CCI Valvular Pathology Assessment 2

Question 1

Which Doppler finding is most characteristic of severe mitral stenosis?

Accepted Answer

Pressure half-time >220 ms

Answer

A pressure half-time greater than 220 ms corresponds to a mitral valve area of approximately 1.0 cm² or less, indicating severe mitral stenosis.

Question 2

In a patient with aortic regurgitation, which echocardiographic measurement is most predictive of the need for surgical intervention?

Accepted Answer

Left ventricular end-systolic diameter >50 mm

Answer

An LV end-systolic diameter greater than 50 mm (or indexed >25 mm/m²) is a Class I indication for surgery in asymptomatic severe aortic regurgitation per ACC/AHA guidelines.

Question 3

The continuity equation is used primarily to calculate which valve area?

Accepted Answer

Aortic valve area

Answer

The continuity equation (AVA = LVOT area × LVOT VTI / AV VTI) is the standard method for calculating aortic valve area by echocardiography.

Question 4

Which condition is most commonly associated with rheumatic mitral stenosis?

Accepted Answer

Commissural fusion with leaflet thickening

Answer

Rheumatic disease causes commissural fusion, leaflet thickening, and subvalvular disease, producing the classic 'hockey stick' anterior leaflet deformity.

Question 5

A patient has a peak aortic valve gradient of 52 mmHg with an AVA of 0.9 cm² but an LVEF of 30%. How should this be classified?

Accepted Answer

Low-flow, low-gradient severe AS

Answer

Reduced stroke volume from low EF produces low gradients despite true severe stenosis, classifying this as low-flow, low-gradient severe AS requiring dobutamine stress echo for confirmation.

CCI - Cardiovascular Credentialing International Practice Test

CCI - Cardiovascular Credentialing International Practice Test

CCI Valvular Pathology Assessment 2