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Valvular Pathology Assessment Flashcards

7 cards from real CCI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. Which echocardiographic parameter best reflects the hemodynamic significance of mitral regurgitation?

    Answer: Effective regurgitant orifice area (EROA)

    EROA quantifies the size of the regurgitant orifice independent of driving pressure, making it the most accurate single parameter for MR severity grading.

  2. Systolic anterior motion (SAM) of the mitral valve leaflet in hypertrophic obstructive cardiomyopathy (HOCM) causes which valvular complication?

    Answer: Dynamic left ventricular outflow tract obstruction with associated mitral regurgitation

    SAM pulls the anterior mitral leaflet into the LVOT during systole, creating dynamic obstruction and an associated posteriorly directed MR jet.

  3. What is the Wilkins score used to assess?

    Answer: Suitability of mitral valve for percutaneous balloon mitral valvuloplasty

    The Wilkins score grades mitral leaflet mobility, thickening, calcification, and subvalvular thickening (0–16); a score ≤8 predicts good outcome with percutaneous balloon mitral valvuloplasty.

  4. In severe aortic stenosis, which hemodynamic finding indicates the poorest prognosis without intervention?

    Answer: Syncope with exertion

    The classic triad of symptoms in AS (angina, syncope, heart failure) signals decompensation; exertional syncope carries a mean survival of approximately 3 years without valve replacement.

  5. Paradoxical low-flow, low-gradient aortic stenosis differs from classic low-flow, low-gradient AS by having:

    Answer: Preserved ejection fraction with reduced stroke volume index

    Paradoxical LFLG AS features preserved EF (≥50%) but low stroke volume index (<35 mL/m²) due to small, hypertrophied LV with diastolic dysfunction causing low gradients despite true severe stenosis.

  6. Which color flow Doppler finding in the hepatic veins indicates severe tricuspid regurgitation?

    Answer: Systolic flow reversal in the hepatic veins

    Systolic reversal of hepatic venous flow is a specific indicator of severe tricuspid regurgitation, reflecting retrograde transmission of high right atrial pressure into the venous system.

  7. In a patient with a bioprosthetic mitral valve, which Doppler finding should raise concern for prosthetic valve stenosis?

    Answer: Mean gradient >5–6 mmHg at rest

    A mean gradient exceeding 5–6 mmHg at rest for a mitral bioprosthesis is above the expected normal range and suggests pathologic obstruction requiring further investigation.