Valvular Heart Disease Flashcards

What is the classic M-mode finding in severe mitral regurgitation caused by a flail leaflet?

Answer: Chaotic fluttering of the posterior mitral leaflet into the LA in systole

A flail mitral leaflet on M-mode shows chaotic, high-frequency systolic motion of the leaflet tip into the LA due to chordal rupture.

Which parameter best differentiates severe mitral regurgitation from moderate on echocardiography using the PISA method?

Answer: EROA ≥ 0.40 cm² and regurgitant volume ≥ 60 mL

Severe primary MR criteria include EROA ≥0.40 cm² and regurgitant volume ≥60 mL per ASE/AHA/ACC guidelines.

What is the Doppler half-time for severe aortic regurgitation (PHT < X ms)?

Answer: < 200 ms

A pressure half-time <200 ms in aortic regurgitation indicates severe AR because rapid equilibration of aortic and LV pressures occurs.

Which echocardiographic sign in aortic regurgitation indicates severe volume overload and correlates with poor prognosis without surgery?

Answer: LV end-systolic dimension > 5.0 cm

An LV end-systolic dimension >5.0 cm in chronic severe AR is a guideline indication for aortic valve replacement even in asymptomatic patients.

What echocardiographic feature distinguishes organic (primary) from functional (secondary) mitral regurgitation?

Answer: Structural leaflet abnormality (prolapse, flail, restricted) in primary; normal leaflets with tethering in secondary

Primary MR involves intrinsic leaflet pathology; secondary (functional) MR occurs in the setting of LV dilation/dysfunction with normal leaflets that fail to coapt due to tethering.

Which feature of the aortic valve on echocardiography is most consistent with infective endocarditis?

Answer: Mobile, oscillating echogenicity attached to a leaflet (vegetation)

Vegetations in endocarditis appear as mobile, oscillating, irregularly shaped echogenic masses attached to valve leaflets, typically on the low-pressure side.