DMS 350

Hypertension

100

What is considered normal blood pressure?

<120/<80

200

If there is systemic hypertension, what would you expect to see on echo?

LV hypertrophy

300

What values do we use to determine the type of LV geometry present? 

LV Mass & Regional wall thickness

400

If a patient has pulmonary hypertension that is not controlled, what would you expect to happen to their heart? 

RV hypertrophy to RV dilation and RA dilation and eventually RV heart failure.

500

What is seen on M-mode with pulmonary hypertension?

Reduced or absent a dip and mid systolic pulmonary notching - "flying w"

Ischemic Heart Disease

100

What is the difference between ischemia and infarction?

Ischemia is a lack of oxygen due to a narrowing or obstruction where infarction is when the heart muscle is damaged. 

200

What is the gold standard for ischemic heart disease?

coronary angiogram

300

You are trying to evaluate the coronary arteries on a patient who may have ischemia.  Where would you find them at if in the Short axis view? (Think of the clock)

RCA at 11 o'clock

LCA at 4 o'clock

400

We calculate wall motion score using what view of the heart? 

Short axis views of the LV at Base, mid pap and apex

500

There is akinesis at the anterolateral aspect of the LV.  What coronary supplies this? 

LAD or CX

Cardiomyopathy

100

Disease of the myocardium characterized by dilatation and decreased systolic function of the LV or both LV and RV is

Dilated cardiomyopathy

200

The heart has a spade shape to it. What type of cardiomyopathy would you aspect

Apical hypertrophy

300

We characterize the septal morphology of the heart into four categories with HCM.  What are they?

Sigmoid, Reverse Curve, Neutral, and Apical

400

With severe restrictive cardiomyopathy, what type of diastolic dysfunction would you expect? 

Grade 3 restrictive filling

500

A multisystem disease with extracellular deposition of the amyloid protein in various tissues is? 

Amyloidosis

Valvular Heart Disease

100

What is the difference between stenosis and regurgitation? 

Stenosis is a narrowing of the valve

Regurgitation is a backward flow of blood due to failure of the valve to properly close

200

The most common congenital abnormality resulting in aortic stenosis is

Bicuspid Valve

300

What is the most common primary reason for MR? 

Mitral valve prolapse due to myxomatous changes.

400

What is myxomatous change? 

a degenerative process where tissue becomes soft and jelly-like due to an excessive buildup of a gel-like substance called mucopolysaccharides in the extracellular matrix, often occurring in connective tissues like heart valves, causing them to become loose and floppy

500

You are performing a doppler of the hepatic veins and notice retrograde flow.  What valvular disease would you expect?

Tricuspid regurgitation

Prosthetic Valves

100

What is the most common complication of bioprosthetic valves? 

Calcification/Degeneration

200

Explain the Ross Procedure:

It is categorized as an autograft bioprosthetic; where you take the patient's pulmonary valve place it in the aortic position and then use a homograft in the pulmonic position. 

300

What would you expect to see on an echo with a mechanical mitral valve? (Think artifact)

Shadowing 

400

What two methods can be used to perform a TAVR? (Think of locations used)

Transapical, Transfemoral

500

True or False: No matter what type of valve the patient had the abnormal values for Peak Velocity, Valve area, and Mean Gradient are all the same. 

False