Doppler Flows: Pulmonary and Hepatic Vein Flows

Restrictive cardiomyopathy: inspiratory exaggeration of diastolic reversal 

Constrictive cardiomyopathy: expiratory exaggeration of diastolic reversal 

Pulmonary hypertension: fixed diastolic reversal 

TR: systolic reversal

PVF: systolic flow reversal in severe MR

Doppler Flows:1

Holodiastolic reversal  in the descending thoracic aorta is usually a sign of at least moderate aortic regurgitation and appears to be more specific if recorded from the thoraco-abdominal aorta

Absence or brief diastolic reversal is specific for mild AI

Tumors in Echocardiography

Benign tumors:

 Myxoma >> lipoma > papillary fibroelastoma

Malignant tumors

 Metastases > Angiosarcoma >> rhabdomyosarcoma > mesothelioma

Pediatrics: most common benign tumor: rhabdomyoma > fibroma 

Tumors that metastasize to the heart

 RCC

 Breast

 Lung

 Melanoma (charcoal heart)

 Lymphoma

 Carcinoid

Common locations

 Fibroma: anterior/ivs of LV

 Myxoma: LA attachment to fossa ovalis (LA>RA>RV>LV; if attached to posterior wall of LA: consider malignancy)

 Leiomyosarcoma: smooth muscle lining the pulmonary veins

 Angiosarcoma: RA (M:F 3:1)

Tumors associated with 

 AIDS: Kaposi's; Malignant lymphoma 

 Tuberous sclerosis: Rhabdomyoma 

Mass seen extending from IVC to RA 

 Hypernephroma > Hepatoma > Uterine Leiomyoma