CCI Valvular Pathology Assessment 4

Question 1

The Carpentier classification for mitral regurgitation Type II refers to:

Accepted Answer

Excessive leaflet motion (prolapse or flail)

Answer

Carpentier Type II includes excessive leaflet motion caused by elongated or ruptured chordae tendineae or papillary muscle, producing prolapse or a flail segment.

Question 2

A patient with aortic stenosis has an LVOT diameter of 2.0 cm, LVOT VTI of 18 cm, and AV VTI of 90 cm. What is the calculated aortic valve area?

Accepted Answer

0.63 cm²

Answer

AVA = π×(1.0)²×18/90 = 3.14×0.18 = 0.63 cm², indicating severe aortic stenosis (AVA <1.0 cm²).

Question 3

Which finding on 2D echocardiography is most specific for mitral valve prolapse?

Accepted Answer

Billowing of mitral leaflet(s) >2 mm posterior to the annular plane in the parasternal long-axis view

Answer

The diagnostic criterion for MVP is systolic displacement of one or both leaflets ≥2 mm beyond the mitral annular plane in the parasternal long-axis view, which avoids false positives from the saddle-shaped annulus.

Question 4

Which echocardiographic feature differentiates rheumatic aortic regurgitation from aortic root dilation-related AR?

Accepted Answer

Leaflet thickening and restricted motion at the tips versus normal leaflet morphology with diastolic coaptation failure

Answer

Rheumatic AR shows thickened, retracted leaflets with restricted motion causing coaptation failure at the tips, while aortic root dilation causes AR by stretching apart otherwise normal leaflets.

Question 5

In a patient undergoing exercise stress echocardiography for asymptomatic mitral stenosis, which finding at peak exercise warrants intervention?

Accepted Answer

Exercise-induced mean mitral gradient >15 mmHg or pulmonary artery systolic pressure >60 mmHg

Answer

Exercise-induced mean gradient >15 mmHg or PASP >60 mmHg identifies hemodynamically significant MS even in asymptomatic patients, supporting earlier intervention per ACC/AHA guidelines.

CCI - Cardiovascular Credentialing International Practice Test

CCI - Cardiovascular Credentialing International Practice Test

CCI Valvular Pathology Assessment 4