Pediatric Echocardiography Flashcards

A 2-year-old child with Down syndrome has an atrioventricular septal defect (AVSD). Which component is essential for classifying it as a complete AVSD?

Answer: Presence of a common AV valve with primum ASD and inlet VSD

Complete AVSD is defined by a common AV valve orifice combined with a primum ASD and an inlet VSD, all resulting from deficiency of the atrioventricular septum.

In pediatric echocardiography, which formula is used to estimate right ventricular systolic pressure (RVSP) from tricuspid regurgitation?

Answer: RVSP = 4V² + RAP, where V is the TR peak velocity

Using the simplified Bernoulli equation, RVSP = 4 × (peak TR velocity)² + estimated right atrial pressure.

Which echocardiographic finding in a neonate is most characteristic of critical pulmonary stenosis with intact ventricular septum?

Answer: Severely thickened, doming pulmonary valve with high-velocity antegrade flow and right-to-left ductal shunting

Critical pulmonary stenosis presents with a severely thickened doming pulmonary valve, high antegrade velocity, right ventricular hypertrophy, and right-to-left shunting at the ductus arteriosus due to ductal dependency.

In a child with coarctation of the aorta, which Doppler pattern in the descending aorta is most diagnostic?

Answer: High-velocity flow with prolonged pressure half-time and diastolic tail

Coarctation produces a high-velocity jet at the narrowing with a diastolic tail (prolonged pressure half-time and continued forward diastolic flow) due to persistent pressure gradient throughout the cardiac cycle.

A newborn with cyanosis has a chest X-ray showing a 'snowman' or 'figure-of-8' heart silhouette. Which echocardiographic finding confirms the likely diagnosis?

Answer: Pulmonary veins draining into a vertical vein connecting to the innominate vein and SVC (supracardiac TAPVR)

The 'snowman' silhouette on chest X-ray is classic for supracardiac total anomalous pulmonary venous return (TAPVR), where pulmonary veins drain via a vertical vein to the innominate vein and SVC.

Which structure separates the left atrium from the right atrium and, when absent or deficient, results in a secundum atrial septal defect?

Answer: Septum secundum (fossa ovalis region)

Secundum ASDs occur due to deficiency of the septum secundum (or excessive resorption of septum primum) in the region of the fossa ovalis.

In a 10-year-old child, the echocardiogram shows a dilated coronary sinus. Which condition should be suspected first?

Answer: Persistent left superior vena cava draining into the coronary sinus

A dilated coronary sinus in a child most commonly indicates a persistent left superior vena cava (PLSVC) draining into the coronary sinus, confirmed by injection of agitated saline into the left arm.