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Chap 11 Part 1
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True/ Flase: Pulmonary Edema & reduced CO are caused by a valve defect and can lead to exertional dyspnea.
True.
Plumonary Congestion, A-fib and LAE is caused by?
MS
What are some possible therapies?
MV replacement, Percutaneous balloon valvotomy (not possible with severe calcification, MS score <8 best candidate)
Some Secondary affects of MS are: name 3
Increased LAP, LAE, A-Fib, Thrombus formation in LAA (dilitation), prone to thrombus formation, spontaneous echo contrast, pHtn
What are the factors affecting pressure gradients?
Volume status, heart rate and stroke volume.
Peak Gradient is calc by the bernoulli equation. Mean Gradient is calc from the VTI across the MV as measured with CW doppler. What are the mild - severe values for mean gradient?
Mild 0-5 mmHg, Moderate 5-10mmHg, Severe >10mmHg
What am I? A reflection of the rate at which Left atrial and ventricular pressures equilibrate during diastole.
PHT. (220/PHT=MVA) (PHT 220 or greater will give severe MS) (with RCM or IHD PHT may falsely increase due to elevated LVEDP)
Name methods of determining Mitral Stenosis Severity. atleast 2
1) PHT , 2) Pressure Gradient, 3) Continuity Equation.
How can you differentiate MV M-Mode if the Stenosis is severe or not?
Severe with flatter M-Mode, Improved with Steeper. Reduced diastolic E-F slope of mitral closure.
True/ False: Decreased excursion in M-mode is Hallmark of MS.
False. Increased echogenecity of the leaflets is Hallmark of MS.
True/ False: Parachute MV is when all chordae attach to a single papillary muscle.
True.
Mitral Stenosis causes leaflets to open with ________ motion. Anterior leaflet appears as _______ _______ in _________(cardiac cycle).
doming motion, hockey stick, diastole.
What are other etiologies besides rheumatic heart disease for Mitral stenosis?
Mitral Annular Calcification (MAC), Congenital MS
How do we label the two major papillary muscles?
Anterolateral (dual blood supply, less prone to ischemic events) Posteromedial (perfused by RCA)
What are the two MV leaflets reffered as?
anterior and posterior.
What is the classic form of MV disease?
Rheumatic Heart disease which involves leaflets and chordae.
What is the MV apparatus comprised of? Name atleast three.
Mitral Annulus, leaflets, chordae tendineae, papillary muscles and the underlying ventricular wall.
Mitral Valve Dysfunction is a result of abnormal ___________.
MV apparatus
Patient evaluation with suspected Mitral Valve disease include (atleast two);
Murmurs, Congestive Heart Failure, Ischemic Heart Disease, DCM & HCM
Mitral Valve values. normal MVA? Mild MS? Moderate? Severe? (atleast 2)
4-6 cm2, 2-4c m2, 1-2 cm2, <1 cm2
True/ False: Mitral valve was the first 4 of the cardiac valves to be evaluated with echo.
True. facts
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