Echocardiogram Cardiac Pathology and Disease Recognition 1 — Questions and Answers
Question 1: Which echocardiographic finding is most characteristic of hypertrophic obstructive cardiomyopathy (HOCM)?
- Dilated left ventricle with reduced EF
- Systolic anterior motion (SAM) of the mitral valve (Correct answer)
- Pericardial effusion with tamponade physiology
- Flail mitral leaflet with severe regurgitation
Correct answer: Systolic anterior motion (SAM) of the mitral valve
SAM of the mitral valve is the hallmark echocardiographic finding of HOCM, causing dynamic left ventricular outflow tract obstruction.
Question 2: On 2D echocardiography, a 'snowstorm' appearance in the left ventricle following contrast injection suggests what condition?
- Left ventricular thrombus
- Hypertrophic cardiomyopathy
- Non-compaction cardiomyopathy (Correct answer)
- Cardiac amyloidosis
Correct answer: Non-compaction cardiomyopathy
Non-compaction cardiomyopathy shows deep trabeculations and recesses in the left ventricle, which fill with contrast giving a 'snowstorm' appearance.
Question 3: Which pattern of left ventricular wall motion abnormality is most consistent with a left anterior descending (LAD) artery occlusion?
- Inferior and posterior wall akinesis
- Lateral wall akinesis only
- Anteroseptal and apical akinesis (Correct answer)
- Basal inferior akinesis
Correct answer: Anteroseptal and apical akinesis
LAD artery occlusion typically causes anteroseptal and apical wall motion abnormalities because the LAD supplies these territories.
Question 4: Cardiac amyloidosis on echocardiography classically demonstrates which of the following?
- Thin, hypokinetic ventricular walls
- Biventricular hypertrophy with a 'sparkling' myocardial texture (Correct answer)
- Isolated right ventricular dilation
- Large pericardial effusion without myocardial changes
Correct answer: Biventricular hypertrophy with a 'sparkling' myocardial texture
Cardiac amyloidosis characteristically shows biventricular hypertrophy with a granular 'sparkling' or 'ground-glass' myocardial texture due to amyloid infiltration.
Question 5: A patient presents with acute chest pain and echocardiography reveals a new regional wall motion abnormality. What is the significance of this finding?
- It confirms pericarditis as the etiology
- It is highly suggestive of acute myocardial ischemia or infarction (Correct answer)
- It is a normal variant in elderly patients
- It indicates hypertensive heart disease
Correct answer: It is highly suggestive of acute myocardial ischemia or infarction
New regional wall motion abnormalities that follow coronary artery territories are highly suggestive of acute myocardial ischemia or infarction.
Question 6: Dilated cardiomyopathy (DCM) on echocardiography is characterized by which of the following?
- Concentric LV hypertrophy with normal systolic function
- LV dilation with globally reduced systolic function (Correct answer)
- Asymmetric septal hypertrophy
- Small hyperdynamic LV with preserved EF
Correct answer: LV dilation with globally reduced systolic function
DCM is characterized by four-chamber dilation with globally reduced systolic function and an ejection fraction typically below 40%.
Echocardiogram Cardiac Pathology and Disease Recognition 1
Which echocardiographic finding is most characteristic of hypertrophic obstructive cardiomyopathy (HOCM)?