 or lower cm/s. Cannot be used on multiple jet. ERO/ROA calculated by PISA. Valve should be completely closed in systole.
Degree of MR / Vena contracta width = mild moderate severe
mild 0-3cm moderate 0.3 - 0.6cm severe >0.6cm
How do you calculate Regurgitant Volume?
RV= SV regurgitant valve - SV competent Valve
Assessing MR severity, values= mild mod severe. (choose one)
color flow jet, Regurgitant fraction, Regurgitant Volume, ROA
Color Flow Jet%= <20 , 20-40 , >40
RV(mL)= <30 , 30-59 , >60
RF(cm)= <0.3 , 0.3-0.7 , >0.7
ROA(cm2)= <0.20 , 0.20-0.39 , >0.40
What is functional MR?
not caused by the valve instead but underlying issues such as, LAE, LVE, DCM, IHD, HOCM (SAM)
What is arrow poiting at in the image shown?
Flail Anterior Leaflet.(can result with disrupted MV apparatus, has eccentric jet on the oppsite side of the flail leaflet, TEE confirms precise location)
what am I? connective tissue disorder characterized by thickening and elongation if Mitraal leaflets and chordae and dilation mitral annulus.
Myxomatous Degenration. often causes flail leaflet
What is shown in the image shown?
Mitral Valve Prolapse (MVP), bowing of the valve into LA During ventricular systole. It can be Bi-leaflet or single.
