MHS Adult Echo Protocol
When strain is performed on a Wednesday at 3:40pm, what reading pool should the echo be assigned to?
MHS Advanced Imaging Pool (807)
***Monday thru Friday 8am-5pm***
No weekends or holidays.
Which cardiac chamber normally forms most of the anterior surface of the heart?
Right Ventricle
What is the primary limitation of PW Doppler when measuring high velocities?
Aliasing
What phenomenon can make an eccentric mitral regurgitation jet appear smaller than it actually is when the jet hugs the atrial wall?
Coandă effect
Patient presents with acute dyspnea and tachycardia. TAPSE =19mm and S' =11cm/s. RV free-wall mid segment is akinetic with preservation of apical motion. What do these findings suggest?
McConell's Sign (RV strain)
What are the three areas in Epic you review for prior studies?
Cardiac/Imaging Tab
Care Everywhere
Historical Patient Data
What imaging mode displays cardiac structures along a single ultrasound beam over time?
M-mode
Using the simplified Bernoulli equation, what is the pressure gradient if the peak velocity across the valve is 4m/s?
64mmHg
Patient has AV Vmax=3.5m/s, AVA = 0.8cm2, MeanPG = 32mmHg, Stroke Volume Index=28mL/m2 and EF= 38%. What type of AS pattern is it?
Low-flow, low-gradient aortic stenosis
Patient has a D-shaped LV during systole and elevated TR velocity. What does that suggest?
RV pressure overload.
When utilizing the GDV Maneuver, what pressure must the patient maintain on the manometer and for how long?
60mmHg for 10 seconds
What is the most common measurement error that can falsely change calculated AVA?
LVOT diameter measurement
What does the E wave of mitral inflow represent?
Early passive LV filling during diastole.
A patient has severe eccentric mitral regurgitation. On TTE, the posterior mitral leaflet appears to move freely into the left atrium during systole due to loss of normal chordal support. What is this finding?
Flail mitral leaflet
Patient has LV hypertrophy, a small LV cavity, biatrial enlargement, restrictive filling, and a "sparkly" myocardial appearance. Your GLS shows relative apical sparing.
Cardiac amyloidosis
What are the four measurements performed on the Aorta in parasternal long axis view?
- LVOT diameter
-AO Sinus
-AO STJ
-AO Asc
What structures should you avoid including in the LV cavity when tracing Simpsons Biplane?
Papillary muscles and trabeculations.
Patient has a TR Vmax of 3m/s and the IVC is measuring 2.4cm and 1.1cm with inspiration. What is RVSP? and if elevated what degree?
RVSP =44mmHg, mildly elevated.
During TEE, a small, highly mobile, filamentous structure is seen attached to the free edge of an otherwise normal aortic valve leaflet. There is no significant regurgitation. What benign valvular finding should be considered?
Lambl's Excrescences
Patient has dyspnea, EF 65%, left atrial enlargement, and evidence of elevated LV filling pressures. What type of heart failure should be considered?
Heart Failure with preserved ejection fraction (HFpEF)
Put these in the correct order for your Syngo Report
-Aorta
-Atria
-Bubble Study
-Catheter/Devices
-LV
-Pericardial Effusion
-Prior Study
-RV
-RVSP
-Valves
-LV
-RV
-Atria
-Bubble Study
-Valves
-RVSP
-Aorta
-Catheter/Devices
-Pericardial Effusion
-Prior Study
You notice a markedly dilated coronary sinus in the posterior AV groove. What congenital venous anomaly should you consider, and what additional echo maneuver can help confirm it?
Persistent left superior vena cava (PLSVC) should be considered. Agitated saline injected into the left arm will typically opacify the dilated coronary sinus before the right atrium.
During evaluation of mitral regurgitation, the sonographer uses color Doppler to identify a hemispheric flow convergence region on the ventricular side of the mitral valve and measures its radius and aliasing velocity. What quantitative method is being used?
PISA (Proximal Isovelocity Surface Area)
During LVOT VTI acquisition, the PW Doppler sample is placed too close to the aortic valve and the tracing begins to show high-velocity flow. How can this affect calculated aortic valve area?
It can overestimate LVOT VTI, resulting in an overestimated stroke volume and potentially an overestimated AVA.
Patient has apical ballooning with hyperdynamic basal segments and no obstructive coronary lesion in the appropriate clinical setting.
Takotsubo Cardiomyopathy