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 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.

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

A respiratory variation in mitral E-wave velocity exceeding 25% is the Doppler equivalent of clinical pulsus paradoxus and indicates significant tamponade physiology.

Question 3

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

Accepted Answer

Dilated IVC with < 50% inspiratory collapse

Answer

Cardiac tamponade elevates right atrial pressure, resulting in a plethoric (dilated) IVC that fails to collapse normally with inspiration.

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

In constrictive pericarditis, the rigid pericardium limits lateral annular expansion while preserving medial longitudinal motion, producing the annulus reversus pattern (medial e' > lateral e').

Question 5

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

Accepted Answer

Early inspiration

Answer

The abrupt septal shift (bounce) in constrictive pericarditis occurs at early inspiration when sudden changes in ventricular filling due to ventricular interdependence are greatest.

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

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

ARDMS Echo Pericardial Disease 2