NBE Stress Echocardiography 4

Question 1

What is the role of atropine in dobutamine stress echocardiography?

Accepted Answer

To augment heart rate when target heart rate is not achieved with maximum dobutamine

Answer

Atropine (0.25–1.0 mg in divided doses) is added when the target heart rate is not reached at maximum dobutamine, as it enhances chronotropic response via vagal blockade.

Question 2

A patient with left bundle branch block (LBBB) undergoes stress echocardiography. Which stress modality is preferred?

Accepted Answer

Vasodilator (adenosine/dipyridamole) stress echocardiography

Answer

Vasodilator stress is preferred in LBBB because exercise and dobutamine can cause septal wall motion abnormalities unrelated to coronary disease due to rate-dependent LBBB-induced septal dysynchrony.

Question 3

During stress echocardiography, which segment classification system divides the left ventricle into 17 segments?

Accepted Answer

AHA 16-segment model with addition of the true apex

Answer

The ASE/AHA 17-segment model adds the true apical cap (segment 17) to the 16-segment model to account for the non-visualizable apex tip.

Question 4

What defines a 'dyskinetic' wall motion pattern in echocardiographic scoring?

Accepted Answer

Paradoxical outward motion during systole

Answer

Dyskinesis is defined as paradoxical outward motion of the myocardial wall during systole, assigned a wall motion score of 4.

Question 5

Which finding during stress echocardiography is most consistent with severe multivessel coronary artery disease?

Accepted Answer

Diffuse global hypokinesis developing at low workload involving multiple territories

Answer

Diffuse, multi-territory wall motion abnormalities developing at low workload suggest extensive ischemia consistent with severe multivessel or left main coronary artery disease.

(NBE) National Board of Echocardiography Practice Test

(NBE) National Board of Echocardiography Practice Test

NBE Stress Echocardiography 4