Transthoracic Echocardiography Flashcards

Which echocardiographic finding is most specific for constrictive pericarditis compared with restrictive cardiomyopathy?

Answer: Respiratory variation in mitral E velocity > 25%

In constrictive pericarditis, the rigid pericardium causes exaggerated interventricular dependence, resulting in > 25% respiratory variation in mitral inflow E velocity.

A patient's TTE shows a bicuspid aortic valve with a doming appearance. Which complication should be most closely monitored?

Answer: Aortic root dilation and aneurysm

Bicuspid aortic valve is associated with aortopathy including aortic root and ascending aorta dilation, requiring serial imaging surveillance.

On a standard TTE, which structure is best seen in the subcostal view that may be difficult to assess from parasternal windows?

Answer: Atrial septum and right ventricle

The subcostal view provides an orthogonal perspective ideal for evaluating the atrial septum (including ASD) and the right ventricle.

The 'hockey stick' or 'elbow' deformity of the anterior mitral leaflet on 2D TTE is classically associated with:

Answer: Rheumatic mitral stenosis

Rheumatic MS causes tip fusion and doming of the anterior mitral leaflet, producing the characteristic hockey-stick appearance on PLAX view.

Which formula correctly expresses left ventricular ejection fraction (LVEF) using biplane Simpson's method?

Answer: (EDV − ESV) / EDV × 100%

LVEF = [(EDV − ESV) / EDV] × 100%; biplane Simpson's method sums disk volumes from apical 4- and 2-chamber views to calculate EDV and ESV.

A dilated right ventricle with D-shaped interventricular septum flattening during systole on PSAX view suggests:

Answer: Right ventricular pressure overload

Systolic septal flattening (D-sign) indicates RV pressure overload; diastolic flattening indicates volume overload.

Which Doppler finding best differentiates severe mitral regurgitation from moderate MR using the vena contracta method?

Answer: Vena contracta width ≥ 7 mm indicates severe MR

A vena contracta width ≥ 7 mm is a specific marker of severe MR, representing the narrowest portion of the regurgitant jet at the orifice.