Transthoracic Echocardiography Flashcards

Which TTE finding is characteristic of an ostium secundum atrial septal defect (ASD)?

Answer: Dropout in the fossa ovalis region with right ventricular volume overload

Ostium secundum ASD appears as a central defect in the fossa ovalis with left-to-right shunting and consequent RV volume overload on TTE.

In a patient with dilated cardiomyopathy, which diastolic pattern on mitral inflow Doppler is associated with the worst prognosis?

Answer: Restrictive filling pattern (E/A > 2, short DT)

A restrictive filling pattern (E/A > 2, deceleration time < 150 ms) in DCM indicates severely elevated filling pressures and portends the poorest prognosis.

Which condition is most likely when TTE reveals a linear echogenic structure in the right atrium moving independently of the atrial walls?

Answer: Chiari network or Eustachian valve variant

A Chiari network is a remnant of the right valve of the sinus venosus — a mobile, filamentous structure in the RA that is a normal variant.

When performing TTE on a patient post-cardiac surgery with a prosthetic mechanical mitral valve, which Doppler parameter is most useful for detecting valve obstruction?

Answer: Peak transmitral velocity and pressure half-time

Elevated peak transmitral velocity and prolonged PHT (≥ 130 ms) indicate increased resistance across the prosthetic valve, suggesting obstruction or pannus.

Which echocardiographic criterion is used to define a positive bubble study (agitated saline contrast) for patent foramen ovale (PFO)?

Answer: ≥ 3 bubbles in the left heart within 3 cardiac cycles of right atrial opacification

A positive bubble study for PFO requires ≥ 3 microbubbles appearing in the left heart within 3 cardiac cycles of right atrial opacification, especially with Valsalva.

A patient has an aortic stenosis with a mean gradient of 45 mmHg but a calculated AVA of 0.7 cm². LVEF is 35%. This scenario is best described as:

Answer: Low-flow, low-gradient severe aortic stenosis

Low EF reduces stroke volume and transvalvular flow, underestimating the gradient despite a truly small AVA — this is low-flow, low-gradient severe AS.

Which TTE view provides the best assessment of the right ventricular free wall for arrhythmogenic right ventricular cardiomyopathy (ARVC)?

Answer: Apical four-chamber

The apical four-chamber view offers the longest axis of the RV free wall, enabling detection of dilation, wall motion abnormalities, and aneurysms seen in ARVC.