ARDMS Echo Pericardial Disease 2

Question 1

Which echocardiographic sign of cardiac tamponade typically appears earliest as pericardial pressure rises?

Accepted Answer

Right atrial systolic collapse

Answer

Right ventricular diastolic collapse

Answer

Inferior vena cava plethora

Answer

Left ventricular diastolic collapse

Question 2

In cardiac tamponade, what degree of respiratory variation in mitral inflow peak E-wave velocity is considered hemodynamically significant?

Accepted Answer

> 25% decrease with inspiration

Answer

> 10% decrease with inspiration

Answer

> 40% decrease with inspiration

Answer

> 50% decrease with inspiration

Question 3

Which inferior vena cava finding on echocardiography is most consistent with cardiac tamponade?

Accepted Answer

Dilated IVC with < 50% inspiratory collapse

Answer

IVC diameter < 1.5 cm with normal inspiratory collapse

Answer

Normal IVC with exaggerated inspiratory collapse

Answer

IVC cannot be assessed in tamponade

Question 4

Which Doppler finding best distinguishes constrictive pericarditis from restrictive cardiomyopathy on tissue Doppler imaging?

Accepted Answer

Medial mitral annulus e' velocity greater than lateral e' velocity (annulus reversus)

Answer

Elevated E/e' ratio > 15

Answer

Prominent mitral E wave

Answer

Decreased mitral deceleration time

Question 5

The interventricular septal bounce in constrictive pericarditis is most pronounced during which phase of respiration?

Accepted Answer

Early inspiration

Answer

End expiration

Answer

Peak inspiration

Answer

End inspiration

Question 6

What hepatic vein Doppler pattern is most characteristic of constrictive pericarditis?

Accepted Answer

Prominent diastolic flow reversal with expiration

Answer

Blunted systolic (S) wave

Answer

Absent diastolic (D) wave

Answer

Increased systolic-to-diastolic ratio

Question 7

Which combination of assessments is recommended when cardiac tamponade is suspected echocardiographically?

Accepted Answer

Combined 2D imaging, M-mode, and Doppler with respiratory variation assessment

Answer

Two-dimensional imaging alone

Answer

Three-dimensional echocardiography only

Answer

Stress echocardiography