Pulmonic Valve Disease
Terms in this set (37)
Where is the Pulmonic valve located in the heart?
On the right side of the heart, between the right ventricle and the pulmonary artery.
What is the function of the Pulmonary Valve?
It is to prevent back flow of blood from the pulmonary artery back into the Right Ventricle in DIASTOLE.
A Normal Pulmonary valve has how many cusps? There names?
and Anterior Pulmonary cusps
What is pulmonic insufficiency?
The backward or retrograde flow of blood through the pulmonary valve into the right ventricle in diastole.
What are the causes of Pulmonary Insufficiency?
Rheumatic heart disease,
Congenital Abnormalities and Carcinoid Heart disease.
What is Tetrology of Fallot?
A congenital heart defect involving 4 anatomical abnormalities of the heart. Typically pulmonic stenosis, VSD, Right ventricular hypertrophy and overriding aorta.
What is Deposited by Carcinoid and where that causes pulmonary insufficiency?
Carcinoid deposits fibrous plaques on the pulmonary valve causing insufficiency.
Describe the auscultation of pulmonary insufficiency.
The murmur of PI resembles that of aortic insufficiency except that it is louder with inspiration and does not produce the peripheral signs noted with insufficiency.
What effect does pulmonary insufficiency have on the tricuspid valve on 2D?
Diastolic flutter on the tricuspid valve
What effect does Pulmonic Insufficiency have on the right ventricle.
dilated right ventricle
What effect does Pulmonic Insufficiency have on the septal motion?
Paradoxical Septal moton
Premature opening of the Pulmonic valve may occur in PI as a result of....?
As a result of High right ventricular pressure.
Normal Pulmonary flow is ______ from the transducer and _______ the baseline.
Normal Pulmonary flow is away from the transducer and below the baseline.
Doppler is performed in what view to evaluate the Pulmonic Valve?
In Parasternal short
What is the normal velocity of the pulmonic valve?
approximately 0.6-1.1 m/s
Increased velocity through the PV valve may be due to?
LT-RT Shunts, hyperdynamic circulatory states, pulmonic stenosis, Inspiration, pulmonic insufficiency.
Describe "PEP" or Pre-ejection period.
The period from the onset of systole to the ejection of blood.
Describe "AT" or acceleration time.
The period valve opening to peak velocity.
Describe "ET" or ejection time.
The time that the valve is open and the blood is being ejected.
What side of the heart is the pressure the lowest?
The right side has a lower pressure.
Why do the right sided events of the heart start first and last longer?
This is due to the pressure being lower on the right side than on the left.
Is the AT shorter in the AV or PV.
AT Shorter in the PV
Is the ET longer in the AV or in the PV
ET Longer in the PV
Is the PEP shoter in the AV or in the PV?
PEP Shorter in the PV
A term for them obstruction of flow from the right ventricle to the pulmonary Artery.
What are the causes of Pulmonic Stenosis?
Congenital , Carcinoid heart disease, rheumatic heart disease, Sinus of Valsalva aneurysm.
Describe the Auscultation of Pulmonary stenosis.
A harsh SYSTOLIC ejection murmur is heard in the pulmonary area (over the left costal boarder)
What are the main physiological findings in pulmonary valvular stenosis?
Prominent jugular venous A wave,
Slow sustained right ventricular lift,
Right ventricular hypertrophy,
Post-stenotic dilation of the Pulmonary artey
What are the clinical symptoms of Pulmonary Stenosis?
Palpitations, hypoxia, dizziness, peripheral edema
What are the qualifications needed for surgery as treatment for Pulmonary Stenosis?
A Systolic pressure gradient greater than 50 mmHg across the pulmonary valve or greater than 70 mmHg in the right ventricle
What phase will Doming of the Pulmonic valve be visualized?
Doming of the Pv valve will be visible during Systole
As a result of Late Pulmonary stenosis _____ of the interventicular septum will be visualized.
As a result of Late Pulmonary stenosis Flattening of the interventicular septum will be visualized.
On M-mode an increased depth of __ wave may be observed?
On M-mode an increased depth of A wave may be observed. A normal A wave is typically 2-3mm
Where is the Doppler placed when assessing the pulmonary valve?
Place in the valve in parasternal short
Once peak velocity is quantitated, the pressure gradient across the valve may be calculated using....
Once peak velocity is quantitated, the pressure gradient across the valve may be calculated using Bernoulli's equation
What is EROA?
Effect Regurgitant Orifice Area
What is PISA?
Proximal Isovelocity Surface Area, used to evaluate severity of valvular regurge.