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

In constrictive pericarditis, longitudinal myocardial function is preserved, so medial e' is normal or supranormal despite elevated filling pressures — the annulus paradoxus — whereas restrictive cardiomyopathy globally reduces e'.

Question 2

Effusive-constrictive pericarditis is diagnosed when:

Accepted Answer

Constrictive physiology persists on hemodynamic assessment after pericardiocentesis

Answer

Effusive-constrictive pericarditis is characterized by the coexistence of pericardial effusion and visceral pericardial constriction, confirmed when elevated right atrial pressure and constrictive Doppler patterns persist even after the effusion is drained.

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

RV diastolic collapse is seen on M-mode as inward (invaginating) motion of the RV free wall during diastole when intrapericardial pressure transiently exceeds RV diastolic pressure.

Question 4

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

Accepted Answer

Hypertensive heart disease

Answer

Hypertensive heart disease primarily causes left ventricular hypertrophy and diastolic dysfunction but is not a recognized cause of large pericardial effusions, unlike malignancy, hypothyroidism, and 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

Approximately 50–60% of pericardial effusions in developed countries are idiopathic, making presumed viral pericarditis the single most common etiology.

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 3