EACVI AEPC Congenital Heart Disease Echocardiography Exam 2026/2027 | Echo CHD Practice Questions & Answers

EACVI AEPC Congenital Heart Disease
Echocardiography Exam 2026/2027 | Echo
CHD Practice Questions & Answers
EACVI AEPC Congenital Heart Disease Echocardiography Exam 2026/2027



DOCUMENT OVERVIEW:

• This comprehensive question practice exam is designed to assess mastery of
congenital heart disease echocardiography principles, anatomy, pathophysiology,
and clinical assessment techniques according to EACVI AEPC standards.

• Study this material by working through questions systematically, reviewing
detailed rationales for both correct and incorrect options to reinforce CHD echo
concepts, anatomical landmarks, and diagnostic criteria essential for clinical
practice.



QUESTIONS BEGIN



QUESTION 1

A secundum atrial septal defect is best characterized echocardiographically
by:

A) Dropout of echoes in the mid-interatrial septum with negative flow on color
Doppler

B) Deviation of the atrial septum primum toward the right atrium

C) Anterior displacement of the ventricular septum during systole

D) Loss of continuity between the aorta and mitral valve

E) Reversal of flow in the hepatic veins throughout systole

CORRECT ANSWER: A) Dropout of echoes in the mid-interatrial septum
with negative flow on color Doppler

,RATIONALE: A secundum ASD is characterized by a defect in the region of the fossa
ovalis, which appears as a loss of echogenicity (dropout) in the mid-interatrial
septum on 2D imaging. Color Doppler demonstrates left-to-right shunt flow across
the defect. This is the pathognomonic finding. Option B describes primum ASD
associated with cleft mitral valve. Option C relates to ventricular septal defects.
Option D indicates aorto-mitral continuity loss seen in endocardial cushion defects.
Option E reflects severe tricuspid regurgitation, not an ASD-specific finding.



QUESTION 2

In a patient with an ostium primum atrial septal defect, which of the
following findings is MOST consistent with the diagnosis:

A) Complete absence of the interatrial septum

B) Cleft anterior mitral leaflet with degree of mitral regurgitation

C) Aneurysmal bulging of the atrial septum toward the left atrium

D) Isolated partial anomalous pulmonary venous return

E) Hypoplastic right ventricular outflow tract

CORRECT ANSWER: B) Cleft anterior mitral leaflet with degree of mitral
regurgitation

RATIONALE: Primum ASDs are part of the spectrum of endocardial cushion defects
and characteristically present with a cleft in the anterior mitral leaflet, resulting in
mitral regurgitation of variable severity. The defect is located in the region of the
fossa ovalis inferior to the normal location. Option A describes a complete
endocardial cushion defect with absent atrial septum. Option C represents a
different pathology. Options D and E are not characteristic features of primum ASD.



QUESTION 3

A sinus venosus atrial septal defect is associated with:

A) Anomalous return of all four pulmonary veins

,B) Partial anomalous pulmonary venous return, typically from the right upper lobe
vein

C) Total anomalous pulmonary venous connection to the brachiocephalic vein

D) Mitral stenosis with restricted leaflet motion

E) Left ventricular outflow tract obstruction

CORRECT ANSWER: B) Partial anomalous pulmonary venous return,
typically from the right upper lobe vein

RATIONALE: Sinus venosus ASDs are located at the junction of the superior vena
cava and right atrium, and are frequently associated with partial anomalous
pulmonary venous return (PAPVR), particularly involving the right upper pulmonary
vein. This association is so frequent that screening for PAPVR is mandatory in sinus
venosus ASD. Option A describes TAPVC. Option C represents complete TAPVC.
Options D and E are unrelated to this ASD variant.



QUESTION 4

The correct echocardiographic view for optimal assessment of an atrial
septum primum in the evaluation of ASD is:

A) Parasternal long-axis view

B) Apical 4-chamber view

C) Subcostal sagittal view

D) Parasternal short-axis view at the aortic valve level

E) Apical 5-chamber view

CORRECT ANSWER: C) Subcostal sagittal view

RATIONALE: The subcostal sagittal view (also called subcostal coronal view)
provides the most direct perpendicular assessment of the atrial septum and is
considered the gold standard for evaluating ASD, particularly secundum defects.
This view aligns the ultrasound beam perpendicular to the plane of the atrial
septum. The apical 4-chamber view is also valuable but is less optimal for precise

, measurement of defect size. Parasternal views are suboptimal for septal
assessment.



QUESTION 5

Which of the following statements regarding ventricular septal defects is
CORRECT:

A) Muscular VSDs are located directly beneath the aortic valve

B) Perimembranous VSDs account for approximately 70-80% of all VSDs

C) Supracristal VSDs are the most common type in adult populations

D) Inlet VSDs are located in the posteroinferior portion of the septum

E) All VSDs require surgical closure to prevent endocarditis

CORRECT ANSWER: B) Perimembranous VSDs account for approximately
70-80% of all VSDs

RATIONALE: Perimembranous (paramembranous) VSDs represent the majority of
VSDs (70-80%) and are located at the junction between the membranous and
muscular portions of the ventricular septum, typically just beneath the aortic valve.
Option A describes supracristal (doubly committed subarterial) VSDs. Option C is
incorrect as supracristal VSDs are rare. Option D correctly describes inlet VSDs but
is not the most common type. Option E is false as small VSDs often close
spontaneously without intervention.



QUESTION 6

A supracristal (doubly committed subarterial) VSD has which of the following
characteristic features:

A) Located between the septal and parietal bands

B) Lack of supporting tissue beneath the aortic and pulmonary valves

C) Associated with primum ASD