ARDMS ECHO STANDARD EXAMS ANSWERS AND
QUESTIONS SET A+
✔✔A common etiology for PHTN is what? - ✔✔Idiopathic
✔✔other etiologies for PHTN include - ✔✔~MS
~ MR
~ Pul. embolism
✔✔In patients with suspected PHTN the RVSP maybe predicted by? - ✔✔CW Doppler
examination of the TR gradient added to the RAP
TR + RAP =RVSP
✔✔T/F documenting there is no PS is the final step in predicting PA pressure - ✔✔True
✔✔After a baby is born what causes the foramen ovale to close - ✔✔Increased LA
pressure from an increased pulmonary flow
✔✔IVC is dilated and there is no collapse what is the RAP - ✔✔15 mmHg
✔✔Pressure overload of the RV may produce what? - ✔✔RVH
Flattened IVS
Large RV
✔✔MVP murmur - ✔✔mid systolic click with late systolic murmur
✔✔In AP4CH which valve is closest to the apex? - ✔✔TV
✔✔Fetal blood oxygenation occurs in the maternal - ✔✔placenta
✔✔T/F, would TEE be a test used to R/O apical thrombus - ✔✔No, TEE has difficulty
visualizing the true LV apex
✔✔in an easy to image adult with beautiful pics which frequ would you likely use
,A. 2.0 MHz
B. 3.5 MHz
C. 5 MHz - ✔✔5 MHz
✔✔chiari network is seen in the - ✔✔Ra
✔✔MS murmur - ✔✔Diastolic RUMBLE with opening snap. LOW frequency= Rumble
✔✔MS m mode findings - ✔✔` decreased E-F slope
` anterior motion of the posterior leaflet
` reduced E wave
` multi echos
✔✔why do MS pts become very symptomatic with A-Fib - ✔✔might lose 50% diastolic
filling with MS. very dependent on atrial kick in this case. With A -fib you lose the extra
filling that comes from the atrial contraction.
✔✔Aortic regurgitation P1/2t - ✔✔Mild > 500msec
Moderate 200 - 500 msec
Severe > 200 msec
✔✔A 32 year old female presents with atypical chest pain. Her blood pressure is
112/50, height 6' and weighs 115 lbs. An echo is performed and shows MVP. What is
the most likely diagnosis for this patient?
Which additional cardiac structures should be evaluated? - ✔✔From the physical
description of this patient and the finding on the echo of MVP she may have Marfan
syndrome.
The aortic valve and aorta should be evaluated for the presence of valvular
regurgitation, aortic dilation 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 revels an abnormally thick anterior MV leaflet and MR? What is the
most likely cause of these echo findings? What additional tests will be helpful in making
the diagnosis for this patient? - ✔✔With a new murmur and the echo finding of mitral
valve thickening in a young person, the most likely diagnosis is MV endocarditis.
Blood cultures will be helpful in identifying the organism and a TEE will further assess
the extent of the mitral leaflet thickening.
✔✔A 32 year old female complains of fatigue and her chest x-ray revels cardiomegaly.
An echo is ordered. RA and RV enlargement appears on the echo. Additionally, there is
a flattened IVS. M-Mode findings of PV mid-systolic closure and an absent A-wave.
Identify the cardiac abnormality consistent with these findings. - ✔✔These echo findings
are consistent with PHTN. A microcavitation (saline contrast) study should be performed
to rule out an atrial level shunt as the cause of the PHTN.
, ✔✔A 22 year old male complains of CP following exercise. An echo displays concentric
LVH (2.5 cm) and a small LV cavity size. Systolic motion of the anterior mitral valve
leaflet (SAM) and PE are not observed. What is the most likely diagnosis for the
patient?
What additional noninvasive tests may help in diagnosing this patient? - ✔✔The findings
of concentric LVH and a small LV cavity size is diagnostic of hypertrophic
cardiomyopathy.
