A left ventricular pacing wire is placed in the coronary sinus in conjuntion with right ventricular pacing wire, this is called?
Cardiac Resynchronization
When obtaining pulmonayr view flow for the detection of diastolic dysfunction, this pulmonary vein should be used to obtain Doppler information?
Right superior vein
A VSD is also referred to as A?
Outlet
Infundibular pulmonary stenosis is uncommon as an isolated lesion and is usually associated with?
VSD
M-mode finding in a patient with IHSS might include all of the following except:
A) mid sys closure of the aortic valve
B) Mitral valve prolaspe
C) sys anterior motion of the mitral valve
D) Asymmetric septal hypertrophy
MVP
In pt. with large pericardial effusions, which of the following can be a false positive dx on m-mode?
MVP
Mitral valve prolaspe is best seen in which echo view?
parasternal long axis
In laminar flow, mean velocity is?
Is equal to the max velocity
A shared problem is pts with constrictive pericarditis and those with cardiac tamponade is
Decreased cardiac output
The communication between the aorta & pulmonary artery that may presist after birth is called?
PDA
The most common tumor mass to cause mitral valve obstruction is?
Atrial myomas
Inhalation of Amyl Nitrite causes decrease in Preload or After load?
Decreased afterload
Premature opening of the pulmonary valve may be seen in?
Contrictive pericarditis
The most common cardiac valvular tumor is?
Fibroelastomas
An underestimation of the severity of aortic stenosis by continous wave doppler may occur with?
Low Cardiac output
The most common location for a true aneurysm to occur is in the ?
Apex
Gradual closure of the aortic valve suggesting decrease in cardiac output is often associated with which CMP?
Dilated CMP
Which of the following is not a possible M-mode finding in a pt with constrictive pericaditis?
A) Paradoxial septal motion
B) Pericardial thicking
C) Flattening of the mid diastolic post wall motion
D) Enlarged LV
Tricuspid Atresia blood flow will shunt from R-L atrial through a ?
Patent Forman Ovale
Small fibrous nodules located at the center of each aortic cusp is called?
Nodules of Art????
Partial anomalous pulmonary venous return is seen which what type of ASD?
Sinus Venous
Atrial myxomas are usually attached to the ?
Fossa ovalis region of the atrial septum
An Anomalie that is most likely associated with a Sinus Venous ASD?
Partial anomalous pulmonary venous return
Adult chest wall echo problem generally operate in what frequency range?
2.5- 4.0 MHz
Pulmonic stenosis is often associated with ?
Tetrology of Fallot
What causes mitral valve pre-systolic closure?
LVEDP
left ventricular end diastolic pressure
Where on the EKG that correlates with venticular depoloration.
Right before the QRS
What causes MV preclosure?
LVEDP
Pulsus paredoxus?
10-20mmHg drop in arterial pressure during inspiration.
Classic finding of Cardiac Tamponade
A cardiac mass involving the superior and inferior portions of interaatrial septum is most likely?
Lipomatous hypertrophy
Echo appearnace of Restrictive CMP?
Ground Glass
LVH-- small or normal cavity
Percardial effusion may be present
Cardiac tamponade is rapid filling of fluid causing?
Restrictive diastolic filling
The remnant of the fetal ductus arteriosus is called?
Ligamentum Arterious
Coarctation of the aortic most often occur at the :
Aortic Isthmus
The best 2D view for eval a patient with suspected PDA is?
Short axis of the aorta
Which of the following is the most common etiology for a pt to develop a restrictive CMP?
A) endomyocardial fibrosis
B) sarcoidosis
C) Amyloidosis
D) hemochromatosis
Amyloidsis
If the IVE is dialted and doesnt collapse with the pt sniffs the RApressure is ext to be?
20mmHg
Which of the following is most often associated with Primum ASD's?
Cleft Mitral Valve
Infundibular pulmonary stenosis is uncommon as a isolated lesion and is usually associated with?
VSD
Pt. with IHSS and high rest flow gradient may be offered all of the following treatments except:
a) medical therpy
b) sub nitro
c) alcholo septal ablation
d) septal myectomy
Sub Nitro
Which of the following is true regarding the mitral doppler spectral trace in a pt with Restrictive/ Infiltrive CMP?
a) Shows E/A reversal
b) resemebles cadiac tamponade
c) diastolic functions is normal
d) resemble contricitive percaridtis
Resembles constictive percarditis
Pt. with IHSS and a high resting outflow gradient maybe offered which of the following?
a) liptor medical tx
b) contrast septal ablastion
c) sub nitrl
d) Surgical septal myectomy
Surgical septal myectomy
In aortic stenosis the pulse pressure is ?
