Pediatric Echocardiography Flashcards

In a neonate with transposition of the great arteries (TGA), which echocardiographic finding confirms the diagnosis?

Answer: Aorta arising from the right ventricle and pulmonary artery from the left ventricle

In TGA, the aorta arises from the morphologic right ventricle and the pulmonary artery from the morphologic left ventricle, resulting in ventriculoarterial discordance.

When assessing tricuspid annular plane systolic excursion (TAPSE) in a child with suspected right ventricular dysfunction, where is the M-mode cursor placed?

Answer: At the lateral tricuspid annulus in the apical 4-chamber view

TAPSE is measured by placing the M-mode cursor at the lateral tricuspid annulus in the apical 4-chamber view and measuring the longitudinal displacement during systole.

A 6-month-old infant has an unrestrictive ventricular septal defect (VSD). Which Doppler finding best indicates the development of elevated pulmonary vascular resistance?

Answer: Low-velocity bidirectional or right-to-left shunting across the VSD

Low-velocity bidirectional or right-to-left shunting across a VSD indicates near-equal or elevated pulmonary vascular resistance relative to systemic resistance.

In pediatric echocardiography, the Z-score is used to interpret cardiac measurements. What does a Z-score of -2.5 for the aortic root dimension indicate?

Answer: The measurement is 2.5 standard deviations below the mean for body surface area

A Z-score of -2.5 indicates the aortic root dimension is 2.5 standard deviations below the mean expected value for a given body surface area.

Which echocardiographic view is most useful for visualizing the right ventricular outflow tract obstruction in tetralogy of Fallot?

Answer: High parasternal or parasternal short-axis view at the great vessel level

The high parasternal or parasternal short-axis view at the great vessel level best demonstrates the subpulmonary infundibulum, pulmonary valve, and main pulmonary artery in tetralogy of Fallot.

In a child with Kawasaki disease, which echocardiographic finding warrants urgent cardiology consultation?

Answer: Coronary artery aneurysm with Z-score ≥ +10

A coronary artery Z-score ≥ +10 indicates a giant aneurysm, conferring high risk of thrombosis and myocardial infarction, requiring urgent management.

In a fetus at 22 weeks gestation, which finding on fetal echocardiography is most consistent with hypoplastic left heart syndrome (HLHS)?

Answer: Small or absent left ventricle with mitral and aortic valve hypoplasia

HLHS is characterized by a severely underdeveloped left heart including a small or absent left ventricle with mitral and/or aortic atresia or hypoplasia.