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Transcript of the video: Closure line of aortic valve on M-Mode echocardiogram, is seen as central line, while in bicuspid aortic valve, it is an eccentric closure, nearer to one of the walls of the aorta. That is an important feature of bicuspid aortic valve on M-Mode echocardiogram. So this is a premature beat. is the normal range.
Though there are several parameters for evaluation of left ventricular diastolic function by echocardiography, the most commonly used are the pulsed Doppler mitral E/A ratio and tissue Doppler mitral E/e’ ratio. Doppler interrogation of mitral valve is usually done from the apex through the apical four chamber view.
This is the schematic diagram of the heart in which you can see right atrium, right ventricle, left atrium, left ventricle, aorta and pulmonary artery. Unlike the valves on the left side like the mitral and aortic, right sided valves can have some leak. Similarly, another right sided valve is the pulmonary valve.
Transcript of video: Hypoplastic Left Heart Syndrome is a very severe form of congenital heart disease, in which, the left ventricle, aorta and mitral and aortic valves are hypoplastic and valves may be atretic as well. A Gore-Tex tube is used and this maintains, this is a Blalock-Taussig shunt, which maintains pulmonary circulation.
Sudden breathlessness at night in those with known heart disease is usually due to collection of fluid in the lungs (pulmonary edema). During day time, when one is walking about, any extra fluid in the body tends to collect in the legs, due to the effect of gravity.
Normally, the main pulmonary artery segment will be concave and left atrial appendage region also will be not prominent. So that is why we see straightening of left border, typically heard of in mitral stenosis with left atrial enlargement and mild pulmonary hypertension. Those are not very clear in this picture.
This is the aortic valve in closed position and mitral valve also appears to be closed in position. From the images you do not know whether the mitral valve is really fully closed or almost about to be closed. You require multiple views to see from where the pulmonary arteries are arising. This could be a conus tissue.
Tracing in the lower part is tissue Doppler imaging from the medial mitral annulus. Opening and closing movements of the aortic and mitral valves are visible. The aorta, right ventricular outflow tract and pulmonary artery up to its bifurcation is imaged in the upward angulation shown in the left panel.
When there is ectopy, there is a chance for spurious mitral regurgitation to occur during left ventriculography. While standard pigtail catheter is mainly used on the left side, Grollman PA is a catheter used for pulmonary angiography, on the right side. So it is used both diagnostically as well as therapeutically.
The cyanosis in Ebstein’s anomaly, is usually not due to pulmonary hypertension, but because tricuspid regurgitation jet is directed across the atrial septal defect. This distance, between the anterior mitral leaflet and septal tricuspid leaflet, is usually only about 5 mm during echocardiography.
If a nominal right atrial pressure of 10 mm Hg is added to it, right ventricular pressure and indirectly the pulmonary artery systolic pressure are obtained, in the absence of pulmonary stenosis. The early diastolic pulmonary regurgitation (PR) gradient (peak PR gradient) will give an estimate of mean pulmonary artery pressure.
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