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

A flail mitral leaflet on M-mode shows chaotic, high-frequency systolic motion of the leaflet tip into the LA due to chordal rupture.

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

Severe primary MR criteria include EROA ≥0.40 cm² and regurgitant volume ≥60 mL per ASE/AHA/ACC guidelines.

Question 3

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

Accepted Answer

< 200 ms

Answer

A pressure half-time <200 ms in aortic regurgitation indicates severe AR because rapid equilibration of aortic and LV pressures occurs.

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

An LV end-systolic dimension >5.0 cm in chronic severe AR is a guideline indication for aortic valve replacement even in asymptomatic patients.

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

Primary MR involves intrinsic leaflet pathology; secondary (functional) MR occurs in the setting of LV dilation/dysfunction with normal leaflets that fail to coapt due to tethering.

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

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

ARDMS Echo Valvular Heart Disease 2