Study

Chap 11 Part 2

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  • Htn and ______ ______ ______ accelerates conditions causing MAC.
    chronic renal insufficiendy
  • Degree of MR / Vena contracta width = mild moderate severe
    mild 0-3cm moderate 0.3 - 0.6cm severe >0.6cm
  • What is functional MR?
    not caused by the valve instead but underlying issues such as, LAE, LVE, DCM, IHD, HOCM (SAM)
  • What does PISA stand for?
    Proximal isovelocity surface area
  • What are the 2 Tumors of MV?
    1. Myxtoma (rare, non-cancerous, bulky & moves w/ MV). 2, Fibroelastoma (highly mobile, 2-10mm, attached to MV or chords).
  • 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.
  • Name atleast 3 other abnormalities of MV.
    Aneurysm, Endocarditis & valve perforation, Cleft MV, Annular dehiscence, radiation damage, drug (phentermine)
  • How do you calculate Regurgitant Volume?
    RV= SV regurgitant valve - SV competent Valve
  • 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: Overtime, MR causes irreversible reduced LV Myocardial Contractility.
    True. MR results in volume overload of LV.
  • When A wave is higher than E wave= ________ dysfunction
    Diastolic Dysfunction (decreased LV compliance)
  • True/ False: Larger the Regurgitant Volume, Darker the envelope of MR flow.
    True. Density is proportional to the number of blood cells within beam.
  • 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 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.
  • 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.
  • 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 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 are changes caused by hemodynamically significant MR. Name Two
    LAE, LVE, Elevated LA pressures, pulmonary congestion
  • 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.
  • what are some Surgical options? Name one.
    Annuloplasty (flail leaflet), MV replacement, Mitraclip
  • MAC and MVP is most commonly seen in ________ leaflet.
    Posterior.