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Normal Values: Difference between revisions

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Normal Values (view source)

Revision as of 18:17, 13 September 2009

65 bytes removed ,  13 September 2009
→‎Mitral stenosis - routine measurements
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|-
! Planimetry
! rowspan="5" | Planimetry
| <ul>
<li>2D parasternal short-axis view</li>
<li>determine the smallest orifice by scanning from apex to base</li>
<li>positioning of measurement plan can be oriented by 3D echo</li>
<li>lowest gain setting to visualize the whole mitral orifice</li>
</ul>
| <ul>
<li>contour of the inner mitral orifice</li>
<li>include commissures when opened</li>
<li>in mid-diastole (use cine-loop)</li>
<li>average measurements if atrial fibrillation</li>
</ul>


|-
|-
! Mitral flow
| - 2D parasternal short-axis view
| <ul>
| - contour of the inner mitral orifice
<li>continuous-wave Doppler</li>
<li>apical windows often suitable (optimize intercept angle)</li>
<li>adjust gain setting to obtain well-defined flow contour</li>
</ul>
| <ul>
<li>mean gradient from the traced contour of the diastolic mitral flow</li>
<li>pressure half-time from the descending sLope of the E-wave (mid-diastole slope if not linear)</li>
<li>average measurements if atrial fibrillation</li>
</ul>


|-
|-
! Systolic pulmonary artery pressure
| - determine the smallest orifice by scanning from apex to base
| <ul>
| - include commissures when opened
<li>continuous-wave Doppler</li>
<li>multiple acoustic windows to optimize intercept angle</li>
</ul>
| <ul>
<li>maximum velocity of tricuspid regurgitant flow</li>
<li>estimation of right atrial pressure according to inferior vena cava diameter</li>
</ul>


|-
|-
! Valve anatomy
| - positioning of measurement plan can be oriented by 3D echo
| <ul>
| - in mid-diastole (use cine-loop)
<li>parasternal short-axis view</li>
 
<li>parasternal long-axis view</li>
|-
<li>apical two-chamber view</li>
| - lowest gain setting to visualize the whole mitral orifice
</ul>
| - average measurements if atrial fibrillation
| <ul>
 
<li>valve thickness (maximum and heterogeneity)</li>
|-
<li>commissural fusion</li>
! rowspan="4" | Mitral flow
<li>extension and location of localized bright zones (fibrous nodutes or calcification)</li>
 
<li>valve thickness</li>
|-
<li>extension of calcification</li>
| - continuous-wave Doppler
<li>valve pliability</li>
| - mean gradient from the traced contour of the diastolic mitral flow
<li>subvalvular apparatus (chordal thickening, fusion, or shortening)</li>
 
<li>subvalvular apparatus (chordal thickening, fusion, or shortening) Detail each component and summarize in a score</li>
|-
</ul>
| - apical windows often suitable (optimize intercept angle)
| - pressure half-time from the descending sLope of the E-wave (mid-diastole slope if not linear)
 
|-
| - adjust gain setting to obtain well-defined flow contour
| - average measurements if atrial fibrillation
 
|-
! rowspan="3" | Systolic pulmonary artery pressure
 
|-
| - continuous-wave Doppler
| - maximum velocity of tricuspid regurgitant flow
 
|-
| - multiple acoustic windows to optimize intercept angle
| - estimation of right atrial pressure according to inferior vena cava diameter
 
|-
! rowspan="13" | Valve anatomy
 
|-
| rowspan="4" | - parasternal short-axis view
 
|-
| - valve thickness (maximum and heterogeneity)
 
|-
| - commissural fusion
|-
| - extension and location of localized bright zones (fibrous nodutes or calcification)
 
|-
| rowspan="5" | - parasternal long-axis view
 
|-
| - valve thickness
 
|-
| - extension of calcification
 
|-
| - valve pliability
 
|-
| - subvalvular apparatus (chordal thickening, fusion, or shortening)
 
|-
| rowspan="3" | - apical two-chamber view
 
|-
| - subvalvular apparatus (chordal thickening, fusion, or shortening)
|-
| Detail each component and summarize in a score


|}
|}
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