EACVI AEPC Congenital Heart Disease
Echocardiography (Echo CHD) [2026] | 250 Practice
Questions with Detailed Answer Explanations |
Bold Italic Answers & Italic Rationales | Echo CHD
Certification Study Guide & Exam Review
Domain 1: Fundamentals, Nomenclature & Segmental Analysis
(Questions 1–40)
1. A sonographer is performing a segmental analysis in a patient with
suspected congenital heart disease. According to the sequential
segmental approach, which of the following represents the correct
order of analysis?
A) Ventriculoarterial connections, atrioventricular connections, atrial
arrangement
B) Atrial arrangement, atrioventricular connections, ventriculoarterial
connections
C) Ventricular morphology, atrial arrangement, atrioventricular
connections
D) Great artery relationships, ventricular morphology, atrial
arrangement
,Answer: B) Atrial arrangement, atrioventricular connections,
ventriculoarterial connections
Explanation: The sequential segmental approach begins with
determining atrial situs (arrangement), followed by assessing the
atrioventricular connections, and finally the ventriculoarterial
connections. This systematic method ensures complete and accurate
diagnosis of complex congenital heart disease.
2. In a patient with situs inversus totalis, which of the following
echocardiographic findings would be expected?
A) The morphologic right atrium is on the left side and the liver is on
the left
B) The morphologic right atrium is on the right side and the liver is on
the right
C) The morphologic left atrium is on the right side and the stomach is
on the right
D) The morphologic right atrium is on the left side and the liver is on
the right
Answer: A) The morphologic right atrium is on the left side and the
liver is on the left
Explanation: Situs inversus totalis involves a mirror-image arrangement
of all thoracic and abdominal organs. The morphologic right atrium and
liver are on the left, while the morphologic left atrium and stomach are
on the right.
3. A sonographer is evaluating a neonate with cyanosis and suspects
transposition of the great arteries. Which of the following
echocardiographic findings is most characteristic of this condition?
A) The aorta arises from the right ventricle and the pulmonary artery
arises from the left ventricle
B) The aorta arises from the left ventricle and the pulmonary artery
,arises from the right ventricle
C) Both great arteries arise from the right ventricle
D) Both great arteries arise from the left ventricle
Answer: A) The aorta arises from the right ventricle and the
pulmonary artery arises from the left ventricle
Explanation: In transposition of the great arteries (TGA), there is
ventriculoarterial discordance: the aorta arises from the morphologic
right ventricle and the pulmonary artery arises from the morphologic
left ventricle, resulting in parallel circulations.
4. A patient with tetralogy of Fallot is being evaluated. Which of the
following is NOT one of the four classic anatomical components of this
condition?
A) Ventricular septal defect
B) Overriding aorta
C) Pulmonary stenosis
D) Atrial septal defect
Answer: D) Atrial septal defect
Explanation: The four features of Tetralogy of Fallot are ventricular
septal defect, overriding aorta, pulmonary stenosis (infundibular), and
right ventricular hypertrophy. An atrial septal defect is not a primary
feature, though it may coexist.
5. A sonographer is assessing a patient with suspected Ebstein
anomaly. Which echocardiographic view best demonstrates the
characteristic apical displacement of the tricuspid valve?
A) Parasternal long-axis view
B) Apical four-chamber view
C) Subcostal short-axis view
D) Suprasternal notch view
, Answer: B) Apical four-chamber view
Explanation: The apical four-chamber view is optimal for demonstrating
the apical displacement of the septal and posterior leaflets of the
tricuspid valve, which is the hallmark of Ebstein anomaly, leading to
"atrialization" of the right ventricle.
6. A patient with a suspected secundum atrial septal defect is
undergoing echocardiography. Which view is most sensitive for
assessing the defect using color Doppler?
A) Parasternal long-axis view
B) Subcostal four-chamber view
C) Apical four-chamber view
D) Parasternal short-axis view
Answer: B) Subcostal four-chamber view
Explanation: The subcostal view places the interatrial septum
perpendicular to the ultrasound beam, minimizing dropout and
optimizing the sensitivity of color Doppler for detecting shunts.
7. A neonate presents with severe cyanosis, and echocardiography
reveals a single arterial trunk arising from the base of the heart. What
is the most likely diagnosis?
A) Transposition of the great arteries
B) Persistent truncus arteriosus
C) Tetralogy of Fallot
D) Pulmonary atresia
Answer: B) Persistent truncus arteriosus
Explanation: Persistent truncus arteriosus is defined by a single arterial
vessel arising from the heart that supplies systemic, pulmonary, and
coronary circulations, often presenting with severe cyanosis in the
neonatal period.
