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 echocardiographic sign of cardiac tamponade typically appears earliest as pericardial pressure rises?
Answer: Right atrial systolic collapse
Right atrial systolic collapse is the earliest sign of tamponade because the right atrium has the lowest intracavitary pressure and the thinnest wall, making it most susceptible to external compression.
In cardiac tamponade, what degree of respiratory variation in mitral inflow peak E-wave velocity is considered hemodynamically significant?
Answer: > 25% decrease with inspiration
A respiratory variation in mitral E-wave velocity exceeding 25% is the Doppler equivalent of clinical pulsus paradoxus and indicates significant tamponade physiology.
Which inferior vena cava finding on echocardiography is most consistent with cardiac tamponade?
Answer: Dilated IVC with < 50% inspiratory collapse
Cardiac tamponade elevates right atrial pressure, resulting in a plethoric (dilated) IVC that fails to collapse normally with inspiration.
Which Doppler finding best distinguishes constrictive pericarditis from restrictive cardiomyopathy on tissue Doppler imaging?
Answer: Medial mitral annulus e' velocity greater than lateral e' velocity (annulus reversus)
In constrictive pericarditis, the rigid pericardium limits lateral annular expansion while preserving medial longitudinal motion, producing the annulus reversus pattern (medial e' > lateral e').
The interventricular septal bounce in constrictive pericarditis is most pronounced during which phase of respiration?
Answer: Early inspiration
The abrupt septal shift (bounce) in constrictive pericarditis occurs at early inspiration when sudden changes in ventricular filling due to ventricular interdependence are greatest.
What hepatic vein Doppler pattern is most characteristic of constrictive pericarditis?
Answer: Prominent diastolic flow reversal with expiration
Constrictive pericarditis produces prominent hepatic vein diastolic flow reversal during expiration, reflecting the abnormal increase in right ventricular pressure that occurs with expiration due to ventricular interdependence.
Which combination of assessments is recommended when cardiac tamponade is suspected echocardiographically?
Answer: Combined 2D imaging, M-mode, and Doppler with respiratory variation assessment
A complete tamponade evaluation requires 2D imaging to identify chamber collapse, M-mode for precise timing of collapse relative to the cardiac cycle, and Doppler to quantify respiratory variation in transvalvular flow velocities.