2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
ECHO URR QUESTIONS AND ANSWER |
LATEST UPDATE
You identify a PFO on an echo and the cardiologist asks you to calculate the LAP. How will
you perform this calculation?
✓ -:- Measure the peak velocity across the PFO, calculate the peak
pressure gradient across the defect and add the RAP.
The mitral deceleration time is 300msec. What is the valve area? A) 1.3cm^2 B) 2.8cm^2 C)
2.5cm^2 D) 1.5cm^2
✓ -:- C) 2.5cm^2 MVA = 759 / deceleration time
Which of the following is preferred to document motion of the disk in a St. Jude valve?
✓ -:- M-mode. M-mode is used to doc the MOTION of ball/disk in a
mechanical valve. Doppler is used to assess the FLOW of the valve.
A patient presents for an echo to rule out WMA. The TTE 2D exam is suboptimal. What
should you do next? A) cancel the order and dismiss the patient B) consult the physician for
permission to perform contrast imaging C) cancel the order and schedule the patient for a
TEE D) contact the ordering physician to recommend that an MRI exam is ordered instead
1|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
✓ -:- B) consult the physician for permission to p erform contrast imaging;
Suboptimal imaging of the LV wall motion on a 2D exam is an indication
for contrast administration. A physician order for the contrast must be
given, prior to performing the contrast exam.
Which Doppler measurement of flow through a stenotic AV best correlated w/ the same
value obtained during heart catheterization?
✓ -:- mean pressure gradient
Which of the following cardiac abnormalities requires the use of the continuity equation for
proper calculation of AVA? A) decreased LV function B) HOCM C) supravalvular AS
D) Transcatheter AVR
✓ -:- A) decreased LV function; The continuity equation compensates for
the changes in LV function when calculating AVA. CW Doppler is used to
assess flow across the AV. Because CW Doppler has no ran ge resolution,
it cannot determine the location of the elevated velocity. HOCM and
supravalvular stenosis will cause an improper AVA calculation b/c the
stenosis is not at the valve. A transcatheter AV replacement relies on the
pressure gradients and the velocity ratio to assess stenosis.
The peak velocity of PI can be used to assess:
2|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
A) Peak systolic pulmonary artery pressure
B) mean pulmonary artery pressure
C) pulmonary artery end diastolic pressure
D) severity of pulmonary stenosis
✓ -:- B) mean pulmonary artery pressure; MPAP =4 x (peak velocity of
PI)^2 The peak velocity of PI is peak diastolic velocity so it cannot be
used to assess systolic pressure. The end diastolic velocity of PI can be
used to assess the end diastolic pressure in t he PA.
If the LVOT Doppler tracing is obtained from a location that is too far from the AV:
A) the SV will be overestimated
B) the AVA will be overestimated by the continuity equation
C) the LVOT velocity will be overestimated
D) the AVA will be underestimated by continuity equation
✓ -:- D) the AVA will be underestimated by continuity equation; If the
Doppler cursor is placed too far from the AV, the LVOT peak velocity
will be reduced from what it would be at the correct location. This will
cause the calculation of a smaller or underestimated AVA or
overestimated level of stenosis. The peak aortic velocity and pressure
gradient will not match the level of stenosis indicated by AVA.
3|P a g e | G r a d e A + | 2 0 2 0 2 5
, 2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
What Doppler measurement is necessary to calculate the end diastolic pressure in the
pulmonary artery?
A) peak pressure gradient of PI
B) peak pressure of TR
C) end diastolic velocity of PI
D) peak systolic velocity of PI
✓ -:- C) end diastolic velocity of PI; PA end diastolic pressure = 4 (end
diastolic pressure velocity of PI)^2 + RA pressure; normal PAEDP + 4 -
12mmhg
If _________________ is present, the RVSP calculation from the TR gradient is inaccurate
as the measurement of the PAP.
A) CHF
B) PI
C) PS
D) PHTN
✓ -:- C) PS; The PA pressure is used to assess the pressure in the lungs. If
the PV is stenotic, the flow velocity and resistance increase the pressures
4|P a g e | G r a d e A + | 2 0 2 0 2 5
ECHO URR QUESTIONS AND ANSWER |
LATEST UPDATE
You identify a PFO on an echo and the cardiologist asks you to calculate the LAP. How will
you perform this calculation?
