Eacvi Aepc Congenital Heart Disease
Echocardiography Echo Chd Practice Exam Latest
2025-2026 Questions And Correct Answers With
Explanation Instant Download Pdf.
1. A 4-day-old neonate with suspected critical coarctation undergoes
echocardiography. The ductus arteriosus is closing. Which Doppler finding in the
descending aorta is most consistent with critical coarctation?
A. Continuous antegrade flow throughout the cardiac cycle
B. Systolic flow reversal with absent diastolic flow
C. High-velocity systolic jet with holodiastolic runoff
D. Laminar low-velocity flow
Correct Answer: C
Critical coarctation with a closing duct produces a high-velocity systolic jet with diastolic
runoff because the obstruction creates a pressure gradient that persists into diastole.
Option A describes a patent ductus with left-to-right shunt. Option B suggests severe
obstruction with reversed flow, which is less typical in the immediate newborn period
before ductal closure is complete.
2. In a patient with congenitally corrected transposition of the great arteries
(ccTGA), which echocardiographic finding is expected?
A. Discordant atrioventricular and ventriculo-arterial connections
B. Concordant atrioventricular and ventriculo-arterial connections
C. Discordant atrioventricular connections with concordant ventriculo-arterial
connections
D. Concordant atrioventricular connections with discordant ventriculo-arterial
connections
,Correct Answer: A
ccTGA is defined by both atrioventricular and ventriculo-arterial discordance. The right
atrium connects to the morphologic left ventricle (which supports the pulmonary
circulation), and the left atrium connects to the morphologic right ventricle (which
supports the systemic circulation via the aorta). This double discordance physiologically
"corrects" the circulation but places the morphologic right ventricle under systemic
pressure.
3. A 12-year-old with repaired Tetralogy of Fallot presents for follow-up.
Echocardiography shows severe pulmonary regurgitation. Which parameter best
quantifies the hemodynamic burden on the right ventricle?
A. Peak pulmonary regurgitation velocity
B. Pulmonary regurgitation pressure half-time
C. Pulmonary regurgitation index (PR index)
D. Right ventricular outflow tract diameter
Correct Answer: C
The pulmonary regurgitation index (PR index) is calculated as the ratio of the duration of
pulmonary regurgitation to the total diastolic duration. A PR index less than 0.77 indicates
severe pulmonary regurgitation and correlates with hemodynamic burden. Peak velocity
reflects the initial pressure gradient but not the severity of regurgitation. Pressure half-
time is less validated for pulmonary regurgitation than for mitral stenosis.
4. Which of the following is the most reliable echocardiographic marker of a sinus
venosus atrial septal defect?
A. Dilated coronary sinus
B. Anomalous pulmonary venous connection to the right atrium or superior vena cava
C. Apical displacement of the tricuspid valve
D. Restrictive right-to-left shunt at the atrial level
Correct Answer: B
, Sinus venosus ASDs are frequently associated with anomalous pulmonary venous
drainage, particularly of the right upper pulmonary vein into the superior vena cava or
right atrium. This association is a hallmark of the defect. A dilated coronary sinus suggests
an unroofed coronary sinus defect, not a sinus venosus defect.
5. In a patient with a large patent ductus arteriosus (PDA), which
echocardiographic view best demonstrates the ductal anatomy and its relationship
to the aortic arch?
A. Apical four-chamber view
B. Parasternal long-axis view
C. High left parasternal "ductal" view
D. Subcostal coronal view
Correct Answer: C
The high left parasternal "ductal" view is specifically oriented to visualize the pulmonary
artery bifurcation, the ductus arteriosus, and its insertion into the descending aorta. This
view allows accurate assessment of PDA size, shape, and shunt direction. The other views
may show indirect signs but do not optimally display the ductal anatomy.
6. A patient with tricuspid atresia is being evaluated. Which echocardiographic
finding is most characteristic?
A. Apical displacement of the tricuspid valve
B. Absence of the tricuspid valve orifice with a hypoplastic right ventricle
C. Overriding of the tricuspid valve
D. Double-orifice tricuspid valve
Correct Answer: B
Tricuspid atresia is characterized by the absence of a direct communication between the
right atrium and the right ventricle, typically due to a muscular or membranous floor in
the tricuspid valve position. The right ventricle is hypoplastic. Apical displacement of the
tricuspid valve describes Ebstein anomaly, not tricuspid atresia.
