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Echo Chapter 15
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What is Chronic thrombus formation is most common after large anterior myocardial infarction, especially with involvement of the apex.
Mural Thrombus
what is shown in the image
LV Pseudoaneursym
what is shown in the image
myocardial diverticulum.
An infrequently encountered abnormality which may be confused for an infarct-related aneurysm is a ______ _________.
myocardial diverticulum.
Surgical approaches to control heart failure in patients with ventricular aneurysm have included reduction ______ and ___ ______.
myoplasty and Dor myoplasty.
Whats shown in the image
LV Aneurysm
true/ false: aneurysm does not occur after non-transmural infarction
True. (its a a dead space reservoir with no ability to eject blood from its diastolic volume and thus compromises stroke volume.)
_________ is defined as a distinct break in the geometry of the left ventricular contour that is present in both diastole and systole with replacement of myocardium by fibrous scar tissue.
Aneurysm
Chronic complication so CAD include:
LV aneurysm , Pseudoaneurysm, LV remodeling, Chronic ischemic dysfunction (Ischemic cardiomyopathy), Functional MR, RV dysfunction
What is shown in the image
papillary muscle rupture
Right Ventricular Infarction Occurs in conjunction with________ MI (>90%)
Inferior. (occluded RCA)
Before acute reperfusion strategies for MI, ventricular thrombus was reported in 25-40% of patients with ________ MI.
Anterior
True/ False: A free wall rupture is the most catastrophic complication of STEMI
True. Involves the tearing or rupture of the acutely infarcted tissue
Delayed pericarditis aka ______________ can also occur after MI, Less prevalent, Consists of recurrent pain with pericardial fluid, Typically occurs around 6 weeks to 3 months post MI.
Dressler syndrome
Larger effusion one should always considered a _____ _____.
myocardial rupture
Post-infarction ______ ______ is reported in 30–40% in patients with STEMI.
pericardial effusion
What are the Some major complications of Acute MI.
ventricular free wall rupture ventricular septal rupture papillary muscle rupture (severe acute mitral regurgitation)
What MI is shown in this image?
Septal MI
What is the normal strain rate?
-20%
_____ ______ ______ is a 2D-based strain imaging modality used to calculate strain rate. .
Speckle Tracking Echocardiography (STE)
Write down from normal to aneurysmal wall motion.
1 for normal contraction or hyperkinesia, *2 for hypokinesis 3 for akinesia, *4 for dyskinesia. *5 for aneurysmal segments
Most commonly used assessment of LV systolic function is ______. Most commonly used method for quantitation of LV volume is ______.
*EF *Simpson rule
what are the Global parameters of LV function>
Ventricular geometry Ejection fraction LV Volumes Diastole and systole
_______ is gold standard to assess origin and course of coronary arteries
CTA
What is Kawasaki Disease.
Is an infectious/inflammatory disease found in childhood. Major manifestation are rash and fever and associated with aneurysms of coronary arteries.
Although the location of the WMA is an accurate marker for the site of ischemia or infarctions, the size of the WMA may be over or underestimated due to __________.
tethering (Tethering refers to the impact that an abnormal segment has on normal adjacent segments, a WMA will be overestimated by ~ 15% due to this)
Regional dilation in area of the scar can result in _________ _________.
ventricular aneurysm. ( is defined as regional area of akinesis or dyskinesis and scar that has abnormal geometry in both diastole and systole)
Around ____ weeks, necrotic myocardium is replaced by fibrosis and scar
6 weeks,
Typically with brief occlusion of 5 minutes- restores _______ seconds Occlusion of 30-60 minutes- restoring function may take ______ hours
*6-120s *24-72hrs
_______ Myocardium occurs with transient occlusion of ____-____ minutes
Stunned myocardium, 20-60 mins
Severity of WMA depends on if _____ vs _______ infarction
transmural vs non-transmural infarction
If coronary obstruction persists for a threshold period of time _______myocardial necrosis and persistent wall motion abnormalities develop. (irreversible myocardial necrosis).
(>4 hours)
Most commonly identified CAD abnormality identified is
Abnormal MV inflow
Coronary Occlusion results in ______ dysfunction.
Diastolic
Clinical presentation of CAD includes:
Stable angina, Unstable angina, MI, Ischemic cardiomyopathy, CHF, SCD
True/ False: CAD is most common Heart Disease in the heart.
True
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