Narrow
What valve directs blood from the inferior vena cava to the foramen ovale during fetal circulation?
Eustachia Valve
Which of the following occurs first in the setting of severe mitral regurgitation due to a flail leaflet?
Dilated RV
What is a common symptom of a patient with endocarditis?
Fever
A loculated pericardial effusion is rare except for pt with?
Post op cardiac surgery
The sac that surrounds the heart is the?
Fibrous pericardium
While performing an echo on a premature baby what 2 findings are to be expected?
PDA
Patent foromen ovale
Which echocardiographic techinque is bet for the detection of MR?
Pulse doppler
Longstanding mitral stenosis leads to?
CHF
Pulm HTN
Left atrial enlargement
The QRS of the Echo reflects which of the following
a) Atrial depolazation
b) Atrial repo.
c) Vent deop
d) Vent repo
Ventricular depolorization
Afib is most commonly associated with which valvular dz?
Rheumatic MS
The most common type of ASD is?
Ostium Secundum
Kawasaki Diasease may lead to ?
Coronary Artery Aneurysm
A young pt is sent to the echo lab with a dx of kawaski dz, what would you look for?
Regional wall motion abnormailty
The most common location for a Pseudoaneruyms Is?
Inferior Basal
For patients with AS and Atrial fib , peak sys aortic velocity will be?
Higher R-R intervals
Pt with Downs Syndrom is most likely to have a common lesion?
AV septal defect
In pt with tricuspid atresisa blood flow will shunt form the R-L atrium through a ?
PFO
What is used in Echo to measure dP/dt?
MR
The mitral valve doppler inflow shows a normal e/a wave. The Tissue doppler shows e/a reveral. The most accurate dx would be?
Pseduo normal
A Pisa calculation can not be preformed to determine the severity of the MR when this is present?
a) Tricuspid stenosis
b) Decreased cardiac output
c) LA enlargement
d) Mult jets
Mult jets
With a hypertrophic CMP you would see?
a) Left atrial volume overload
b) LA pressure overload
c) LV pressuer overload
d) LV volume overload
Left ventricular overload
Which type of MV abnormally often occurs when the heart muscle has been damaged by MI?
a) underdeveloped MV
b) Cleft MV
c) mitral regurg
d) Mitral stenosis
MR
A finding of holodiastolic flow reversal in the descending aorta maybe a false positive of severe aortic regurgitation if the patient has?
PDA
What technique is used to reduce sidelobes ?
Apolization
The most common area for a sinus of valsuva aneurysm is?
RCC
Left atrial thrombus is often seen in pt with?
Mitral stenosis
Pt. with Ebsteins anomaly often have an associated congential abnormally?
Secudum ASD
What is a know compliction of bioprosthetic heart valve?
Pannus Growth
The normal mean left atrial pressure is comparable to?
Left vent diastolic
The velocity time integral measurment calculates?
Mean velocities
In normal development what is the last to close?
foramen ovale
The congenital cardiac anomaly seen most freguently in adults is?
Biscuspid Aortic Valve
The doppler jet of MS obtained at the apex is somtimes confused with?
Aortic insufficiencey
An advantage of CW doppler to PW is?
Peak velocity detection
Know inlet location?
Subvalvular low near mitral and tricuspid valve
Which window is best for eval the ball excursion of a starr edwards MV using M-mode tech?
Apical
An ex of a Bioprosthetic cardial valve?
Ionescu-shiley Bovine
M-mode echo demonstration of mid-systolic closure of the pulmonary valve along with a decreased "a" wave is most consistent with?
Pulmonary hypertension
The right vent can be measured from the m-mode of the LV during this part of the cardial cycle?
Diastolic
Range: 1.3-2.5cm
Pt. with a higher than normal heart rate may cause the doppler signal of the LV inflow to:
Have a single E/A wave velocity
Which two dimensional echo view is best for the assessment of the interatrial septum?
Subcostal 4 chamber
What is the number and location of the papilllary muscles of a normal mitral valve?
2-- posteromedial, anterolatera
A pt with LA myxoma may have symptoms similar to those pt having
Mitral stenosis
Myocardial blood flow is most predominate during which phase of the cardiac cycle?
Diastolic
In constictive pericardities does the E wave increase or decrease with inspiration?
Decrease
In normal pt why does the peak velocity of flow in the pulmonary artery occur later than the peak velocity in the Aorta?
Vascular resistence if lower
Tricuspid valve closure normally occurs?
less than 0.06 seconds after the mitral valve
Which m-mode finding is considered to be a specific indicator of a fensestrated aortic valve?
