Adult Echocardiography Quiz (92 Questions) With
Complete Solution
A 32-year-old female presents with atypical chest pain. Her blood pressure is 112/50, height 6' and
weight 115 lbs. An echocardiogram is performed which shows mitral valve prolapse. What is the most
likely diagnosis for this patient?
Which additional cardiac structures should be evaluated? - Marfan Syndrome
-ANSWER: The aortic valve and aorta should be evaluated for teh presence of valvular regurg, aortic
dilatation and possible dissection
A 39-year-old male with no cardiac history enters the doctor's office complaining of flu-like symptoms
for one week. A previously undocumented systolic murmur is heard. An echocardiogram reveals an
abnormally thick anterior mitral valve leaflet and mild mitral regurgitation. What is the most likely
cause of these echo findings?
What additional tests will be helpful in making the diagnosis this patient? - Mitral valve endocarditis
- ANSWER: blood cultures will be helpful in identifying the organism and a TEE will further assess the
extent of thickening
A 55-year-old female complains of increasing displeasure on exertion for 3 months. Her physical
examination reveals jugular venous distention, ascites and a pericardial knock. What is the most
likely clinical diagnosis? - ANSWER: Constrictive pericarditis (all signs could result from a restriction
to diastolic filling)
A 32-year-old female complains of fatigue and her check x-ray reveals cardiomegaly. RA and RV
enlargement appears on the echo. Additionally, there is a flattened IVS, m-mode findings of pulmonic
valve mid-systolic closure and an absent A-wave. Identify the cardiac abnormality consistent with
these findings. - ANSWER: Pulmonary hypertension
A 22-year-old male complains of chest pain following exercise. An echocardiogram displays
concentric LV hypertrophy (2.5cm) and a small LV cavity size. Systolic motion of the mitral leaflet
(SAM) and pericardial effusion are not observed. What is the most likely diagnosis for this patient? -
ANSWER: Hypertrophic cardiomyopathy
A 38-year-old male is sent to the lab for evaluation after complaining of severe dyspnea on exertion
for 2 months. M-mode findings include a dilated LV, increased E point to septal separation (EPSS), B-
notch on the MV and overall hypocontractile LV wall motion. What type of cardiac abnormality do
these findings suggest? - ANSWER: Dilated cardiomyopathy
After a chest x-ray revealed cardiomegaly, a 58-year-old female, with a primary complaint of
increasing dyspnea on exertion, is sent for an echo. The echo demonstrates LV hypertrophy with a
"bright" myocardial appearance, LA enlargement and a small pericardial effusion. What is this
patient's most likely cardiac diagnosis? - ANSWER: Infiltrative (restrictive) cardiomyopathy
A 56-year-old female visits her doctor with the complaint of SOB. Upon physical examination, a low
frequency diastolic (rumbling) murmur is detected. The patient denies any history of rheumatic fever.
What three cardiac abnormalities might be present in this patient? - ANSWER: - Mitral stenosis
- LA myxomas
- Aortic regurgitation
, A 31-year-old male with a history of uncontrolled systemic hypertension enters the emergency room
with severe chest pain that he describes as "ripping". What is a likely cardiac diagnosis for this
patient?
Which noninvasive exam would be useful to confirm the diagnosis? - May be experiencing a MI, but
everything indicates the possibility of an aortic dissection
- ANSWER: TEE (chest CT is also good)
An 18-year-old male complains of "palpitations". His chest x-ray reveals cardiomegaly and as a result,
and echo is ordered. The echo reveals RA and RV enlargement. The TV appears abnormally displaces
towards the apex. What is this patient's most probable cardiac abnormality? - ANSWER: Ebstein's
Anomaly
In the parasite real short-axis view, at the level of the mitral valve and papillary muscle, how many
segments is the LV divided into? Name the ventricular segments. - ANSWER: 6 segments
1. Inferolateral
2. Anterolateral
3. Anterior
4. Anteroseptal
5. Inferoseptal
6. Inferior
In the apical 4 view, which 2 walls of the LV are seen? - ANSWER: Inferoseptal and anterolateral
In the Apical 2 view, which 2 walls of the LV are seen? - ANSWER: Anterior and inferior
Which walls of the LV are seen in the parasternal and apical long-axis views? Which 2 AV leaflets are
seen in these views? - Anteroseptal and inferolateral walls of the LV
The right and no coronary leaflets are seen
Where is the coronary sinus located in the parasternal long-axis view? - ANSWER: Lies in the
posterior atrioventricular groove
Where is the coronary sinus located in relation to the descending aorta? - ANSWER: Anterior to the
descending aorta
How would you angle to view the coronary sinus in the apical 4 view? - ANSWER: Angle posterior
Why is it important to know the location of the coronary sinus and the descending aorta - ANSWER:
They are important landmarks that can help differentiate pericardial effusions from pleural effusions.
What would cause the coronary sinus to become dilated - ANSWER: Due to increased pressure in the
RA or increased flow into the coronary sinus as in some congenital malformations
Name the three major coronary arteries. Where are they located on the surface of the heart? -
ANSWER: - Right: arises from the right aortic-root sinus, follows the right atrioventricular junction,
and descends along the posterior interventricular groove
- Left anterior descending: follows the anterior interventricular groove
- circumflex: courses along the left atrioventricular junction
Name the cardiac walls supplied by each of the coronary arteries - ANSWER: Right coronary: inferior,
inferoseptal, right ventricular apex, right ventricular free wall
Left anterior descending: anterior, anteroseptal, left ventricular apex
Circumflex: anterolateral, inferolateral
Complete Solution
A 32-year-old female presents with atypical chest pain. Her blood pressure is 112/50, height 6' and
weight 115 lbs. An echocardiogram is performed which shows mitral valve prolapse. What is the most
likely diagnosis for this patient?
