NBE Stress Echocardiography 5

Question 1

Which finding during dobutamine stress echocardiography suggests stress-induced cardiomyopathy (Takotsubo)?

Accepted Answer

Apical ballooning with basal hyperkinesis developing during infusion

Answer

Apical ballooning with compensatory basal hyperkinesis is the hallmark of Takotsubo (stress) cardiomyopathy, which can rarely be triggered by dobutamine infusion.

Question 2

A patient's resting LVEF is 35%. During low-dose dobutamine (10 mcg/kg/min), LVEF increases to 50%. This response most likely indicates:

Accepted Answer

Contractile reserve suggesting hibernating or stunned myocardium

Answer

An LVEF improvement of ≥5% with low-dose dobutamine indicates contractile reserve, characteristic of viable hibernating myocardium that may improve with revascularization.

Question 3

Which parameter measured during exercise stress echocardiography provides the strongest prognostic information?

Accepted Answer

Peak exercise wall motion score index (WMSI)

Answer

Peak exercise WMSI is a powerful independent predictor of cardiac events, with higher scores correlating with worse prognosis and extent of coronary artery disease.

Question 4

During supine bicycle stress echocardiography, images can be acquired during exercise because:

Accepted Answer

Patient remains in left lateral decubitus position on the bicycle, allowing continuous imaging

Answer

Supine bicycle protocols allow continuous echocardiographic imaging throughout exercise because the patient maintains an imaging-friendly position throughout the test.

Question 5

What is the appropriate action when a patient develops sustained ventricular tachycardia (VT) during dobutamine stress echocardiography?

Accepted Answer

Immediately terminate dobutamine infusion and treat per ACLS protocols

Answer

Sustained VT is an absolute indication to terminate the dobutamine infusion immediately and manage the arrhythmia according to ACLS protocols.

(NBE) National Board of Echocardiography Practice Test

(NBE) National Board of Echocardiography Practice Test

NBE Stress Echocardiography 5