Diastolic flutter of the aortic valve
What 2D views are best for imaging of a discete subaortic membrane?
Subcostal long axis
Apical 4 chamber
In pt with IHSS , they will display
MR
SAM
Which term is used to describe a segment of ventricular wall that exhibits no motion?
Akinesis
Which echo window is used in the detection assessment of the IVC?
Subcostal
In order to record the vegetation of endocarditis by echo, the vegetation must have a diameter of at least?
3mm
A true aneusysm of the LV can usually be distinguised from a pseudoaneurysm because?
has a smaller narrow neck than an true
Which type of CMP is associated with amyloidosis?
Infiltrative
Carcinoid heart dz, the cardiac songrapher must devote special attention to identifiying abnormal finding of the?
Tricuspid Valve
Mitral regurg results in Preload or afterload
Preload
In AS the LV sys pressure exceeds that of the aorta
Myocardial blood flow in the normal heart returns to the RA vis the?
Coronary Sinus
The coronary arteries mainly fill during?
Diastole
What congential abnormality best describes the aorta arises from the right ventricle and the pulmonary artery arises from the left ventricle refers to:
D transpostion of the great vessels
A pt. presents to the ER with a MI and new systolic murmur . The most common reason for the murmur is?
Papillary muscle dysfunction
A mitral vavle "e" velocity of greater than ___ ma indicte severe MR
1.2m/sec
What is considered a increase risk factor for ischemic hearat dz?
Systemic hypertension
In Marfan Syndrom why does aortic dissection and MVP occur?
Decreased Fibrillin
Premature closure of the aortic valve on m-mode is most consistent with?
MR
MR in patients with Rheumatic mitral stenosis is most likely due to ?
Left atrial enlargement
Which cardiac chamber is most likely to be involved with metatatic tumor?
Right Atrium
When Starr-Edward prosthetic valves are located in both the mitral and aortic postions, mitral regurgitation is best detected from which window?
Subcostal
The heart reponds to increased in preload by increase in ?
Contractitly
What is the primary effect of long standing aortic regurgitation?
Decreased ejection fraction
Dp/dt measurement of MR assess what?
LV sys function
Coarctation of the aorta is associated with?
Biscuspid Aortic valve
The majority of organisms attach to the _____ side of the antrioventricualar valve?
Atrial
The pressure 1/2 time of the MV can be inaccurate when which of the following anbormalites are present?
D) Aortic insuff
Rheumatic mitral stenosis with an ASD best describes?
Lutembachers syndrom
In differentiating MR and LVOT doppler tracing th following should be considered?
MR duration is longer than LVOT outflow
The tricuspid regurg murmur may increase with inspiration . This known is?
Carvallo's sign
Fine fluttering of the AMVL suggest?
Aortic regurg
A MI that extends through all the layers of the heart is known as?
Transmural
What % of patients with Marfan's syndrom have MVP?
60-80%
A CW 1/2 time (aortic) of 175 sec . This indicates what degree of aortic regurg
Severe
The most common typer of VSD?
Membranous
A shunt from a PDA will be noted from the ?
Aorta pulmonary artery
High risk patient for infiltrive endocarditis include those with?
IV drug use
A left ventricular thrombus is usally in a area of ?
Abnorma wall motion
What is the best echo techinque for revealing hibernating or stunnd myocardium?
Dobutamine
Mitral stenosis murmur?
Diastolic rumble with an opening snap
The atrial septal defect that affects the upper portion of the interatrial septum is?
Sinus Venosus
Isovolumetric timing with ECG
R wave contraction
T wave relaxation
When measuring 2D measurements end diastolic is defined as?
Onset of the QRS
What CMP is caused by genetics?
hypertrophic CMP
The valve located at the ostium of the IVE is?
Eustachian Valve
A VSD defect is noted on the apical 4chamber view near the apex. This typer of defect is referred to as an?
Muscular VSD
The left main coronary artery divides into the ?
LAD
Left cx
A common ele abnormality seen in pt with a dilated CMP?
Conduction defects
eg.LBBB
The tricuspid regurgitation murmur may increase with inspiration. This is know?
Carvallo sign
Which valve opens during ventricular systole?
Semilurar
Name 4 m-mode finding asso with Mitral Stenosis
Decrease e-f slope
Decrease E wave amplitude
Mult reverblant echo
Ant displacemnt of the PMVL
Pt with severe pulmonic stenosis may have an "A" wave measurment on the pulmonic valve m-mode tracing greater than ?