TTE

Question 1

When evaluating 2D echo of LV, what are the things you want to specifically look at and evaluation

Answer 1

1. wall motion
2. wall thickness
3. chamber size
4. valve motion
5. valve thickness
6. over-all function

Question 2

Answer 2

1. Aortic valve - RIGHT coronary cusp
2. Aortic valve NON-coronary cusp (but maybe LEFT)
3. Anterior MV leaflet
4. Posterior MV leaflet

Question 3

TAPSE

Abnormal Value

Answer 3

< 17 mm

Question 4

MAPSE

Abnormal Value

Answer 4

< 8 mm

(associated with LV EF <50%; sensitivity 98%; specificity 82%)

12-15 mm is normal

Question 5

What are the name of the aortic valve cusps?

Answer 5

Question 6

Apical akinesis with basal hyperkinesis.

Answer 6

Takotsubo’s CM

Echo appearance.

Question 7

Takotsubo’s CM

Echo appearance.

Answer 7

Apical akinesis with basal hyperkinesis.

Question 8

Answer 8

Question 9

Answer 9

Question 10

Answer 10

Question 11

Answer 11

Question 12

Pulmonary Doppler - Where to position the PW sector?

Answer 12

Pulsed wave doppler needs its sample volume placed 1cm proximal to the pulmonary valve to quantify pulmonary regurgitation.

Question 13

Tricuspid regurgitation - incidence

Answer 13

90% of all individuals have mild TR

Question 14

Normal VTI_LVOT

Answer 14

18-20

Question 15

RV free wall thickeness

normal

Answer 15

≤ 5mm

Question 16

When and where to measure RV wall?

Answer 16

Subxiphoid

During diastole

Question 17

Why is there more movement with RV than LV during contraction?

Answer 17

Fibers are oriented more longitudinal with RV

Question 18

TAPSE ≤ 16

in setting of PE

Increases mortality by

Answer 18

4.4x more likely to die from PE

(Lobo et al, 2014)

Question 19

How to measure PA pressure?

Answer 19

1. Identify TR jet.
2. CW Doppler through the jet to create spectral waveform.
3. Can see velocity (V)

VxVx4+CVP is an estimate.

Less than 25 is normal.

Question 20

Where to measure ESN / PW for Pulmonic valve?

Answer 20

Just BEFORE the pulmonic valve

Question 21

ESN Wave form

Can’t use in what chronic condition?

Answer 21

Chronic pulmonary hypertension

Question 22

Why does the 2 point ultrasound work?

Answer 22

DVTs occur in areas of high turbulence.

Branching points are areas of high turbulence.

Question 23

Nazerian et al (2014)

LR of POC Multiorgan U/S for Dx of PE in CHEST

If positive abnomrality in:

echo

lung

DVT

Answer 23

Echo 3.6x

Lung 15x

DVT 21.7x

Question 24

When to measure

Aortic Valve / LVOT

Answer 24

mid systole

when valves are wide open

Question 25

What direction is negative degrees for axis?

Answer 25

Question 26

Normal PA pressure?

Answer 26

25

Question 27

E/E' Ratio (using PW for E; TDI for E') Normal

Answer 27

\<8

Question 28

E/E' Ratio (using PW for E; TDI for E') Intermediate

Answer 28

8-14

Question 29

E/E' Ratio (using PW for E; TDI for E') LAP Increased

Answer 29

\>14

Question 30

E/A Ratio (MV Inflow Pattern (using PW alone)) LAP Normal

Answer 30

\<0.8

Question 31

E/A Ratio (MV Inflow Pattern (using PW alone)) Intermediate LAP

Answer 31

0.8 - 2.0

Question 32

E/A Ratio (MV Inflow Pattern (using PW alone)) LAP increased

Answer 32

\>2.0

Question 33

S' (cut-off for abnormal)

Answer 33

Dichotomous; <10 is abnormal.

Question 34

In the A4C, on screen, what are the 2 large zones you could see of LV?

Answer 34

On RIGHT of image of LV, LATERAL, anterolateral On LEFT of image of LV, inferoseptal

Question 35

In the A2C, on screen, what are the 2 large zones you could see of LV?

Answer 35

On RIGHT of image of LV, anterior. On LEFT of image of LV, inferior.

Question 36

In the A3C, on screen, what are the 2 large zones you could see of LV?

Answer 36

On RIGHT of image of LV, anterioroseptal On LEFT of image of LV, lateral/posterolateral.