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EACVI/AEPC CONGENITAL HEART DISEASE ECHOCARDIOGRAPHY (ECHO CHD)
PRACTICE EXAM 2026 SOLVED QUESTIONS & ANSWERS VERIFIED 100 %
EACVI/AEPC Congenital Heart Disease Echocardiography (Echo CHD) Practice
Exam — Questions with Rationales
1. Which of the following best describes the relationship between ultrasound
frequency and axial resolution?
A) Higher frequency decreases axial resolution
B) Higher frequency increases axial resolution
C) Frequency has no effect on axial resolution
D) Axial resolution is determined only by the transducer diameter
Rationale: Axial resolution is inversely proportional to wavelength; higher frequency
produces shorter wavelength, improving axial resolution.
2. The Nyquist limit is defined as:
A) The maximum velocity that can be accurately measured with pulsed-wave Doppler
B) The maximum depth of penetration for a given frequency
C) The minimum velocity detectable by continuous-wave Doppler
D) The frequency of the transducer crystal
Rationale: The Nyquist limit is half the pulse repetition frequency and represents the
maximum velocity measurable by pulsed-wave Doppler without aliasing.
3. Which Doppler modality is most appropriate for measuring high-velocity flows
such as those across a stenotic aortic valve?
A) Pulsed-wave Doppler
B) Continuous-wave Doppler
C) Tissue Doppler imaging
D) Color flow Doppler
, Page 2 of 70
Rationale: Continuous-wave Doppler does not have a Nyquist limit and can measure
arbitrarily high velocities, making it ideal for stenotic lesions.
4. In the parasternal long-axis view, which structure is located most anteriorly?
A) Left atrium
B) Right ventricular outflow tract
C) Descending aorta
D) Coronary sinus
Rationale: The right ventricular outflow tract is the most anterior structure in the
parasternal long-axis view.
5. Which echocardiographic view is most appropriate for initial assessment of the
atrial septum in an infant with suspected atrial septal defect?
A) Parasternal long-axis view
B) Apical four-chamber view
C) Subcostal coronal view
D) Suprasternal notch view
Rationale: The subcostal coronal view provides optimal visualization of the atrial
septum, particularly the fossa ovalis region.
6. The Bernoulli equation is used to:
A) Calculate cardiac output
B) Estimate pressure gradients from Doppler velocities
C) Measure chamber volumes
D) Assess ventricular function
Rationale: The simplified Bernoulli equation (ΔP = 4V²) converts peak Doppler velocity
to a pressure gradient across a stenosis or valve.
7. Which of the following is a potential bioeffect of ultrasound?
A) Ionizing radiation damage
B) Heating and cavitation
C) Magnetic field interference
D) Radioactive contamination
Rationale: Ultrasound can produce thermal (heating) and mechanical (cavitation)
bioeffects, which are monitored by the thermal index and mechanical index.
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8. The mechanical index (MI) is a measure of:
A) Thermal bioeffect potential
B) Cavitation bioeffect potential
C) Image resolution
D) Doppler sensitivity
Rationale: The mechanical index estimates the potential for mechanical bioeffects
(cavitation) from ultrasound exposure.
9. Which transducer frequency is most appropriate for imaging a neonate's heart?
A) 1–2 MHz
B) 2–4 MHz
C) 5–8 MHz
D) 10–12 MHz
Rationale: Higher frequencies (5–8 MHz or higher) provide better resolution for small
neonatal hearts, though penetration is limited.
10. What is the primary advantage of using a phased-array transducer for
echocardiography?
A) High frame rates and small footprint
B) High spatial resolution at depth
C) Low cost
D) Wide field of view
Rationale: Phased-array transducers have a small footprint that fits between ribs and
can achieve high frame rates, essential for cardiac imaging.
11. Which of the following describes the correct use of color flow Doppler?
A) It measures peak velocities
B) It displays direction and velocity of blood flow
C) It assesses tissue deformation
D) It measures chamber dimensions
Rationale: Color flow Doppler provides a visual display of blood flow direction
(red/blue) and velocity (color intensity) within a region of interest.
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12. Aliasing on spectral Doppler is most likely to occur with:
A) Continuous-wave Doppler at high velocities
B) Pulsed-wave Doppler at high velocities
C) Color flow Doppler at low velocities
D) Tissue Doppler at normal velocities
Rationale: Pulsed-wave Doppler is limited by the Nyquist limit; velocities exceeding this
limit produce aliasing.
13. Which of the following is a standard indication for transesophageal
echocardiography in CHD?
A) Routine screening for ASD
B) Assessment of pulmonary valve stenosis
C) Guidance of percutaneous atrial septal defect closure
D) Measurement of blood pressure
Rationale: TEE is used to guide device closure of ASDs, assess shunt closure, and
evaluate complex anatomy not well seen on TTE.
14. The "5-chamber" view is obtained by:
A) Tilting the transducer superiorly from the apical 4-chamber view
B) Rotating the transducer 90 degrees
C) Moving the transducer to the subcostal position
D) Tilting the transducer inferiorly from the apical 4-chamber view
Rationale: Anterior angulation from the apical 4-chamber view brings the left
ventricular outflow tract and aortic root into view, creating the 5-chamber view.
15. Which of the following best describes the role of multimodality imaging in
CHD?
A) Echocardiography alone is sufficient for all CHD assessment
B) Cardiac MRI and CT complement echocardiography for assessment of extracardiac
anatomy and complex hemodynamics
C) Nuclear cardiology is the primary imaging modality for CHD
D) Echocardiography is only used for initial diagnosis
Rationale: Multimodality imaging integrates echocardiography with CMR, CT, and
catheterization for comprehensive assessment of complex CHD.
