Valvular Pathology
What is the hallmark 2D finding in mitral stenosis?
Hockey stick/doming
What is the simplified Bernoulli equation?
ΔP = 4 × (velocity)².
Which view best assesses the aortic valve morphology?
Parasternal long axis or short axis view.
What is the mean pressure gradient range for moderate MS
5-10mmHg
What symptom is most common in AS?
Exertional dyspnea
Which view best visualizes the mitral valve leaflets in their entirety?
Parasternal long axis view.
What chamber is most anterior in the chest?
Right ventricle.
Name one cause of tricuspid stenosis.
Carcinoid heart disease or RHD or congenital
Calculate MVA using PHT of 220 ms.
MVA = 220 ÷ PHT → 220 ÷ 220 = 1.0 cm².
What does a doming anterior mitral leaflet suggest?
Mitral stenosis – anterior leaflet doming.
What is the AVA range for moderate AS?
1.0–1.5 cm²
What murmur is associated with MR?
Holosystolic murmur
Which view allows for visualization of all three aortic valve cusps?
Parasternal short axis at the level of the aortic valve.
What structure connects the papillary muscles to the valve leaflets?
Chordae tendineae.
Describe the inflow CW doppler characteristics of severe AR
Steep slope longer PHT
What is the normal range for RVSP?
Normal RVSP: <30 mmHg.
Identify the best view for assessing TR severity.
Apical four-chamber view.
What is the pressure half-time range for moderate AR?
200–500 ms
What is the treatment approach for a high-risk patient with severe AS?
TAVR
What view is ideal for assessing the interatrial septum for a PFO?
Subcostal four-chamber view.
Which segments are visualized in the apical four-chamber view for wall motion assessment?
Basal, mid, and apical lateral and septal segments.
What valve pathology is associated with thickened, fibrotic, shrunken cups usually with fusion at the commissures of the AOV that appears triangular when open.
rheumatic heart disease
What formula is used to calculate AVA using the continuity equation?
AVA = (LVOT CSA × LVOT VTI) ÷ AV VTI.
What does a eccentric jet in MR typically indicate?
MVP or severe MR
What is the pressure gradient for mild PHTN
30-40mmHg
What murmur is associated with severe AI?
Austin Flint
What view is best for measuring RV size and function?
Apical four-chamber view.
Which coronary artery supplies the lateral wall of the left ventricle?
Left circumflex artery.
What is the EROA threshold for severe mitral regurgitation?
EROA between >.40 cm² indicates severe MR.
How do you calculate EROA for MR?
EROA=(PISAr)2 x VA ÷ VTI of mitral regurgitant jet.
What is the significance of flow reversal at the descending aorta?
Severe Aortic Insufficiency
Abnormal Mitral Inflow E/A Ratio
<.8 cm/s
What ECG finding associated with a-fib
Which 2 views is used to assess the LAA ?
Apical two-chamber view & Parasternal short axis at the level of the aortic valve.
Which wall segment is most commonly affected in an anterior myocardial infarction?
Anterior wall (supplied by the LAD).