ARDMS Echo Valvular Heart Disease 2

Question 1

What is the classic M-mode finding in severe mitral regurgitation caused by a flail leaflet?

Accepted Answer

Chaotic fluttering of the posterior mitral leaflet into the LA in systole

Answer

Anterior systolic motion of the posterior leaflet

Answer

Fixed, non-moving mitral leaflet

Answer

Diastolic fluttering of the anterior leaflet

Question 2

Which parameter best differentiates severe mitral regurgitation from moderate on echocardiography using the PISA method?

Accepted Answer

EROA ≥ 0.40 cm² and regurgitant volume ≥ 60 mL

Answer

EROA ≥ 0.20 cm² and regurgitant volume ≥ 30 mL

Answer

EROA ≥ 0.10 cm² and regurgitant volume ≥ 15 mL

Answer

Vena contracta ≥ 0.3 cm only

Question 3

What is the Doppler half-time for severe aortic regurgitation (PHT < X ms)?

Accepted Answer

< 200 ms

Answer

> 500 ms

Answer

200–400 ms

Answer

400–600 ms

Question 4

Which echocardiographic sign in aortic regurgitation indicates severe volume overload and correlates with poor prognosis without surgery?

Accepted Answer

LV end-systolic dimension > 5.0 cm

Answer

LV end-diastolic dimension > 6.0 cm only

Answer

LA dilation only

Answer

Normal LV dimensions

Question 5

What echocardiographic feature distinguishes organic (primary) from functional (secondary) mitral regurgitation?

Accepted Answer

Structural leaflet abnormality (prolapse, flail, restricted) in primary; normal leaflets with tethering in secondary

Answer

Severity of MR only

Answer

Presence of LA dilation only

Answer

LV systolic function only

Question 6

Which feature of the aortic valve on echocardiography is most consistent with infective endocarditis?

Accepted Answer

Mobile, oscillating echogenicity attached to a leaflet (vegetation)

Answer

Calcified, immobile leaflet

Answer

Leaflet thickening without mobility

Answer

Aortic annular calcification only