EACVI AEPC Congenital Heart Disease
Echocardiography (Echo CHD) Online Exam
Questions and Answers Plus Rationales
1. What is the primary role of echocardiography in managing
congenital heart disease (CHD)?
A) Surgical intervention planning only
B) Definitive treatment of CHD
C) Non-invasive diagnosis and haemodynamic assessment
D) Genetic counselling for CHD patients
Echocardiography provides real-time, non-invasive information on
cardiac anatomy, function and haemodynamics, which is essential
in CHD management.
2. Which imaging modality is most appropriate for fetal heart
assessment during pregnancy?
A) Cardiac MRI
B) Fetal echocardiography
C) Transoesophageal echocardiography
D) Chest X-ray
Fetal echocardiography is the preferred modality for prenatal
detection of congenital heart defects, with detailed visualization of
fetal cardiac anatomy.
3. In which congenital heart defect is the atrial septal defect (ASD)
most commonly of the ostium secundum type?
A) Sinus venosus defect
B) Ostium primum defect
, C) Ostium secundum defect
D) Coronary sinus defect
The ostium secundum ASD is the most common type of ASD and
occurs at the region of the fossa ovalis.
4. Which of the following is a characteristic echocardiographic
feature of Tetralogy of Fallot?
A) Large atrial septal defect with left-to-right shunt
B) VSD with right ventricular outflow tract obstruction and
overriding aorta
C) Coarctation of the aorta with post-stenotic dilation
D) Dextrocardia with isolated ventricular septal defect
Tetralogy of Fallot consists of a VSD, RVOT obstruction (pulmonary
stenosis), overriding aorta and right ventricular hypertrophy.
5. Which type of coarctation of the aorta is typically located just
distal to the ductus arteriosus?
A) Pre-ductal (infantile) coarctation
B) Post-ductal (adult) coarctation
C) Juxtaductal coarctation
D) Supravalvular coarctation
Juxtaductal coarctation lies adjacent to the ductus arteriosus
insertion—often seen in congenital cases.
6. Which echocardiographic sign is most indicative of a patent ductus
arteriosus (PDA)?
A) Continuous left-to-right shunt flow in Doppler imaging
B) Absence of flow across the aortic arch
C) Enlarged right atrium only
D) Dextrocardia with no shunt flow
, In PDA you typically see continuous flow from the aorta into the
pulmonary artery on Doppler throughout systole and diastole.
7. What is the key echocardiographic feature of Hypoplastic Left
Heart Syndrome (HLHS)?
A) Large secundum ASD with right-to-left shunt
B) Under-development of the left ventricle, mitral and aortic
valves
C) Isolated ventricular septal defect with normal left ventricle
D) Pulmonary artery hypertension only
HLHS is characterised by under-development of left-sided
structures including left ventricle, mitral valve, aortic valve and
ascending aorta.
8. In single ventricle physiology, what is a typical echocardiographic
finding?
A) Two well-separated ventricles with normal AV valves
B) One dominant ventricle with associated atrioventricular valve(s)
C) Normal left and right ventricles but abnormal great arteries
D) Normal biventricular physiology with only a minor shunt
Single ventricle physiology usually shows one morphologic
ventricle with a common atrioventricular or single AV valve and
absence or rudimentary second ventricle.
9. Which type of Total Anomalous Pulmonary Venous Return (TAPVR)
involves pulmonary veins draining into the superior vena cava via
a vertical vein?
A) Supracardiac
B) Cardiac
C) Infracardiac
, D) Mixed
In the supracardiac type, pulmonary veins drain into a vertical vein
ascending to the SVC.
10. What diameter ratio is considered significant for an atrial
septal defect on echocardiography when assessing right
atrial/ventricular enlargement?
A) RA/RV < 1.0
B) RA/RV = 1.0
C) RA/RV > 1.0
D) RA/RV > 2.0
A right atrium/ventricle enlargement ratio > 1.0 suggests volume
overload from significant left-to-right shunt such as an ASD.
11. In the assessment of ventricular function in CHD, which
echocardiographic modality adds volumetric and spatial
information beyond 2-D?
A) M-mode imaging
B) Standard 2-D imaging
C) Doppler echocardiography
D) 3-D echocardiography
3-D echocardiography provides detailed spatial reconstruction of
cardiac chambers and is especially useful in complex congenital
heart disease.
12. Which of the following statements is true regarding Doppler
evaluation in CHD?
