Question | Answer |
what is AR | backflow of blood through the aorta in diastole |
what does chronic mean? | persisting over a long period of time |
what does acute mean | short, severe course ex. tear a cusp |
what are some AR etiologies | inflammation, structural changes, stress |
what is inflammatory etiology? | reaction of tissue to injury, infection, or irriation Ex. pheumatic, phen phen, syphilis, lupus |
what are some structural changes that can occur? | senile calcific disease, dilation -Ao dissection, endocarditis, trauma, bicuspid valve |
What are some other problems that can be caused by stress etiology | hypertension, aortic aneurysm and or dissection, atherosclerosis |
what are some complications of AR | LV volume overload Increased risk of infective endocarditis Decrease LV function(systolic) late in course Jet around 4m/s Circular heart poor function |
what are some secondary changes with AR | chronic AR=progressive volume overload of the LV see greater that normal EF Mod AR expect Frank Starling ^ preload ^contraction Prognosis related to EF |
Murmur that is heard with AR | Austin Flint |
Symptoms of AR | Austin Flint Murmur Wide pulse pressure DOE |
what is a wide pulse pressure? | diastolic BP less than normal Systolic BP greater than normal |
Is the austin flint murmur a diastolic or systolic event? | diastolic murmur |
What would you use to diagnose AR | Doppler and Color Doppler are sensitive tools to detect AR |
What would an AR pressure waveform look like? | Increased diastolic LV pressure |
What is one way to evaluate AR | CW Doppler signal intensity more RBC, more dense the spectral envelope |
What does the slope diastolic decay indicate? | Pressure is equalizing rapidly during diastole |
AR peak velocity is around___m/s | 4 |
How can if tell if AR is severe on M-mode | early diastolic closure of the MV No A wave! |
What will you find on M-mode with AR | Diastolic flutter of the AMVL |
Where do you place the PW for SV calculation? | Put PW Doppler in the same area diameter was measured for accuracy |
what does ERO stand for | Effective Regugitant Orifice |
what does ROA stand for | Regurgitant Orifice Area |
What are the 3 components of an AR jet? | Flow convergence Vena contracta Jet direction and size |
what is the vena contracta | smallest neck at the level of the aortic valve approximation of EROA >0.6 cm SEVERE |
P1/2 time is affected by increased____ | LVEDP |
How do you assess AR by Doppler | CW Doppler Density of signal reflects RV Spectral slope Pressure half time ERO |
what is a tip in evaluating descending aortic flow | use highest frequency transducer optimize color |
TRUE or False holodiastolic reversal of flow in the descending Ao indicates severe aortic regurgitation | TRUE |
What type of Doppler do you use in the Descending Ao | PW Doppler |
True or False Is it normal to see red flow in the descending Ao during diastole | FALSE |
True or false Significant flow reversal in the descending Ao that is absent in the abdominal Ao, indicates that the AR is moderate but not severe. | TRUE |
True or False Flow reversal in both the descending and abdominal Ao indicates severe AR | TRUE |
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