Spectral Doppler tracings provide important hemodynamic insights. This book is dedicated to interpretation of spectral Doppler recordings, similar to EKG books focused on EKG interpretation. Examples of some spectral Doppler patterns which may not be widely known:. Notched aortic

Is this tracing consistent with constriction?.

What do you want to know?.

A young patient with recent acute pericarditis, now with occasional leg heaviness. Hepatic vein PW Doppler obtained. @JaeKOh2

Answer: hemopericardium. Left pleural effusion is also seen.

From archives: a patient after recent cardiac procedure, with transient hypotension. Attempted 2-ch view, 2D TTE. What are the findings?

Peculiar regional wall motion abnormality of RV, with basal hyperkinesis and apical akinesis. This pattern has been described in acute PE, as well as other settings, such as isolated RV stress cardiomyopathy and acute respiratory failure. In this patient with respiratory failure.

An elderly patient with respiratory distress. What is the finding and potential explanation?

Broad and high velocity A wave due to decreased RV compliance and high RV pressure. Interestingly, RA contractility is preserved despite the diagnosis.

A patient with advanced cardiac amyloidosis. PW Doppler of the hepatic vein is obtained in the subcostal view. What is the finding?

Respirophasic septal shift, small effusion and thickened pericardium, findings consistent with constriction. M mode is very valuable in pericardial disease.

Is M mode still relevant? A patient with history of open heart surgery. M mode obtained in the parasternal short axis view. What is the finding?

Monophasic filling is seen. This is a patient in sinus rhythm, HR 85, with wide and distorted QRS. What is likely explanation for monophasic filling? Abnormally prolonged relaxation with delayed filling, shortened diastole and E and A fusion. What can provide clues to pre-A.

An elderly patient with known severe left ventricular dysfunction is admitted with hypotension. Annular tissue Doppler velocities are low. What are the likely left ventricular filling pressures?

Mechanical mitral valve thrombosis on 2D TEE.

From archives of cannot miss diagnoses. A patient with prior open heart surgery, now in shock. What is the diagnosis?

Answer: prominent isovolumic flow caught by CW Doppler. Of note, prolonged isovolumic relaxation time is associated with normal LV filling pressures.

An elderly patient with generalized weakness. Transaortic CW Doppler interrogation is shown. What are the waves highlighted by the arrows? What are the implications?

Patient 1: dilated LV with systolic dysfunction and b bump indicating elevating filling pressures.Patient 2: non-dilated LV with preserved EF and mid-diastolic filling.Both with triple mitral valve opening but different mechanism and context.

Does M mode still have a role in hemodynamic assessment? Two elderly patients with dyspnea, mitral M modes shown. What are the findings and implications?

RT @DavidWienerMD: @argulian Great teaching as usual by @argulian . From the 2025 @ASE360 Chamber Quantification Guidelines: .

Answer: RCA, basal inferoseptum is thin and akinetic.