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True/ False: The ability of M mode and 2D echo to visualize vegetations is a useful and significant application of echocardiography.
True
Echo is a sensitive technique for identifying valvular vegetations
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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
-
Valve motion in endocarditis is
eccentric
exaggerated
reduced
normal
normal
a "trademark" of endocarditis is the normal motion of the valve leaflets.
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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
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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
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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
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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
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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
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Complications secondary to endocarditis noted echocardiographically include
fistula
myxoma
aneurysm
abscess
T, F, T, T
myxoma is not a secondary finding of endocarditis. Fistulas, aneurysms and abscesses may be secondary findings
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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
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