ARDMS Echo Hemodynamic Assessment 3

Question 1

Left ventricular dP/dt can be estimated from echocardiography using:

Accepted Answer

The time for the MR jet velocity to rise from 1 m/s to 3 m/s (32/Δt mmHg/s)

Answer

LV dP/dt = 32 / time (s) between MR velocities of 1 m/s and 3 m/s; a value <1000 mmHg/s indicates severely impaired LV contractility.

Question 2

Which echocardiographic pattern reflects Grade III (restrictive) diastolic dysfunction?

Accepted Answer

E/A > 2 with shortened deceleration time (<160 ms) and elevated E/e' > 14

Answer

Grade III (restrictive) diastolic dysfunction shows E/A > 2, short deceleration time, and elevated filling pressures, indicating severely impaired compliance.

Question 3

Which finding on echo-guided hemodynamic assessment indicates fluid responsiveness?

Accepted Answer

IVC collapsibility index >18% in a mechanically ventilated patient or >50% in a spontaneously breathing patient

Answer

Greater IVC respiratory variation predicts fluid responsiveness; >18% variation with positive pressure ventilation or >50% with spontaneous breathing suggests preload dependence.

Question 4

The end-systolic pressure-volume relationship (ESPVR) is a load-independent measure of contractility. Which echo index best approximates it?

Accepted Answer

End-systolic elastance derived from pressure-volume analysis

Answer

End-systolic elastance (Ees) from the pressure-volume loop is the gold standard for load-independent contractility, though echocardiography approximates it using combined pressure-area or volume measurements.

Question 5

In a patient with low-flow, low-gradient aortic stenosis (LVEF < 50%), dobutamine stress echo is used to:

Accepted Answer

Distinguish true severe AS (fixed, small AVA) from pseudo-severe AS (AVA normalizes with increased flow)

Answer

Low-dose dobutamine stress echo increases flow; true severe AS maintains a small AVA (<1.0 cm²) despite increased gradient, while pseudo-severe AS shows AVA increasing above 1.0 cm².

ARDMS Echo - American Registry for Diagnostic Medical Sonography Echocardiography Practice Test

ARDMS Echo - American Registry for Diagnostic Medical Sonography Echocardiography Practice Test

ARDMS Echo Hemodynamic Assessment 3