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Advanced Imaging and Stress Echocardiography Flashcards

6 cards from real ARDMS ECHO practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 6 Advanced Imaging and Stress Echocardiography flashcards as text

  1. What is the significance of a positive 'crescent sign' or 'string sign' on color Doppler in intracardiac masses?

    Answer: Flow within the mass suggests a vascular tumor (e.g., hemangioma) rather than a thrombus

    Detection of internal blood flow (vascularity) within a cardiac mass by color Doppler or contrast echo suggests a vascular tumor rather than an avascular thrombus.

  2. During TEE-guided transcatheter aortic valve replacement (TAVR), which measurement is critical for valve sizing?

    Answer: Aortic annulus diameter or area measured by 3D TEE

    Accurate aortic annulus sizing — ideally by 3D TEE or CT — is critical for TAVR to select the correct prosthesis size and minimize paravalvular leak.

  3. Which echocardiographic finding differentiates cardiac tamponade from severe TR as a cause of elevated venous pressures and hypotension?

    Answer: Pericardial effusion with right heart chamber collapse and respiratory variation in Doppler flows in tamponade

    Tamponade shows pericardial effusion with diastolic RV collapse, RA systolic inversion, IVC plethora, and >25% respiratory variation in mitral/tricuspid flows — findings absent in isolated severe TR.

  4. What role does contrast echocardiography play in the evaluation of apical hypertrophic cardiomyopathy?

    Answer: Improves visualization of apical wall thickening and 'ace of spades' LV cavity shape

    LV contrast opacification reveals the characteristic 'ace of spades' apical cavity obliteration in systole and confirms apical wall hypertrophy in patients with poor acoustic windows.

  5. Which echocardiographic feature is used to differentiate hypertrophic cardiomyopathy (HCM) from athlete's heart?

    Answer: LV wall thickness > 15 mm, abnormal diastolic function, and small LV cavity in HCM

    HCM is favored by wall thickness >15 mm, small or normal LV cavity, abnormal diastolic function, and LV hypertrophy in non-exercising family members, while athlete's heart shows normal diastolic function and larger cavities.

  6. In stress echocardiography for valvular assessment, what finding during exercise indicates hemodynamically significant mitral stenosis?

    Answer: Mean mitral gradient > 15 mmHg or PASP > 60 mmHg with exercise

    Exercise-induced mean mitral gradient >15 mmHg or pulmonary artery systolic pressure >60 mmHg identifies symptomatic hemodynamic consequences of mitral stenosis, supporting valve intervention.