✔✔In order to identify the presence or absence of an obstructive component- - ✔✔An
amyl nitrate or Valsalva challenge should be performed while the LVOT is interrogated
by CW Doppler.
✔✔A 38 yo male is sent to the echo lab for evaluation after complaining of severe
dyspnea on exertion for 2 months. M-mode findings include a dilated LV, increased
EPSS, B-notch on the MV and overall hyper contractile LV wall motion. What type of
cardiac abnormality do these findings suggest? - ✔✔The M-mode findings of a dilated
LV, increased EPSS, B-notch on the mitral valve and overall hyper contractile LV wall
motion identify a patient with 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 from a echo. The echo
demonstrates left ventricular hypertrophy with a "bright" Myocardial appearance, left
atrial enlargement and a small pericardial effusion. What is the patient's most likely
cardiac diagnosis? - ✔✔LVH with a "bright" myocardial, LAE and a small PE are echo
findings most consistent with a diagnosis of infiltrative (restrictive) cardiomyopathy.
✔✔LA myxomas mimic ---- with regard to both physical findings and symptoms. -
✔✔MS
✔✔AR, if the AR jet hits the ---------- , the MV's opening can be restricted. As a result, a
"rumbling" diastolic murmur (--------), rather than the typical "-------" AR diastolic murmur,
will be heard. - ✔✔Mitral Valve Anterior Leaflet, Austin Flint, "blowing"
✔✔An 18 year old male complains of "palpitation". His chest x-ray reveals cardiomegaly
and as a result, an echo is ordered. The echo reveals RA an RV enlargement. The TV
appears abnormally displaced towards the apex. What is this patient's most probable
cardiac abnormality?
What additional test should be performed in the echo lab? - ✔✔The pt probably had
Ebstein's Anomaly. Often patients with Ebstein's Anomaly are asymptotic and the
finding is a surprise when an echo is performed for something like evaluating a murmur.
A saline bubble/contrast study should be performed to identify the presence or absence
of an associated ASD.
QUESTIONS SET A+
✔✔A common etiology for PHTN is what? - ✔✔Idiopathic
✔✔other etiologies for PHTN include - ✔✔~MS
~ MR
~ Pul. embolism
✔✔In patients with suspected PHTN the RVSP maybe predicted by? - ✔✔CW Doppler
examination of the TR gradient added to the RAP
TR + RAP =RVSP
✔✔T/F documenting there is no PS is the final step in predicting PA pressure - ✔✔True
✔✔After a baby is born what causes the foramen ovale to close - ✔✔Increased LA
pressure from an increased pulmonary flow
✔✔IVC is dilated and there is no collapse what is the RAP - ✔✔15 mmHg
✔✔Pressure overload of the RV may produce what? - ✔✔RVH
Flattened IVS
Large RV
✔✔MVP murmur - ✔✔mid systolic click with late systolic murmur
✔✔In AP4CH which valve is closest to the apex? - ✔✔TV
✔✔Fetal blood oxygenation occurs in the maternal - ✔✔placenta
✔✔T/F, would TEE be a test used to R/O apical thrombus - ✔✔No, TEE has difficulty
visualizing the true LV apex
✔✔in an easy to image adult with beautiful pics which frequ would you likely use
,A. 2.0 MHz
B. 3.5 MHz
C. 5 MHz - ✔✔5 MHz
✔✔chiari network is seen in the - ✔✔Ra
✔✔MS murmur - ✔✔Diastolic RUMBLE with opening snap. LOW frequency= Rumble
✔✔MS m mode findings - ✔✔` decreased E-F slope
` anterior motion of the posterior leaflet
` reduced E wave
` multi echos
✔✔why do MS pts become very symptomatic with A-Fib - ✔✔might lose 50% diastolic
filling with MS. very dependent on atrial kick in this case. With A -fib you lose the extra
filling that comes from the atrial contraction.