Echocardiography (Echo CHD) [2026] | 250 Practice
Questions with Detailed Answer Explanations |
Bold Italic Answers & Italic Rationales | Echo CHD
Certification Study Guide & Exam Review
Domain 1: Fundamentals, Nomenclature & Segmental Analysis
(Questions 1–40)
1. A sonographer is performing a segmental analysis in a patient with
suspected congenital heart disease. According to the sequential
segmental approach, which of the following represents the correct
order of analysis?
A) Ventriculoarterial connections, atrioventricular connections, atrial
arrangement
B) Atrial arrangement, atrioventricular connections, ventriculoarterial
connections
C) Ventricular morphology, atrial arrangement, atrioventricular
connections
D) Great artery relationships, ventricular morphology, atrial
arrangement
,Answer: B) Atrial arrangement, atrioventricular connections,
ventriculoarterial connections
Explanation: The sequential segmental approach begins with
determining atrial situs (arrangement), followed by assessing the
atrioventricular connections, and finally the ventriculoarterial
connections. This systematic method ensures complete and accurate
diagnosis of complex congenital heart disease.
2. In a patient with situs inversus totalis, which of the following
echocardiographic findings would be expected?
A) The morphologic right atrium is on the left side and the liver is on
the left
B) The morphologic right atrium is on the right side and the liver is on
the right
C) The morphologic left atrium is on the right side and the stomach is
on the right
D) The morphologic right atrium is on the left side and the liver is on
the right
Answer: A) The morphologic right atrium is on the left side and the
liver is on the left
Explanation: Situs inversus totalis involves a mirror-image arrangement
of all thoracic and abdominal organs. The morphologic right atrium and
liver are on the left, while the morphologic left atrium and stomach are
on the right.
3. A sonographer is evaluating a neonate with cyanosis and suspects
transposition of the great arteries. Which of the following
echocardiographic findings is most characteristic of this condition?
A) The aorta arises from the right ventricle and the pulmonary artery
arises from the left ventricle
B) The aorta arises from the left ventricle and the pulmonary artery
,arises from the right ventricle
C) Both great arteries arise from the right ventricle
D) Both great arteries arise from the left ventricle
Answer: A) The aorta arises from the right ventricle and the
pulmonary artery arises from the left ventricle
Explanation: In transposition of the great arteries (TGA), there is
ventriculoarterial discordance: the aorta arises from the morphologic
right ventricle and the pulmonary artery arises from the morphologic
left ventricle, resulting in parallel circulations.
4. A patient with tetralogy of Fallot is being evaluated. Which of the
following is NOT one of the four classic anatomical components of this
condition?
A) Ventricular septal defect
B) Overriding aorta
C) Pulmonary stenosis
D) Atrial septal defect
Answer: D) Atrial septal defect
Explanation: The four features of Tetralogy of Fallot are ventricular
septal defect, overriding aorta, pulmonary stenosis (infundibular), and
right ventricular hypertrophy. An atrial septal defect is not a primary
feature, though it may coexist.
5. A sonographer is assessing a patient with suspected Ebstein
anomaly. Which echocardiographic view best demonstrates the
characteristic apical displacement of the tricuspid valve?
A) Parasternal long-axis view
B) Apical four-chamber view
C) Subcostal short-axis view
D) Suprasternal notch view
, Answer: B) Apical four-chamber view
Explanation: The apical four-chamber view is optimal for demonstrating
the apical displacement of the septal and posterior leaflets of the
tricuspid valve, which is the hallmark of Ebstein anomaly, leading to
"atrialization" of the right ventricle.
6. A patient with a suspected secundum atrial septal defect is
undergoing echocardiography. Which view is most sensitive for
assessing the defect using color Doppler?
A) Parasternal long-axis view
B) Subcostal four-chamber view
C) Apical four-chamber view
D) Parasternal short-axis view
Answer: B) Subcostal four-chamber view
Explanation: The subcostal view places the interatrial septum
perpendicular to the ultrasound beam, minimizing dropout and
optimizing the sensitivity of color Doppler for detecting shunts.
7. A neonate presents with severe cyanosis, and echocardiography
reveals a single arterial trunk arising from the base of the heart. What
is the most likely diagnosis?
A) Transposition of the great arteries
B) Persistent truncus arteriosus
C) Tetralogy of Fallot
D) Pulmonary atresia
Answer: B) Persistent truncus arteriosus
Explanation: Persistent truncus arteriosus is defined by a single arterial
vessel arising from the heart that supplies systemic, pulmonary, and
coronary circulations, often presenting with severe cyanosis in the
neonatal period.
