Pericardial Disease Flashcards
7 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 7 Pericardial Disease flashcards as text
Which tissue Doppler finding supports constrictive pericarditis over restrictive cardiomyopathy?
Answer: Normal or elevated medial e' with elevated E/e' ratio (annulus paradoxus)
In constrictive pericarditis, longitudinal myocardial function is preserved, so medial e' is normal or supranormal despite elevated filling pressures — the annulus paradoxus — whereas restrictive cardiomyopathy globally reduces e'.
Effusive-constrictive pericarditis is diagnosed when:
Answer: Constrictive physiology persists on hemodynamic assessment after pericardiocentesis
Effusive-constrictive pericarditis is characterized by the coexistence of pericardial effusion and visceral pericardial constriction, confirmed when elevated right atrial pressure and constrictive Doppler patterns persist even after the effusion is drained.
On M-mode echocardiography, right ventricular diastolic collapse in cardiac tamponade is identified as:
Answer: Inward invagination of the RV free wall during diastole
RV diastolic collapse is seen on M-mode as inward (invaginating) motion of the RV free wall during diastole when intrapericardial pressure transiently exceeds RV diastolic pressure.
Which etiology is LEAST likely to cause a large pericardial effusion?
Answer: Hypertensive heart disease
Hypertensive heart disease primarily causes left ventricular hypertrophy and diastolic dysfunction but is not a recognized cause of large pericardial effusions, unlike malignancy, hypothyroidism, and tuberculosis.
What approximate percentage of pericardial effusions in developed countries are classified as idiopathic (presumed viral) in etiology?
Answer: 50–60%
Approximately 50–60% of pericardial effusions in developed countries are idiopathic, making presumed viral pericarditis the single most common etiology.
Which respiratory variation in tricuspid inflow peak E-wave velocity is considered abnormal and consistent with tamponade or constrictive physiology?
Answer: > 25% increase with inspiration
A > 25% inspiratory increase in tricuspid inflow peak E-wave velocity indicates exaggerated ventricular interdependence, consistent with tamponade or constrictive pericarditis.
Which finding on two-dimensional echocardiography is most specific for the diagnosis of constrictive pericarditis?
Answer: Pericardial thickening > 4 mm with abrupt posterior septal motion (septal bounce)
Pericardial thickening combined with the characteristic abrupt interventricular septal bounce (reflecting ventricular interdependence) is the most specific 2D echocardiographic marker of constrictive pericarditis.