Surname 1

Student

Professor

Course

Date

VD overview and MD

Dyspnea on Exertion

This is a shortness of breath, failure to breathe faster, and or not breathing deep enough,

mostly during physical activities.

Vascular, cardiac changes that occur after RVH

 The right ventricular wall becomes thicker, and this is due to pressure.

 Widening and overstretching of right ventricular due to overwork or abnormal relaxation.

 RA pressure raises CHF.

Methods of Echo Assessment

Pressure

A continuous-wave Doppler. This gives an estimate in transvalvular pressure and flow 

buy this pressure gradient sample size over Doppler can't be manipulated; it shows a pulse wave,

helps in calculating the stroke variance. 

 Surname 2

Pulse wave Doppler

Helps in estimating sub valvula flow. Shows a valve area by continuity equation V1/V2,

the dimensionless index, and diastolic function. Resistance to flow and offers a good look of a

flow-through valve.

Color flow Doppler (location, severity)

It gives the measurement to see how big the flow is and PISA and vena contracta are used

in this method of echo assessment. 

Prolapse

The flaps of the Mitral Valve bulge into the left upper chamber of the heart like a

parachute. Mitral valve regurgitation occurs when the mitral valve prolapses, causing blood to

seep into the left atrium. Mitral valve prolapses are not life-threatening in most persons and do

not require therapy or lifestyle adjustments. However, treatments are necessary for specific

persons with mitral valve prolapse.

Types of MR

There are only two types, which are;

Secondary degeneration

This is also known as functional degeneration and it is characterized by enlargement in

the left ventricle due to other disorders.

 Surname 3

Degenerative MR

Damage to the mitral valve apparatus with prolapse or flail of the leaflets causes

degenerative MR. It is also known as primary MR. It might be due to old age, a congenital

abnormality, or an underlying cardiac condition. 

Their difference

Secondary degeneration is the enlargement in the left ventricle due to other disorders while

degenerative MR is caused by damage of the mitral valve apparatus with prolapse or flail of the

leaflets.

PISA

The span of the proximal iso velocity surface zone (PISA) was measured

employing a 4-chamber amplified picture. In each example, the Nyquist includes a

constrained set to empower the most excellent permeability of the wall painting spewing

forth (MR) proximal stream merging. Between the lower line of the isovacuum surface

and the mitral recovering ethereal level, we get the PISA sweep is measurement. The

vena contracta (VC) width was measured employing an amplified parasternal long-axis

picture.

The transducer was every so often angulated off of the commonplace imaging

plane to concurrently recognize the three components: the range of proximal stream

increasing speed, the VC, and the downstream expansion of the mitral spewing forth fly,

in arrange to deliver a perfect VC. The VC width is the distance across the neck within

the accepting chamber between the proximal stream joining and the stream expansion.
 Surname 4

In apical four-chamber view, measure mitral annulus diameter, measure the

mitral inflow UTI at valve tips with pulsed wave doppler. In PLAX, measure the

diameter of the LVOT annulus in centimeters at mid systole. In apical five view

chamber measure systolic VTI of LVOT outflow with pulsed wave just below the

annulus. Mitral regurgitant fraction-RF =MR volume/forward SV (x100)

 Mild MR = less than or equal to 30%

 Moderate MR = 31-49%

 Severe MR = greater than or equal to 50%

Vena contracta

Apical 4 or 3 chamber usually indicates central jets; 2 chambers may reveal none central

jets at P1-P2 and P2-P3, often from clefts or folds from myxomatous or organic disease.

However, functional MR usually has multiple jets in all 2D views because the entire valve has

malcoaptation. Therefore, the VC may be more reliable in functional MR. Fraction given for

Mild MR is less than or equal to thirty percent while Vena Contracta number is given for Severe

MR is sixty ml/beat.

Importance of severity scale

It is always highly accurate and provides the best information for a report. The information is

easy to follow and work on.

Eyeballing MR
 Surname 5

Another name for eyeballing MR is qualitative MR. It's the most common method of

interpretation. But unfortunately, we can tell all apical views, depth and it's also generally

inaccurate unless torrential.

TTE Apical 4 chamber view

Bi leaflet prolapse is considered to be repaired, replaced which is more technical. And

prolapse is regarded as an A1, a P1, or a P2 prolapse.

Post repair

The type of plasty the narrator says was performed is stretch flow.

Surgical decisions

Decision-making during surgery, especially during emergency surgery, is a critical

component of clinical practice that requires more training than is currently provided. Current

surgical training practices offer little time for reflection, and perhaps there is now a demand for a

more comprehensive examination of surgeon cognition employing naturalistic choice research

methodologies. Techniques for improving situational awareness and decision-making abilities

utilizing low fidelity approaches are being developed, and these might be applied for surgeons.

The doctor's decision to operate depends on the patient's symptoms, the ability t repair and

not to replace, operation risks, MR effect on LV, LA, and RV, Severity type of MR.

Symptoms of Mitral Stenosis

 Breath shortness: you may have difficulty breathing, especially if you are busy or

sleeping.

 Tiredness: During increasing physical exertion, you might rapidly weary.

 Surname 6

 Ankles and feet are swollen: swelling might take place when the blood flow is disrupted.

 Heart palpitations: A fast, fluttering heartbeat might be seen.

 Fainting or dizziness: In particular, you may be lightheaded throughout your business or

may even lose consciousness throughout your business.

 Blood coughing: Notice your doctor when you see blood indications when you cough.

 Pain in the chest: In the lungs and chest, you may experience discomfort.

 Systemic embolism

Associated effects of Mitral Stenosis

 Atrial dysrhythmias left atrial enlargement.

 Risk of embolization with AFIB.

 Congestive heart failure.

 Pulmonary disease from chronically high pressures.

 Endocarditis risks.
 Surname 7

Work cited page.

1. Sharma, S., Hashmi, M., and Badi Reddy, M., 2021. Dyspnea on Exertion. [online]

Ncbi.nlm.nih.gov. Available at:

<https://www.ncbi.nlm.nih.gov/books/NBK499847/#:~:text=Dyspnea%20on%20exertion

%20is%20the,deeply%20enough%20during%20physical%20activity.> [Accessed 5 June

2021].