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Exam (elaborations)

echo board Questions and Answers

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101. An intraoperative trans-esophageal echocardiogram (TEE) revealed mitral regurgitation with the following measurements: regurgitant jet area 4 cm2, PISA radius 0.8 cm at a Nyquist limit of 50 cm/s at a heart rate of 82 beats/min and arterial blood pressure 80/40 mmHg. This represents: ...

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  • August 2, 2024
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  • 2024/2025
  • Exam (elaborations)
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  • ECHO
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echo board Questions and
Answers


101. An intraoperative trans-esophageal echocardiogram (TEE) revealed mitral

regurgitation


with the following measurements: regurgitant jet area 4 cm2, PISA radius 0.8

cm at


a Nyquist limit of 50 cm/s at a heart rate of 82 beats/min and arterial blood

pressure


80/40 mmHg. This represents:


A. Mild mitral regurgitation (MR)


B. Moderate MR


C. Severe MR


Ans- Severe MR

,102. For the patient in the above question, if the systolic blood pressure is

increased to


145 mmHg, assuming that the effective orifice area is unchanged, then the:


A. MR jet size will double


B. MR jet size will not change


C. MR jet size will more than double


Ans- MR jet size will more than double




103. For a given regurgitant volume all of the following result in a reduction in

the jet size


except:


A. Fast heart rate


B. Doubling the sector angle


C. Increasing the imaging depth


D. Increasing the blood pressure


Ans- Increasing the blood pressure

,104. In a patient with severe MR all of the following factors increase its

hemodynamic


impact except:


A. Mitral stenosis


B. Left ventricular hypertrophy


C. Compliant left atrium


D. Concomitant aortic regurgitation


Ans- Compliant left atrium




105. In a patient undergoing aortic valve replacement (AVR) for aortic stenosis,

there was


evidence of moderate MR on a preoperative transthoracic echocardiogram.

After the


AVR, the next step to be taken is:


A. Replace the mitral valve


B. Leave the mitral valve alone


C. Assess for MR with intraoperative TEE, and decide if repair or replacement

is needed

, D. None of the above


Ans- Assess for MR with intraoperative TEE, and decide if repair or

replacement is needed




106. A patient with old inferior wall myocardial infarction (MI) has severe MR

with a


posterolaterally directed jet in the left atrium. The most likely cause of MR in

this


patient is: A. Flail posterior leaflet


B. Dilated mitral annulus


C. Tented or apically tethered posterior mitral leaflet


D. Tented or apically tethered anterior mitral leaflet


Ans- Tented or apically tethered posterior mitral leaflet




107. Presence of severe aortic regurgitation (AR) in a patient with mitral

stenosis is likely to


do the following to the calculated mitral valve area by the pressure half-time

method:

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