A) Doppler cannot assess shunt magnitude
B) Doppler is only useful for valve stenosis
C) Doppler can estimate pressure gradients and quantify shunts
Echocardiography (Echo CHD) Online Exam
Questions and Answers Plus Rationales
1. What is the primary role of echocardiography in managing
congenital heart disease (CHD)?
A) Surgical intervention planning only
B) Definitive treatment of CHD
C) Non-invasive diagnosis and haemodynamic assessment
D) Genetic counselling for CHD patients
Echocardiography provides real-time, non-invasive information on
cardiac anatomy, function and haemodynamics, which is essential
in CHD management.
2. Which imaging modality is most appropriate for fetal heart
assessment during pregnancy?
A) Cardiac MRI
B) Fetal echocardiography
C) Transoesophageal echocardiography
D) Chest X-ray
Fetal echocardiography is the preferred modality for prenatal
detection of congenital heart defects, with detailed visualization of
fetal cardiac anatomy.
3. In which congenital heart defect is the atrial septal defect (ASD)
most commonly of the ostium secundum type?
A) Sinus venosus defect
B) Ostium primum defect
, C) Ostium secundum defect
D) Coronary sinus defect
The ostium secundum ASD is the most common type of ASD and
occurs at the region of the fossa ovalis.
4. Which of the following is a characteristic echocardiographic
feature of Tetralogy of Fallot?
A) Large atrial septal defect with left-to-right shunt
B) VSD with right ventricular outflow tract obstruction and
overriding aorta
C) Coarctation of the aorta with post-stenotic dilation
D) Dextrocardia with isolated ventricular septal defect
Tetralogy of Fallot consists of a VSD, RVOT obstruction (pulmonary
stenosis), overriding aorta and right ventricular hypertrophy.
5. Which type of coarctation of the aorta is typically located just
distal to the ductus arteriosus?
A) Pre-ductal (infantile) coarctation
B) Post-ductal (adult) coarctation
C) Juxtaductal coarctation
D) Supravalvular coarctation
Juxtaductal coarctation lies adjacent to the ductus arteriosus
insertion—often seen in congenital cases.
6. Which echocardiographic sign is most indicative of a patent ductus
arteriosus (PDA)?
A) Continuous left-to-right shunt flow in Doppler imaging
B) Absence of flow across the aortic arch
C) Enlarged right atrium only
D) Dextrocardia with no shunt flow
, In PDA you typically see continuous flow from the aorta into the
pulmonary artery on Doppler throughout systole and diastole.
7. What is the key echocardiographic feature of Hypoplastic Left
Heart Syndrome (HLHS)?
A) Large secundum ASD with right-to-left shunt
B) Under-development of the left ventricle, mitral and aortic
valves
C) Isolated ventricular septal defect with normal left ventricle
D) Pulmonary artery hypertension only
HLHS is characterised by under-development of left-sided
structures including left ventricle, mitral valve, aortic valve and
ascending aorta.
8. In single ventricle physiology, what is a typical echocardiographic
finding?
A) Two well-separated ventricles with normal AV valves
B) One dominant ventricle with associated atrioventricular valve(s)
C) Normal left and right ventricles but abnormal great arteries
D) Normal biventricular physiology with only a minor shunt
Single ventricle physiology usually shows one morphologic
ventricle with a common atrioventricular or single AV valve and
absence or rudimentary second ventricle.
9. Which type of Total Anomalous Pulmonary Venous Return (TAPVR)
involves pulmonary veins draining into the superior vena cava via
a vertical vein?
A) Supracardiac
B) Cardiac
C) Infracardiac
, D) Mixed
In the supracardiac type, pulmonary veins drain into a vertical vein
ascending to the SVC.
10. What diameter ratio is considered significant for an atrial
septal defect on echocardiography when assessing right
atrial/ventricular enlargement?
A) RA/RV < 1.0
B) RA/RV = 1.0
C) RA/RV > 1.0
D) RA/RV > 2.0
A right atrium/ventricle enlargement ratio > 1.0 suggests volume
overload from significant left-to-right shunt such as an ASD.
11. In the assessment of ventricular function in CHD, which
echocardiographic modality adds volumetric and spatial
information beyond 2-D?
A) M-mode imaging
B) Standard 2-D imaging
C) Doppler echocardiography
D) 3-D echocardiography
3-D echocardiography provides detailed spatial reconstruction of
cardiac chambers and is especially useful in complex congenital
heart disease.
12. Which of the following statements is true regarding Doppler
evaluation in CHD?
A) Doppler cannot assess shunt magnitude
B) Doppler is only useful for valve stenosis
C) Doppler can estimate pressure gradients and quantify shunts
