Wk 4 Terry Reynolds *Disease of Aorta Flashcards
The two-dimensional echocardiographic view that is the best approach for ruling out coarctation of the aorta is:
A. Parasternal long-axis view
B. Parasternal short-axis view of the aortic valve
C. Subcostal five-chamber view
D. Suprasternal long-axis view of the aortic arch
D. Suprasternal long-axis view of the aortic arch
- Associated anomalies of sinus of Valsalva aneurysm include all the following EXCEPT:
A. Atrial septal defect
B. Bicuspid aortic valve
C. Coarctation of the aorta
D. Ventricular septal defect
A Atrial septal defect
*Aneurysms of the sinus of Valsalva are extremely rare.
Ruptured aneurysms of the sinus of Valsalva are frequently associated with other congenital defects, particularly with:
- VSD
- AR
- BAV
- coarctation of the aorta
- In sinus of Valsalva aneurysm, the coronary cusp most often affected is:
A. Right coronary cusp
B. Non coronary cusp
C. Left coronary cusp
D. Each coronary cusp is equally affected
A Right coronary cusp
*check out the location from 3 different echo views
- A two-dimensional echocardiographic finding of an aortic intimal flap indicates aortic:
A. Aneurysm
B. Dissection
C. Insufficiency
D. Supravalvular stenosis
B
- Possible complications of aortic dissection include all the following EXCEPT:
A. Aortic insufficiency
B. Left ventricular inflow tract obstruction
C. Pericardial effusion/tamponade
D. Progressive enlargement
B
- A patient with a long-standing history of hypertension is sent to the echocardiography laboratory after developing chest pain that radiated to the back. The electrocardiogram demonstrated left ventricular hypertrophy, and the chest roentgenogram revealed a widening of the superior mediastineum. A possible diagnosis is:
A. Acute severe aortic insufficiency due to infective endocarditis
B. Aortic dissection
C. Mitral valve prolapse
D. Pericarditis
B. Aortic dissection
*note: roentgenogram - an X-ray photograph.
*Symptoms:
- Sudden severe chest or upper back pain, often described as a tearing or ripping sensation, that spreads to the neck or down the back
- Sudden severe stomach pain
- Loss of consciousness
- Shortness of breath
- Symptoms similar to those of a stroke, including sudden vision problems, difficulty speaking, and weakness or loss of movement (paralysis) on one side of your body
- Weak pulse in one arm or thigh compared with the other
- Leg pain
- Difficulty walking
*Echo Findings:
- aortic regurgitation (acute dilatation of the aortic root, aortic leaflet prolapse, dissection flap prolapse, pre-existing disease, e.g. bicuspid valve)
- pericardial effusion and/or tamponade
- regional wall motion abnormality heralding coronary artery occlusion.
- An intimal flap in the aorta is discovered in the parasternal long-axis view, suprasternal long-axis view, and abdominal aorta. The type of aortic dissection present is DeBakey type:
A. I
B. II
C. III
D. IV
A: type I
- Echocardiographic criteria for the diagnosis of aortic dissection include all the following EXCEPT:
A. Decrease in aortic root dimension
B. Normal aortic leaflet motion
C. Recognition of an intimal flap as an oscillating two-dimensional structure within the aorta
D. Widening of the anterior and posterior aortic root walls
A: Decrease in aortic root dimension
- A fusiform aneurysm is an aneurysm that involves the:
A. One point of the aorta at which there is an expansion of a pouch with a relatively small neck
B. Descending aorta only
C. Entire aorta from the aortic root to the ligamentum arteriosum
D. Entire circumference of the aorta
D Entire circumference of the aorta
- The cardiovascular abnormalities seen in patients with Marfan’s syndrome include all the following EXCEPT:
A. Aortic dissection
B. Dilatation of the aortic root
C. Mitral valve prolapsed
D. Myocardial ischemia
D: Myocardial ischemia
cardiovascular manifestation of Marfan’s syndrome
- dilatation of aortic root & aortic dissection 60-80%
- dilatation of PA (dissection is rare)
- MR/MVP/MAC 52-68%
- Endothelial dysfunction/abnormal aorta elasticity 80-100%
- A possible etiology for aortic aneurysm is:
A. Aortic insufficiency
B. Coronary artery disease
C. Dilated cardiomyopathy
D. Marfan’s syndrome
D: Marfan’s syndrome
- A connective tissue disorder associated with aortic aneurysm is:
A. Ehlers-Danlos syndrome
B. Marfan’s syndrome
C. Pseudoxanthoma elasticum
D. Turner’s syndrome
B: Marfan’s syndrome
Ehlers-Danlos syndrome
- a group of inherited disorders that affect your connective tissues — primarily your skin, joints and blood vessel walls
- cardiac manifestation: AV/MV dysfunction & arterial dilatation and dissection
Turner’s syndrome
- Turner syndrome can cause a variety of medical and developmental problems, including short height, failure of the ovaries to develop and heart defects
- common cardiac manifestation: BAV, coarctation of aorta *mainly congenital heart disease
- Turner’s syndrome is strongly associated with:
A. Atrial septal defect
B. Coarctation of the aorta
C. Tetralogy of Fallot
D. Truncus arteriosus
B: Coarctation of the aorta
cardiac manifestation - congenital heart issue including BAV and coarctation of aorta
- In coarctation of the aorta, blood pressure in the legs:
A. Is lower than in the right arm
B. Is higher than in the right arm
C. Is equal to blood pressure in the right arm
D. Cannot be compared with blood pressure in the right arm
A: Is lower than in the right arm
- Narrowing of the aorta at the aortic isthmus is:
A. Aortic arch aneurysm
B. Aortic dissection
C. Coarctation of the aorta
D. Persistent patent ductus arteriosus
C
- The Doppler finding associated with persistent patent ductus arteriosus is:
A. Diastolic flow reversal in the descending thoracic aorta
B. Increased flow velocity at the aortic isthmus
C. Increased pressure half-time of the mitral valve
D. Systolic flow reversal in the pulmonary veins
A: Diastolic flow reversal in the descending thoracic aorta
