5/6/2018

What condition is suggested by the

M mode part of the examination
1. Pulmonary embolism
2. Inferior wall ischemia
3. Pulmonary hypertension
4. Malignancy
5. Hypertrophic obstructive cardiomyopathy

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42 year old woman, recently

immigrated from Iraq
History of Murmur

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LVVd= 144 cc
LVVs=50 cc
BSA 1.75

SV =94 cc
EF 65%

LVVdi=82 cc/M2
LAVi=38 cc/M2
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LVOT VTI 30 cm
LVOT diameter 2 cm
SV= p x (2/2)2 x 30 = 94 cc
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Characterize the echo profile

1. LV dilation + high SV
2. LV dilation + normal
SV
3. Normal LV size + high
SV
4. Normal LV size +
normal SV
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LVVd= 144 cc
LVVs=50 cc
SV =94 cc

LVVdi=82 cc/M2

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Which condition would be most

compatible with the findings?
LVVd= 144 cc
1. Acute severe MR
LVVs=50 cc 2. Chronic severe MR
SV =94 cc 3. Acute severe AR
EF 65% 4. Chronic severe AR
5. Hypertensive heart
LVVdi=82 cc/M2 disease 9

Forward Stroke volume =

CSA x VTI
πD2/4 x VTI = 0.785 D2 x VTI

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“Forward SV”
VTI method

Flow = CSA x VTI

CSA = p x r2

LVOT VTI 30 cm
LVOT diameter 2 cm
SV= p x (2/2)2 x 30 = 94 cc
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In AR, in absence
of MR:

Total SV = Forward SV

Other possibilities for

these findings include
LVVd= 144 cc 1. Amyloidosis
LVVs=50 cc 2. Atrial Septal Defect
SV =94 cc 3. Cardiac Sarcoidosis
EF 65% 4. Left to right shunt
5. All of the above
LVVdi=82 cc/M2 14

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15

Your diagnosis?
1. Kawasaki disease
2. Coarctation of the
aorta
3. Aortic dissection
4. Takayasu aortitis
5. Patent ductus
arteriosus
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Diastolic data:

E 1 M/s
E/A 1.4

E/A 1.4
TD velocities are normal
LAVi 38 cc/M2 17
No TR jet

Grade the diastolic

function in this patient
E/A 1.4 1. Normal
TD velocities 2. Grade 1
are normal 3. Grade 2
LAVi 38 cc/M2 4. Grade 3
No TR jet 5. Indeterminate

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E/A 1.4
TD velocities are
normal
LAVi 38 cc/M2
No TR jet

Nagueh
19 JASE 2016

Nagueh
20 JASE 2016

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Bonus Question

Why is the LA big?

1. Diastolic dysfunction
2. Mistakenly included
pulmonary veins in tracing
3. Known issue in PDA when
using BSA for size
indexation
4. High cardiac output
5. Occult mitral valve disease

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