ARDMS Echo Pericardial Disease 3

Question 1

Which tissue Doppler finding supports constrictive pericarditis over restrictive cardiomyopathy?

Accepted Answer

Normal or elevated medial e' with elevated E/e' ratio (annulus paradoxus)

Answer

Reduced medial e' < 7 cm/s with high E/e'

Answer

Equal medial and lateral e' velocities < 5 cm/s

Answer

Lateral e' > 12 cm/s with low E/e'

Question 2

Effusive-constrictive pericarditis is diagnosed when:

Accepted Answer

Constrictive physiology persists on hemodynamic assessment after pericardiocentesis

Answer

Hemodynamics normalize completely after pericardiocentesis

Answer

Left ventricular collapse is present with large effusion

Answer

IVC collapsibility normalizes after pericardiocentesis

Question 3

On M-mode echocardiography, right ventricular diastolic collapse in cardiac tamponade is identified as:

Accepted Answer

Inward invagination of the RV free wall during diastole

Answer

Inward motion of the RV free wall during systole

Answer

Septal motion toward the LV during systole

Answer

Flat posterior LV wall motion

Question 4

Which etiology is LEAST likely to cause a large pericardial effusion?

Accepted Answer

Hypertensive heart disease

Answer

Malignancy

Answer

Hypothyroidism

Answer

Tuberculosis

Question 5

What approximate percentage of pericardial effusions in developed countries are classified as idiopathic (presumed viral) in etiology?

Accepted Answer

50–60%

Answer

10–20%

Answer

30–40%

Answer

80–90%

Question 6

Which respiratory variation in tricuspid inflow peak E-wave velocity is considered abnormal and consistent with tamponade or constrictive physiology?

Accepted Answer

> 25% increase with inspiration

Answer

> 10% increase with inspiration

Answer

> 40% increase with inspiration

Answer

> 50% increase with inspiration

Question 7

Which finding on two-dimensional echocardiography is most specific for the diagnosis of constrictive pericarditis?

Accepted Answer

Pericardial thickening > 4 mm with abrupt posterior septal motion (septal bounce)

Answer

Biatrial enlargement

Answer

Dilated inferior vena cava

Answer

Reduced left ventricular ejection fraction