AE Adult Echocardiography Online Practice Questions

Explanation:
The Simpson biplane method (method of disks) is the recommended two-dimensional echocardiographic technique to quantify left ventricular ejection fraction (LVEF), especially when regional wall motion abnormalities are present. It involves tracing endocardial borders in apical two-and four-chamber views to calculate LV volumes and EF, accounting for segmental dysfunction.
Visual estimation is subjective and less accurate. The Quinones method (single plane area-length) and Teichholz method rely on geometric assumptions and are less accurate in abnormal ventricles.
ASE chamber quantification guidelines strongly endorse Simpson biplane for LVEF assessment in regional wall motion abnormalities 【 12:ASE Chamber Quantification Guidelines†p.70-75 】【 16:Textbook of Clinical Echocardiography, 6e†p.60-65 】 .

Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
The Doppler waveform shows a typical left ventricular outflow tract or aortic valve velocity pattern. The arrow points to the steep rise and peak velocity of the jet, which corresponds to systolic ejection ― the phase of the cardiac cycle when blood is rapidly ejected from the left ventricle into the aorta.
Isovolumic contraction precedes ejection and is represented by a flat baseline with no flow as ventricles build pressure. Isovolumic relaxation occurs after ejection before the mitral valve opens. Early diastole corresponds to mitral inflow, not aortic outflow.
This timing and flow pattern are standard in echocardiographic Doppler interpretation as described in the "Textbook of Clinical Echocardiography" and ASE Doppler imaging guidelines 【 16:Textbook of Clinical Echocardiography, 6e†p.100-105 】【 12:ASE Doppler Guidelines†p.50-55 】 .

Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
The suprasternal long axis window is best accessed with the patient in the supine position with the neck extended. To optimize image quality, instructing the patient to turn their head slightly toward the left side moves the trachea and clavicle away from the ultrasound beam path, allowing better visualization of the aortic arch and great vessels.
Moving the probe inferior to the sternum accesses the subxiphoid window rather than suprasternal. Left lateral decubitus improves parasternal and apical windows but not suprasternal. Rotating the transducer indicator toward the patient's right shoulder would change the imaging plane but is not a primary method to improve image quality.
This technique is highlighted in the "Textbook of Clinical Echocardiography, 6e", Chapter on Echocardiographic Windows and Acoustic Access 【 20:90-95†Textbook of Clinical Echocardiography 】 .

Explanation:
Comprehensive and Detailed Explanation From Exact Extract:
Anteroseptal hypokinesis is most often due to ischemia or infarction in the left anterior descending (LAD) artery territory, a major branch of the left coronary artery. The LAD supplies the anterior wall and the interventricular septum.
The right coronary artery generally supplies the inferior wall and right ventricle. The circumflex artery supplies the lateral wall. The posterior descending artery supplies the inferior wall.
This coronary artery distribution and wall motion correlation is fundamental in stress echocardiography and ischemic heart disease assessment as detailed in ASE guidelines and clinical echocardiography references 【 12:ASE Stress Echocardiography Guidelines†p.300-310 】【 16:Textbook of Clinical Echocardiography, 6e†p.380-385 】 .

Explanation:
The video shows an apical four-chamber or subcostal echocardiographic view demonstrating a markedly enlarged right atrium with atrialization of part of the right ventricle, displacement of the tricuspid valve septal leaflet downward into the RV cavity, and severe tricuspid regurgitation. These findings are hallmark features of Ebstein anomaly, a congenital malformation of the tricuspid valve causing apical displacement of the septal and posterior leaflets.
Patent foramen ovale and ventricular septal defects have different echocardiographic features without tricuspid leaflet displacement. Eisenmenger syndrome refers to advanced pulmonary hypertension due to shunts but is not a specific congenital structural abnormality.
These diagnostic criteria and echocardiographic hallmarks are described in adult congenital heart disease literature and echocardiography textbooks 【 16:Textbook of Clinical Echocardiography, 6e†p.570-575 】【 12:ASE Adult Congenital Guidelines†p.400-405 】 .