Transthoracic Echocardiography Flashcards

Which TTE measurement is used to calculate the continuity equation for aortic valve area (AVA)?

Answer: LVOT diameter, LVOT VTI, and aortic jet VTI

AVA = (LVOT area × LVOT VTI) / Aortic jet VTI; both the LVOT diameter and velocity-time integrals are essential inputs.

A tissue Doppler e' velocity of 6 cm/s at the medial mitral annulus combined with an E/e' ratio of 16 suggests:

Answer: Elevated left ventricular filling pressures

An E/e' ratio > 14 using the medial annulus indicates elevated LV filling pressures (estimated mean LAP > 12 mmHg).

During assessment of aortic regurgitation severity, a pressure half-time (PHT) < 200 ms on CW Doppler of the aortic regurgitant jet indicates:

Answer: Severe aortic regurgitation

A short PHT (< 200 ms) indicates rapid equilibration of aortic and LV diastolic pressures, consistent with severe AR and poor diastolic filling.

What is the recommended transducer frequency range for standard adult transthoracic echocardiography?

Answer: 2–4 MHz

Adult TTE typically uses 2–4 MHz phased-array transducers, balancing adequate penetration with acceptable resolution.

Which condition is most likely when TTE shows a 'swinging heart' within a large pericardial effusion?

Answer: Cardiac tamponade

The pendular motion of the heart ('swinging heart') within a large effusion is associated with tamponade and causes electrical alternans on ECG.

In evaluating tricuspid regurgitation by TTE, the simplified Bernoulli equation (4v²) applied to the TR jet peak velocity estimates:

Answer: Right ventricular systolic pressure

RVSP = 4 × (TR peak velocity)² + estimated RAP; this equals PASP in the absence of pulmonary stenosis or RVOT obstruction.

Which parasternal short-axis level is used to assess the mitral valve leaflet tips for planimetry?

Answer: Mitral valve tip level

Planimetry of the mitral valve orifice is performed at the leaflet tip level in the PSAX view to directly trace the valve opening area.