EACVI/AEPC CONGENITAL HEART DISEASE ECHOCARDIOGRAPHY (ECHO CHD)
PRACTICE EXAM 2026 SOLVED QUESTIONS & ANSWERS VERIFIED 100 %
EACVI/AEPC Congenital Heart Disease Echocardiography (Echo CHD) Practice
Exam — Questions with Rationales
1. Which of the following best describes the relationship between ultrasound
frequency and axial resolution?
A) Higher frequency decreases axial resolution
B) Higher frequency increases axial resolution
C) Frequency has no effect on axial resolution
D) Axial resolution is determined only by the transducer diameter
Rationale: Axial resolution is inversely proportional to wavelength; higher frequency
produces shorter wavelength, improving axial resolution.
2. The Nyquist limit is defined as:
A) The maximum velocity that can be accurately measured with pulsed-wave Doppler
B) The maximum depth of penetration for a given frequency
C) The minimum velocity detectable by continuous-wave Doppler
D) The frequency of the transducer crystal
Rationale: The Nyquist limit is half the pulse repetition frequency and represents the
maximum velocity measurable by pulsed-wave Doppler without aliasing.
3. Which Doppler modality is most appropriate for measuring high-velocity flows
such as those across a stenotic aortic valve?
A) Pulsed-wave Doppler
B) Continuous-wave Doppler
C) Tissue Doppler imaging
D) Color flow Doppler
, Page 2 of 70
Rationale: Continuous-wave Doppler does not have a Nyquist limit and can measure
arbitrarily high velocities, making it ideal for stenotic lesions.
4. In the parasternal long-axis view, which structure is located most anteriorly?
A) Left atrium
B) Right ventricular outflow tract
C) Descending aorta
D) Coronary sinus
Rationale: The right ventricular outflow tract is the most anterior structure in the
parasternal long-axis view.
5. Which echocardiographic view is most appropriate for initial assessment of the
atrial septum in an infant with suspected atrial septal defect?
A) Parasternal long-axis view
B) Apical four-chamber view
C) Subcostal coronal view
D) Suprasternal notch view
Rationale: The subcostal coronal view provides optimal visualization of the atrial
septum, particularly the fossa ovalis region.
6. The Bernoulli equation is used to:
A) Calculate cardiac output
B) Estimate pressure gradients from Doppler velocities
C) Measure chamber volumes
D) Assess ventricular function
Rationale: The simplified Bernoulli equation (ΔP = 4V²) converts peak Doppler velocity
to a pressure gradient across a stenosis or valve.
7. Which of the following is a potential bioeffect of ultrasound?
A) Ionizing radiation damage
B) Heating and cavitation
C) Magnetic field interference
D) Radioactive contamination
Rationale: Ultrasound can produce thermal (heating) and mechanical (cavitation)
bioeffects, which are monitored by the thermal index and mechanical index.
, Page 3 of 70
8. The mechanical index (MI) is a measure of:
A) Thermal bioeffect potential
B) Cavitation bioeffect potential
C) Image resolution
D) Doppler sensitivity
Rationale: The mechanical index estimates the potential for mechanical bioeffects
(cavitation) from ultrasound exposure.
9. Which transducer frequency is most appropriate for imaging a neonate's heart?
A) 1–2 MHz
B) 2–4 MHz
C) 5–8 MHz
D) 10–12 MHz
Rationale: Higher frequencies (5–8 MHz or higher) provide better resolution for small
neonatal hearts, though penetration is limited.
10. What is the primary advantage of using a phased-array transducer for
echocardiography?
A) High frame rates and small footprint
B) High spatial resolution at depth
C) Low cost
D) Wide field of view
Rationale: Phased-array transducers have a small footprint that fits between ribs and
can achieve high frame rates, essential for cardiac imaging.
11. Which of the following describes the correct use of color flow Doppler?
A) It measures peak velocities
B) It displays direction and velocity of blood flow
C) It assesses tissue deformation
D) It measures chamber dimensions
Rationale: Color flow Doppler provides a visual display of blood flow direction
(red/blue) and velocity (color intensity) within a region of interest.
, Page 4 of 70
12. Aliasing on spectral Doppler is most likely to occur with:
A) Continuous-wave Doppler at high velocities
B) Pulsed-wave Doppler at high velocities
C) Color flow Doppler at low velocities
D) Tissue Doppler at normal velocities
Rationale: Pulsed-wave Doppler is limited by the Nyquist limit; velocities exceeding this
limit produce aliasing.
13. Which of the following is a standard indication for transesophageal
echocardiography in CHD?
A) Routine screening for ASD
B) Assessment of pulmonary valve stenosis
C) Guidance of percutaneous atrial septal defect closure
D) Measurement of blood pressure
Rationale: TEE is used to guide device closure of ASDs, assess shunt closure, and
evaluate complex anatomy not well seen on TTE.
14. The "5-chamber" view is obtained by:
A) Tilting the transducer superiorly from the apical 4-chamber view
B) Rotating the transducer 90 degrees
C) Moving the transducer to the subcostal position
D) Tilting the transducer inferiorly from the apical 4-chamber view
Rationale: Anterior angulation from the apical 4-chamber view brings the left
ventricular outflow tract and aortic root into view, creating the 5-chamber view.
15. Which of the following best describes the role of multimodality imaging in
CHD?
A) Echocardiography alone is sufficient for all CHD assessment
B) Cardiac MRI and CT complement echocardiography for assessment of extracardiac
anatomy and complex hemodynamics
C) Nuclear cardiology is the primary imaging modality for CHD
D) Echocardiography is only used for initial diagnosis
Rationale: Multimodality imaging integrates echocardiography with CMR, CT, and
catheterization for comprehensive assessment of complex CHD.
