Echocardiogram – Continuous wave Doppler from apical 5 chamber view – Cardiology MCQ – Answer

Identify the jet marked in the continuous wave Doppler taken from the apical five chamber view:

Correct answer: b) Aortic regurgitation

In the apical five chamber view, the transducer is kept at the apex and hence a flow towards the transducer will be aortic regurgitation (AR jet) when the cursor is passing through the left ventricular outflow tract (LVOT) as in this case (see the 2-D image in the inset at the top). The aortic stenosis jet (AS Jet) is seen below the baseline as it is away from the transducer in this view. Peak velocity of the AS Jet (Vmax) is 508 cm/s and the mean velocity (Vmean) 348 cm/s. This will correspond to a peak gradient (Max PG) of 103 mm Hg mean gradient of 58 mm Hg (Mean PG). The velocity time integral (VTI) is shown as 110 cm. VTI is electronically calculated when we trace out the AS Jet manually for getting the peak and mean gradients. The Doppler gradients are suggestive of severe aortic stenosis. Of course, there is associated aortic regurgitation as well as seen above.

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