Wk 4 Terry Reynolds *Septal Defect

Question 1

A bright horizontal echo that gives the edge of an atrial or ventricular septal defect a broadened appearance is referred to as the:

A. A sign
B. Fo sign
C. T sign
D. W sign

Answer 1

C. T sign

*Note:

• flying “W sign” indicated PHTN on m mode

Question 2

When attempting to determine the presence of a perimembranous ventricular septal defect in the parasternal long-axis view, the echocardiographer should tilt the probe:

A. Anteriorly
B. Posteriorly
C. Medially
D. Laterally

Answer 2

C. Medially

Question 3

When attempting to determine whether an inlet ventricular septal defect from the apical four-chamber view is present, the echocardiographer should tilt the probe:

A. Anteriorly
B. Posteriorly
C. Medially
D. Laterally

Answer 3

B. Posteriorly

*Inlet VSD - near LVOT, showing LVOT from A4C need to slightly tilt TDR posteriorly to show A5C

Question 4

A saline contrast injection to rule out atrial septal defect is performed. Contrast appears in the left atrium 4 to 8 cycles after the appearance of contrast in the right atrium. The best explanation is:

A. Left-to-right atrial septal defect shunt
B. Right-to-left atrial septal defect shunt
C. Left ventricle-to-right atrium shunt
D. Pulmonary arteriovenous fistula

Answer 4

D. Pulmonary arteriovenous fistula

pulmonary artery directly connected to pulmonary vein without bypassing lung - bubble appears to LA

*Note:

Once bubbles start entering the right side – we also count how many cycles it takes for bubbles to cross to the left-side

• ​Intra-cardiac shunt: usually crosses within 1-2 cardiac cycles
• Intra-pulmonary shunt: usually crosses within 4-8 cardiac cycles

Question 5

The recommended maneuver to use when performing a transesophageal contrast examination in a patient with a possible patent foramen ovale is:

A. Inhalation of amyl nitrate
B. Squatting
C. Supine to standing
D. Valsalva maneuver

Answer 5

D. Valsalva maneuver