✔✔Aortic regurgitation P1/2t - ✔✔Mild > 500msec
Moderate 200 - 500 msec
Severe > 200 msec
✔✔A 32 year old female presents with atypical chest pain. Her blood pressure is
112/50, height 6' and weighs 115 lbs. An echo is performed and shows MVP. What is
the most likely diagnosis for this patient?
Which additional cardiac structures should be evaluated? - ✔✔From the physical
description of this patient and the finding on the echo of MVP she may have Marfan
syndrome.
The aortic valve and aorta should be evaluated for the presence of valvular
regurgitation, aortic dilation 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 revels an abnormally thick anterior MV leaflet and MR? What is the
most likely cause of these echo findings? What additional tests will be helpful in making
the diagnosis for this patient? - ✔✔With a new murmur and the echo finding of mitral
valve thickening in a young person, the most likely diagnosis is MV endocarditis.
Blood cultures will be helpful in identifying the organism and a TEE will further assess
the extent of the mitral leaflet thickening.
✔✔A 32 year old female complains of fatigue and her chest x-ray revels cardiomegaly.
An echo is ordered. RA and RV enlargement appears on the echo. Additionally, there is
a flattened IVS. M-Mode findings of PV mid-systolic closure and an absent A-wave.
Identify the cardiac abnormality consistent with these findings. - ✔✔These echo findings
are consistent with PHTN. A microcavitation (saline contrast) study should be performed
to rule out an atrial level shunt as the cause of the PHTN.
, ✔✔A 22 year old male complains of CP following exercise. An echo displays concentric
LVH (2.5 cm) and a small LV cavity size. Systolic motion of the anterior mitral valve
leaflet (SAM) and PE are not observed. What is the most likely diagnosis for the
patient?
What additional noninvasive tests may help in diagnosing this patient? - ✔✔The findings
of concentric LVH and a small LV cavity size is diagnostic of hypertrophic
cardiomyopathy.
✔✔In order to identify the presence or absence of an obstructive component- - ✔✔An
amyl nitrate or Valsalva challenge should be performed while the LVOT is interrogated
by CW Doppler.
✔✔A 38 yo male is sent to the echo lab for evaluation after complaining of severe
dyspnea on exertion for 2 months. M-mode findings include a dilated LV, increased
EPSS, B-notch on the MV and overall hyper contractile LV wall motion. What type of
cardiac abnormality do these findings suggest? - ✔✔The M-mode findings of a dilated
LV, increased EPSS, B-notch on the mitral valve and overall hyper contractile LV wall
motion identify a patient with 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 from a echo. The echo
demonstrates left ventricular hypertrophy with a "bright" Myocardial appearance, left
atrial enlargement and a small pericardial effusion. What is the patient's most likely
cardiac diagnosis? - ✔✔LVH with a "bright" myocardial, LAE and a small PE are echo
findings most consistent with a diagnosis of infiltrative (restrictive) cardiomyopathy.
✔✔LA myxomas mimic ---- with regard to both physical findings and symptoms. -
✔✔MS
✔✔AR, if the AR jet hits the ---------- , the MV's opening can be restricted. As a result, a
"rumbling" diastolic murmur (--------), rather than the typical "-------" AR diastolic murmur,
will be heard. - ✔✔Mitral Valve Anterior Leaflet, Austin Flint, "blowing"
✔✔An 18 year old male complains of "palpitation". His chest x-ray reveals cardiomegaly
and as a result, an echo is ordered. The echo reveals RA an RV enlargement. The TV
appears abnormally displaced towards the apex. What is this patient's most probable
cardiac abnormality?
What additional test should be performed in the echo lab? - ✔✔The pt probably had
Ebstein's Anomaly. Often patients with Ebstein's Anomaly are asymptotic and the
finding is a surprise when an echo is performed for something like evaluating a murmur.
A saline bubble/contrast study should be performed to identify the presence or absence
of an associated ASD.
