Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
57 Cards in this Set
- Front
- Back
This is a narrowing, thickening and/or obstruction of the MV that impedes diastolic blood flow |
Mitral Stenosis (MS)
|
|
What kind of murmur is found with MS?
|
Low pitched, diastolic rumble with an opening snap
|
|
What is the top cause of MS?
|
Rheumatic Fever (typically resulting from strep infection between ages of 5-15)
|
|
What are 5 causes of MS?
|
1. Rheumatic Fever
2. MAC (severe) 3. Congenital Anomoly (MV atresia, parachute MV) 4. LA Mass, Tumor, Veg 5. Prosthetic Valve Dysfunction |
|
The first effect of MS is seen where?
|
Elevated LA Pressure
|
|
What happens to stenotic MV leaflets during systole?
|
Doming
|
|
If stenotic MV elevates LA pressure, what happens to the LA eventually?
|
LAE
|
|
LAE can cause what form of dysrhythmia?
|
Atrial Fibrillation
|
|
If stenotic MV elevates LA pressure, what can happen to the pulmonary veins?
|
Backup and Enlargement of Pulmonary Veins
|
|
The first effect of MS is seen where?
|
Elevated LA Pressure
|
|
What happens to stenotic MV leaflets during systole?
|
Doming
|
|
If stenotic MV elevates LA pressure, what happens to the LA eventually?
|
LAE
|
|
LAE can cause what form of dysrhythmia?
|
Atrial Fibrillation
|
|
If stenotic MV elevates LA pressure, what can happen to the pulmonary veins?
|
Backup and Enlargement of Pulmonary Veins
|
|
If backup & enlargement of pulmonary veins occur, what happens to the pulmonary artery?
|
Backup & Enlargement of Pulmonary Artery; Pulmonary Hypertension
|
|
Pulmonary hypertension can cause what?
|
RAE
|
|
RAE can cause what (outside of the RA)?
|
TV Annulus Enlargement, causing TR
|
|
Pulmonary Hypertension & RAE can cause what?
|
Dilatation of the IVC and SVC
|
|
Dilatation of the IVC/SVC can cause what?
|
Dilatation & Enlargement of the Hepatic Veins/Jugular Vein
|
|
Dilatation & Enlargement of the Hepatic Veins/Jugular Vein can cause what?
|
Ascites, Edema
|
|
Turbulent blood flow through and around the MV can put the patient at increased risk for what?
|
Infective Endocarditis
|
|
What effect does MS have on cardiac output?
|
Decreased Cardiac Output
|
|
Signs/Symptoms:
- dyspnea, - hemoptysis - fatigue - chest pain - syncope, - right heart failure |
MS
|
|
What effect does MS have on the appearance of the MV leaflets in PLAX 2D?
|
Doming / Hockey Stick
|
|
Does MS cause the MV leaflets to thin or thicken? By how much?
|
Thicken > 3mm
|
|
How does MS affect MV orifice area? Where can this be measured using planimetry?
|
Decreased MV Area
Measured in PSAX MV |
|
What effect does MS have on chordae tendinaea?
|
Thickening & Fibrosis
|
|
Slower filling of LV (due to increased LA pressure) causes what?
|
LAE
|
|
What two things may be seen in the LA, associated with MS?
|
Smoke
Thrombus |
|
Chronic volume and pressure overload causes what 2 effects on the right side?
|
RVE & RVH
|
|
Chronic volume and pressure overload causes what effect on the left side?
|
Small, "D" shaped LV in systole and/or diastole
|
|
Other findings of MS include dilation of what 4 structures?
|
RA
SVC IVC Hepatic Vein |
|
In M-Mode, what effect will MS have on E-F slope?
|
Decreased E-F Slope (slower filling holds the valve open longer)
|
|
In M-Mode, what effect will MS have on A wave of anterior MV leaflet?
|
Decreased A Wave (slower filling holds the valve open longer)
|
|
In M-Mode, what effect will MS have on MV leaflet excursion?
|
Decreased D-E Excursion
<= 15 mm |
|
In M-Mode, what effect will MS have on the appearance of MV leaflets?
|
Thicker & Brighter
|
|
In M-Mode, what effect will MS have on the posterior MV leaflet (PMVL)?
|
Anterior motion of the PMVL, due to stenosis & tethering
|
|
In M-Mode, what effect will MS have on the LA?
|
LAE
|
|
Flattening of the IVS results from what? best visualized in what view?
|
Increased RV Pressure
PSAX (MV/PAP/AP Levels) |
|
What type of wall motion frequently accompanies a flattened IVS?
|
Paradoxical Wall Motion
(aka Septal Shift) |
|
RV Dilatation and RVH frequently result in what?
|
Right Heart Failure
|
|
The following M-Mode findings indicate what?
- RVFW hypertrophy - RVE - flattened IVS - small LV - possible paradoxical wall motion |
PHTN, likely due to MS
|
|
What is indicated if the IVC fails to collapse during the sniff test?
|
PHTN, likely due to MS
|
|
What is the most common method for assessing MS?
|
P1/2t (Pressure Half Time)
|
|
Besides P1/2t, what are two other methods for assessing MS?
|
Deceleration Time
PISA (Proximal Isovelocity Surface Area) |
|
The time required for the peak pressure gradiant across the MV to reduce by half
|
P1/2t
|
|
What is the relationship between P1/2t and MS?
|
Directly Related
|
|
What else can be calculated from the P1/2t?
|
MVA (MV Area)
|
|
In what views should MS be assessed? Using what modality?
|
Apical 4 or 5
CW Doppler |
|
How is P1/2t obtained from the CW doppler results?
|
Measure the E-F deceleration slope
|
|
How is MVA calculated from P1/2t?
|
MVA = 220 / (P1/2t)
|
|
Is MS milder or more severe with a flatter E-F slope (CW doppler)?
|
Flatter = More Severe
|
|
How can a sonographer reduce errors when attempting to evaluate MS using CW doppler?
|
Change sweep speed from 50 mm/s to 100 mm/s
|
|
What is the normal MV area?
|
4 - 6 cm(2)
|
|
What is MV area for mild MS?
|
1.5 - 2.5 cm(2)
|
|
What is MV area for moderate MS?
|
1.0 - 1.5 cm(2)
|
|
What is MV area for severe MS?
|
< 1.0 cm(s)
|