CCI Echocardiography Techniques and Applications 2 — Questions and Answers
Question 1: Which echocardiographic finding is characteristic of cardiac tamponade?
- Left ventricular hypertrophy
- Right ventricular diastolic collapse and respiratory variation in mitral inflow >25% (Correct answer)
- Mitral valve prolapse with regurgitation
- Enlarged left atrium only
Correct answer: Right ventricular diastolic collapse and respiratory variation in mitral inflow >25%
Cardiac tamponade produces RV diastolic collapse, RA systolic collapse, and >25% respiratory variation in mitral inflow velocity due to elevated pericardial pressure.
Question 2: What is the normal left ventricular ejection fraction (LVEF) range according to American Society of Echocardiography (ASE) guidelines?
- 40–50%
- 45–55%
- ≥55% (Correct answer)
- 60–70%
Correct answer: ≥55%
ASE guidelines define normal LVEF as ≥55%, with mildly reduced EF at 41–54%, moderately reduced at 30–40%, and severely reduced at <30%.
Question 3: In two-dimensional echocardiography, which method of calculating LVEF traces the endocardial border in two orthogonal apical views?
- Teichholz formula
- Simpson's biplane method of discs (Correct answer)
- Quinones method
- Devereux formula
Correct answer: Simpson's biplane method of discs
Simpson's biplane method of discs traces the endocardial border in the apical four-chamber and two-chamber views to calculate LV volumes and ejection fraction.
Question 4: Which finding on echocardiography is most consistent with hypertrophic obstructive cardiomyopathy (HOCM)?
- Dilated left ventricle with global hypokinesis
- Asymmetric septal hypertrophy with systolic anterior motion of the mitral valve (Correct answer)
- Concentric LV hypertrophy with preserved EF and restrictive filling
- Apical LV aneurysm
Correct answer: Asymmetric septal hypertrophy with systolic anterior motion of the mitral valve
HOCM is characterized by asymmetric septal hypertrophy (ASH) and systolic anterior motion (SAM) of the mitral valve, which causes dynamic LVOT obstruction.
Question 5: What is the primary advantage of harmonic imaging over fundamental imaging in echocardiography?
- Increased temporal resolution
- Reduced side lobe artifacts and improved endocardial border definition (Correct answer)
- Higher frame rate
- Better far-field penetration at low frequencies
Correct answer: Reduced side lobe artifacts and improved endocardial border definition
Harmonic imaging uses the second harmonic frequency generated by tissue, reducing near-field artifacts and side lobes to improve endocardial border visualization.
Question 6: During stress echocardiography, which new wall motion abnormality at peak stress is most indicative of significant coronary artery disease?
- Hyperkinesis in the inferolateral wall
- Stress-induced hypokinesis or akinesis in a coronary territory (Correct answer)
- Isolated right ventricular dilation
- Increased LVEF with exercise
Correct answer: Stress-induced hypokinesis or akinesis in a coronary territory
New stress-induced regional wall motion abnormality (hypokinesis or akinesis) in a coronary distribution indicates myocardial ischemia due to significant CAD.
CCI Echocardiography Techniques and Applications 2
Which echocardiographic finding is characteristic of cardiac tamponade?