Echocardiography Echo Chd Practice Exam Latest
2025-2026 Questions And Correct Answers With
Explanation Instant Download Pdf.
1. A 4-day-old neonate with suspected critical coarctation undergoes
echocardiography. The ductus arteriosus is closing. Which Doppler finding in the
descending aorta is most consistent with critical coarctation?
A. Continuous antegrade flow throughout the cardiac cycle
B. Systolic flow reversal with absent diastolic flow
C. High-velocity systolic jet with holodiastolic runoff
D. Laminar low-velocity flow
Correct Answer: C
Critical coarctation with a closing duct produces a high-velocity systolic jet with diastolic
runoff because the obstruction creates a pressure gradient that persists into diastole.
Option A describes a patent ductus with left-to-right shunt. Option B suggests severe
obstruction with reversed flow, which is less typical in the immediate newborn period
before ductal closure is complete.
2. In a patient with congenitally corrected transposition of the great arteries
(ccTGA), which echocardiographic finding is expected?
A. Discordant atrioventricular and ventriculo-arterial connections
B. Concordant atrioventricular and ventriculo-arterial connections
C. Discordant atrioventricular connections with concordant ventriculo-arterial
connections
D. Concordant atrioventricular connections with discordant ventriculo-arterial
connections
,Correct Answer: A
ccTGA is defined by both atrioventricular and ventriculo-arterial discordance. The right
atrium connects to the morphologic left ventricle (which supports the pulmonary
circulation), and the left atrium connects to the morphologic right ventricle (which
supports the systemic circulation via the aorta). This double discordance physiologically
"corrects" the circulation but places the morphologic right ventricle under systemic
pressure.
3. A 12-year-old with repaired Tetralogy of Fallot presents for follow-up.
Echocardiography shows severe pulmonary regurgitation. Which parameter best
quantifies the hemodynamic burden on the right ventricle?
A. Peak pulmonary regurgitation velocity
B. Pulmonary regurgitation pressure half-time
C. Pulmonary regurgitation index (PR index)
D. Right ventricular outflow tract diameter
Correct Answer: C
The pulmonary regurgitation index (PR index) is calculated as the ratio of the duration of
pulmonary regurgitation to the total diastolic duration. A PR index less than 0.77 indicates
severe pulmonary regurgitation and correlates with hemodynamic burden. Peak velocity
reflects the initial pressure gradient but not the severity of regurgitation. Pressure half-
time is less validated for pulmonary regurgitation than for mitral stenosis.
4. Which of the following is the most reliable echocardiographic marker of a sinus
venosus atrial septal defect?
A. Dilated coronary sinus
B. Anomalous pulmonary venous connection to the right atrium or superior vena cava
C. Apical displacement of the tricuspid valve
D. Restrictive right-to-left shunt at the atrial level
Correct Answer: B
, Sinus venosus ASDs are frequently associated with anomalous pulmonary venous
drainage, particularly of the right upper pulmonary vein into the superior vena cava or
right atrium. This association is a hallmark of the defect. A dilated coronary sinus suggests
an unroofed coronary sinus defect, not a sinus venosus defect.
5. In a patient with a large patent ductus arteriosus (PDA), which
echocardiographic view best demonstrates the ductal anatomy and its relationship
to the aortic arch?
A. Apical four-chamber view
B. Parasternal long-axis view
C. High left parasternal "ductal" view
D. Subcostal coronal view
Correct Answer: C
The high left parasternal "ductal" view is specifically oriented to visualize the pulmonary
artery bifurcation, the ductus arteriosus, and its insertion into the descending aorta. This
view allows accurate assessment of PDA size, shape, and shunt direction. The other views
may show indirect signs but do not optimally display the ductal anatomy.
6. A patient with tricuspid atresia is being evaluated. Which echocardiographic
finding is most characteristic?
A. Apical displacement of the tricuspid valve
B. Absence of the tricuspid valve orifice with a hypoplastic right ventricle
C. Overriding of the tricuspid valve
D. Double-orifice tricuspid valve
Correct Answer: B
Tricuspid atresia is characterized by the absence of a direct communication between the
right atrium and the right ventricle, typically due to a muscular or membranous floor in
the tricuspid valve position. The right ventricle is hypoplastic. Apical displacement of the
tricuspid valve describes Ebstein anomaly, not tricuspid atresia.
