Davies--Evaluation for Endocarditis

  1. True/ False:  The ability of M mode and 2D echo to visualize vegetations is a useful and significant application of echocardiography.

    Echo is a sensitive technique for identifying valvular vegetations
  2. True/False : Vegetations have been seen on echo at sites other than on the valves. These sites include

    aneurysm of the sinus of valsalva
    calcified mitral annulus
    infected ventricular setal defect
    left atrial appendage
    T, T, T, F

    vegetations have been observed on echo in all of the listed instances EXCEPT in the left atrial appendage
  3. Valve motion in endocarditis is


    a "trademark" of endocarditis is the normal motion of the valve leaflets.
  4. True/False:  2D echo assists in evaluating the mitral valve in endocarditis by detecting associated:

    flail mitral valve
    left atrial thorombosis
    ruptured chordae tendineae
    mitral valve prolapse
    T, F, T, T

    With MV endocarditis one may see MVP, flail leaflets and/or ruptured chordae tendineae. A LA thrombus, however is not an associated finding , it is associated with MS
  5. True/False:  Predisposing factors for endocarditis of the arotic valve include:

    intravenous drug abuse
    rheumatic deformity of the valve
    biscuspid aortic valve
    calcification of aortic cusps in the elderly
    F, T, T, T

    IV use leads to endocarditis of the right sided valves, not the left. The common causes of AV endocarditis include rheumatic deformity of the valve and calcification/degeneration of the aortic valves in the elderly
  6. True/False:  Imaging of vegetations is best attempted using the 2D echo method because it defines:

    type of infection
    size of the vegetation
    pattern of motion
    location relative to other cardiac structures
    F, T, T, T

    non invasive method can determine the type of infection present in endocarditis. Echo allows visualization of the size, shape, and exact location relative to other cardiac structures
  7. True/False:  Mitral valve M-mode findings in endocarditis include

    leaflet separation in systole
    an abnormal mass of echoes on the valve leaflet
    unobstructed motion of the valve leaflets
    eccentric motion from beat to beat
    F, T, T, F

    mitral valve motion is preserved in endocarditis and one sees an abnormal mass of echoes on the leaflets. systolic leaflet separation is a finding in some form of mitral regurgitation. eccentric motion from beat to beat is a feature of flail mitral valve not endocarditis
  8. True/False:  Vegetations from endocarditis may

    erode and disrupt the valve leaflets and adjacent structures
    obstruct flow through the valve
    dislodge, causing peripheral embolization
    disappears with no adverse effect
    T, T, T, F

    vegetations from endocarditis on cardiac valves do not simply disappear, although they may embolize. They do erode and disrupt the valve and surrounding structures, and if large enough can obstruct valvular flow
  9. Complications secondary to endocarditis noted echocardiographically include

    T, F, T, T

    myxoma is not a secondary finding of endocarditis. Fistulas, aneurysms and abscesses may be secondary findings
  10. True/False:  Echo is NOT the procedure of choice to diagnose endocarditis because 

    not enough research has been performend to substantiate use of the techinique
    it cannot differentiate new from old vegatations
    it cannot identify vegetations smaller than 2mm
    the results are rarely definitive
    F, T, T, F

    echo is helpful in visualizing the vegetations in endocarditis, but the lesions must be larger than 2mm to be seen. Test is uanble to detect abnormalities in the earliest stages, and differentiate between old and new lesions
Card Set
Davies--Evaluation for Endocarditis