CCI Echocardiography Techniques and Applications 1 — Questions and Answers
Question 1: Which echocardiographic view is obtained by placing the transducer at the left parasternal border to visualize the long axis of the heart?
- Apical four-chamber view
- Parasternal long-axis view (Correct answer)
- Subcostal view
- Suprasternal notch view
Correct answer: Parasternal long-axis view
The parasternal long-axis view is obtained at the left parasternal border and displays the left ventricle, mitral valve, aortic valve, and aortic root along the long axis.
Question 2: In M-mode echocardiography, which measurement is used to calculate left ventricular ejection fraction using the Teichholz method?
- Left ventricular end-diastolic and end-systolic dimensions (Correct answer)
- Mitral valve E-point septal separation only
- Peak aortic velocity
- Right ventricular diameter
Correct answer: Left ventricular end-diastolic and end-systolic dimensions
The Teichholz method uses left ventricular end-diastolic dimension (LVEDD) and end-systolic dimension (LVESD) from M-mode to calculate ejection fraction.
Question 3: What does an E/A ratio greater than 2 with a short deceleration time indicate in Doppler assessment of mitral inflow?
- Normal diastolic function
- Grade I diastolic dysfunction (impaired relaxation)
- Grade III restrictive diastolic dysfunction (Correct answer)
- Pseudonormal filling pattern
Correct answer: Grade III restrictive diastolic dysfunction
An E/A ratio >2 with a deceleration time <160 ms indicates Grade III (restrictive) diastolic dysfunction, suggesting elevated filling pressures.
Question 4: Which Doppler modality uses a sample volume placed at a fixed depth and provides spectral analysis of flow at that specific location?
- Continuous wave Doppler
- Color flow Doppler
- Pulsed wave Doppler (Correct answer)
- Tissue Doppler imaging
Correct answer: Pulsed wave Doppler
Pulsed wave Doppler uses a sample volume at a specific depth with range resolution, allowing interrogation of flow at a precise location but limited by the Nyquist limit.
Question 5: During a transesophageal echocardiogram (TEE), which structure is best visualized in the mid-esophageal four-chamber view?
- Aortic arch
- Descending thoracic aorta
- Left atrial appendage
- All four cardiac chambers and AV valves (Correct answer)
Correct answer: All four cardiac chambers and AV valves
The mid-esophageal four-chamber view at approximately 0 degrees displays all four chambers, the mitral valve, tricuspid valve, and interatrial septum simultaneously.
Question 6: What is the significance of a left ventricular wall motion score index (WMSI) greater than 1.0 on stress echocardiography?
- Normal myocardial function throughout
- Evidence of regional wall motion abnormalities suggesting ischemia or infarction (Correct answer)
- Hyperdynamic left ventricular function
- Right ventricular pressure overload
Correct answer: Evidence of regional wall motion abnormalities suggesting ischemia or infarction
A WMSI >1.0 indicates that at least one segment has abnormal wall motion (hypokinesis, akinesis, or dyskinesis), suggesting ischemia or prior infarction.
CCI Echocardiography Techniques and Applications 1
Which echocardiographic view is obtained by placing the transducer at the left parasternal border to visualize the long axis of the heart?