Aortic Stenosis Discussion Assignment

Aortic Stenosis Discussion Assignment
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Aortic Stenosis Discussion Assignment
1. Which of these M-mode images is suggestive of valvular
aortic stenosis?
A. Figure 13.1A
B. Figure 13.2B
C. Figure 13.3C
D. Figure 13.4D
2. Which of these continuous-wave spectral Doppler tracings
is most suggestive of aortic stenosis?
Figure 13.2
Chapter 13
Aortic Stenosis
Patrick Collier and Brian Grifn
Figure 13.1
(c) 2015 Wolters Kluwer. All Rights Reserved.
84 Section IV Valvular Heart Disease
A. Normal aortic ow
B. Mild aortic stenosis
C. Moderate aortic stenosis
D. Severe aortic stenosis
4. Which of the following comorbid conditions will least
impact the simplied Bernoulli equation (p = 4v2
) to
measure transaortic valve gradients?
A. Severe aortic regurgitation
B. Severe anemia
C. Thyrotoxicosis
Aortic Stenosis Discussion Assignment
D. AV stula
E. Severe mitral stenosis
A. Figure 13.5A
B. Figure 13.6B
C. Figure 13.7C
D. Figure 13.2D
3. Assessment of aortic stenosis severity by the continuity
equation (using TVI) here suggests (Fig. 13.3):
Figure 13.2 (Continued)
Figure 13.3 (Continued)
Figure 13.3
(c) 2015 Wolters Kluwer. All Rights Reserved.
Chapter 13 Aortic Stenosis 85
5. The largest source of error in calculation of aortic valve
area by the continuity equation is:
A. Peak velocity across the aortic valve
B. LVOT diameter
C. Peak velocity across the LVOT
D. Time–velocity integral of aortic valve CW spectral
Doppler display
E. Time–velocity integral of LVOT PW spectral Doppler
display
6. Which of the following statements regarding calculation
of the dimensionless index is most appropriate?
A. A dimensionless index of 0.30 or less is consistent
with severe aortic stenosis.
B. Dimensionless index can be calculated by
Vmax LVOT/Vmax AV or VTI LVOT/VTI AV.
Aortic Stenosis Discussion Assignment
C. Dimensionless index is not useful if LVOT velocities
are elevated.
D. Dimensionless index is affected by the error in
measurement of LVOT diameter.
7. A patient has severe mitral stenosis (MVA 0.9 cm2
, mean
gradient 11 mm Hg), severe aortic stenosis (AVA 0.9 cm2
,
mean gradient 44 mm Hg), and no signi’cant valvular
regurgitation. The difference between transaortic and
transmitral gradients is explained by:
A. Relative differences in ow rates across each valve
B. Relative differences in blood velocities across the
aortic and mitral valves
C. Relative difference in pressures between the left
atrium/left ventricle in diastole and that of the left
ventricle/aorta in systole
D. Mild to moderate aortic regurgitation
8. Which of the following statements is most appropriate
regarding aortic valve gradients?
A. Aortic valve peak gradients by echo are instantaneous
and overestimate the true gradient.
B. Catheter-based aortic valve peak-to-peak gradients are
generally lower than echo-based peak gradients.
C. Increased cardiac output is more likely to affect
measurement of catheter-based gradients rather than
echo-based gradients.
D. Catheter-based aortic valve mean gradients are
generally higher than echo-based mean gradients.
9. With regard to pseudosevere aortic stenosis:
A. This phenomenon relates to calculation of a falsely
reduced aortic valve area due to reduced excursion of
the aortic valve leaets in the setting of low cardiac
output.
B. It can be distinguished from severe aortic stenosis
using high-dose dobutamine infusion.
C. It is suggested by a mean gradient of 40 mm Hg and
change in valve area
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