✓ -:- Measure the peak velocity across the PFO, calculate the peak
pressure gradient across the defect and add the RAP.
The mitral deceleration time is 300msec. What is the valve area? A) 1.3cm^2 B) 2.8cm^2 C)
2.5cm^2 D) 1.5cm^2
✓ -:- C) 2.5cm^2 MVA = 759 / deceleration time
Which of the following is preferred to document motion of the disk in a St. Jude valve?
✓ -:- M-mode. M-mode is used to doc the MOTION of ball/disk in a
mechanical valve. Doppler is used to assess the FLOW of the valve.
A patient presents for an echo to rule out WMA. The TTE 2D exam is suboptimal. What
should you do next? A) cancel the order and dismiss the patient B) consult the physician for
permission to perform contrast imaging C) cancel the order and schedule the patient for a
TEE D) contact the ordering physician to recommend that an MRI exam is ordered instead
1|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
✓ -:- B) consult the physician for permission to p erform contrast imaging;
Suboptimal imaging of the LV wall motion on a 2D exam is an indication
for contrast administration. A physician order for the contrast must be
given, prior to performing the contrast exam.
Which Doppler measurement of flow through a stenotic AV best correlated w/ the same
value obtained during heart catheterization?
✓ -:- mean pressure gradient
Which of the following cardiac abnormalities requires the use of the continuity equation for
proper calculation of AVA? A) decreased LV function B) HOCM C) supravalvular AS
D) Transcatheter AVR
✓ -:- A) decreased LV function; The continuity equation compensates for
the changes in LV function when calculating AVA. CW Doppler is used to
assess flow across the AV. Because CW Doppler has no ran ge resolution,
it cannot determine the location of the elevated velocity. HOCM and
supravalvular stenosis will cause an improper AVA calculation b/c the
stenosis is not at the valve. A transcatheter AV replacement relies on the
pressure gradients and the velocity ratio to assess stenosis.
The peak velocity of PI can be used to assess:
2|P a g e | G r a d e A + | 2 0 2 0 2 5
,2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
A) Peak systolic pulmonary artery pressure
B) mean pulmonary artery pressure
C) pulmonary artery end diastolic pressure
D) severity of pulmonary stenosis
✓ -:- B) mean pulmonary artery pressure; MPAP =4 x (peak velocity of
PI)^2 The peak velocity of PI is peak diastolic velocity so it cannot be
used to assess systolic pressure. The end diastolic velocity of PI can be
used to assess the end diastolic pressure in t he PA.
If the LVOT Doppler tracing is obtained from a location that is too far from the AV:
A) the SV will be overestimated
B) the AVA will be overestimated by the continuity equation
C) the LVOT velocity will be overestimated
D) the AVA will be underestimated by continuity equation
✓ -:- D) the AVA will be underestimated by continuity equation; If the
Doppler cursor is placed too far from the AV, the LVOT peak velocity
will be reduced from what it would be at the correct location. This will
cause the calculation of a smaller or underestimated AVA or
overestimated level of stenosis. The peak aortic velocity and pressure
gradient will not match the level of stenosis indicated by AVA.
3|P a g e | G r a d e A + | 2 0 2 0 2 5
, 2024 /2025 | © copyright | This work may not be copied for profit gain | Excel!
What Doppler measurement is necessary to calculate the end diastolic pressure in the
pulmonary artery?
A) peak pressure gradient of PI
B) peak pressure of TR
C) end diastolic velocity of PI
D) peak systolic velocity of PI
✓ -:- C) end diastolic velocity of PI; PA end diastolic pressure = 4 (end
diastolic pressure velocity of PI)^2 + RA pressure; normal PAEDP + 4 -
12mmhg
If _________________ is present, the RVSP calculation from the TR gradient is inaccurate
as the measurement of the PAP.
A) CHF
B) PI
C) PS
D) PHTN
✓ -:- C) PS; The PA pressure is used to assess the pressure in the lungs. If
the PV is stenotic, the flow velocity and resistance increase the pressures
4|P a g e | G r a d e A + | 2 0 2 0 2 5