Which additional cardiac structures should be evaluated? - Marfan Syndrome
-ANSWER: The aortic valve and aorta should be evaluated for teh presence of valvular regurg, aortic
dilatation and possible dissection
A 39-year-old male with no cardiac history enters the doctor's office complaining of flu-like symptoms
for one week. A previously undocumented systolic murmur is heard. An echocardiogram reveals an
abnormally thick anterior mitral valve leaflet and mild mitral regurgitation. What is the most likely
cause of these echo findings?
What additional tests will be helpful in making the diagnosis this patient? - Mitral valve endocarditis
- ANSWER: blood cultures will be helpful in identifying the organism and a TEE will further assess the
extent of thickening
A 55-year-old female complains of increasing displeasure on exertion for 3 months. Her physical
examination reveals jugular venous distention, ascites and a pericardial knock. What is the most
likely clinical diagnosis? - ANSWER: Constrictive pericarditis (all signs could result from a restriction
to diastolic filling)
A 32-year-old female complains of fatigue and her check x-ray reveals cardiomegaly. RA and RV
enlargement appears on the echo. Additionally, there is a flattened IVS, m-mode findings of pulmonic
valve mid-systolic closure and an absent A-wave. Identify the cardiac abnormality consistent with
these findings. - ANSWER: Pulmonary hypertension
A 22-year-old male complains of chest pain following exercise. An echocardiogram displays
concentric LV hypertrophy (2.5cm) and a small LV cavity size. Systolic motion of the mitral leaflet
(SAM) and pericardial effusion are not observed. What is the most likely diagnosis for this patient? -
ANSWER: Hypertrophic cardiomyopathy
A 38-year-old male is sent to the lab for evaluation after complaining of severe dyspnea on exertion
for 2 months. M-mode findings include a dilated LV, increased E point to septal separation (EPSS), B-
notch on the MV and overall hypocontractile LV wall motion. What type of cardiac abnormality do
these findings suggest? - ANSWER: Dilated cardiomyopathy
After a chest x-ray revealed cardiomegaly, a 58-year-old female, with a primary complaint of
increasing dyspnea on exertion, is sent for an echo. The echo demonstrates LV hypertrophy with a
"bright" myocardial appearance, LA enlargement and a small pericardial effusion. What is this
patient's most likely cardiac diagnosis? - ANSWER: Infiltrative (restrictive) cardiomyopathy
A 56-year-old female visits her doctor with the complaint of SOB. Upon physical examination, a low
frequency diastolic (rumbling) murmur is detected. The patient denies any history of rheumatic fever.
What three cardiac abnormalities might be present in this patient? - ANSWER: - Mitral stenosis
- LA myxomas
- Aortic regurgitation
, A 31-year-old male with a history of uncontrolled systemic hypertension enters the emergency room
with severe chest pain that he describes as "ripping". What is a likely cardiac diagnosis for this
patient?
Which noninvasive exam would be useful to confirm the diagnosis? - May be experiencing a MI, but
everything indicates the possibility of an aortic dissection
- ANSWER: TEE (chest CT is also good)
An 18-year-old male complains of "palpitations". His chest x-ray reveals cardiomegaly and as a result,
and echo is ordered. The echo reveals RA and RV enlargement. The TV appears abnormally displaces
towards the apex. What is this patient's most probable cardiac abnormality? - ANSWER: Ebstein's
Anomaly
In the parasite real short-axis view, at the level of the mitral valve and papillary muscle, how many
segments is the LV divided into? Name the ventricular segments. - ANSWER: 6 segments
1. Inferolateral
2. Anterolateral
3. Anterior
4. Anteroseptal
5. Inferoseptal
6. Inferior
In the apical 4 view, which 2 walls of the LV are seen? - ANSWER: Inferoseptal and anterolateral
In the Apical 2 view, which 2 walls of the LV are seen? - ANSWER: Anterior and inferior
Which walls of the LV are seen in the parasternal and apical long-axis views? Which 2 AV leaflets are
seen in these views? - Anteroseptal and inferolateral walls of the LV
The right and no coronary leaflets are seen
Where is the coronary sinus located in the parasternal long-axis view? - ANSWER: Lies in the
posterior atrioventricular groove
Where is the coronary sinus located in relation to the descending aorta? - ANSWER: Anterior to the
descending aorta
How would you angle to view the coronary sinus in the apical 4 view? - ANSWER: Angle posterior
Why is it important to know the location of the coronary sinus and the descending aorta - ANSWER:
They are important landmarks that can help differentiate pericardial effusions from pleural effusions.
What would cause the coronary sinus to become dilated - ANSWER: Due to increased pressure in the
RA or increased flow into the coronary sinus as in some congenital malformations
Name the three major coronary arteries. Where are they located on the surface of the heart? -
ANSWER: - Right: arises from the right aortic-root sinus, follows the right atrioventricular junction,
and descends along the posterior interventricular groove
- Left anterior descending: follows the anterior interventricular groove
- circumflex: courses along the left atrioventricular junction
Name the cardiac walls supplied by each of the coronary arteries - ANSWER: Right coronary: inferior,
inferoseptal, right ventricular apex, right ventricular free wall
Left anterior descending: anterior, anteroseptal, left ventricular apex
Circumflex: anterolateral, inferolateral
