ARDMS Echo Cardiac Hemodynamics 1 — Questions and Answers
Question 1: Which Doppler measurement is used to calculate cardiac output in echocardiography?
- Stroke volume × heart rate (Correct answer)
- Peak mitral E velocity × heart rate
- IVRT × heart rate
- E/A ratio × heart rate
Correct answer: Stroke volume × heart rate
Cardiac output is calculated by multiplying stroke volume (derived from LVOT VTI and diameter) by heart rate.
Question 2: What does a restrictive filling pattern on mitral inflow Doppler indicate?
- Grade III or IV diastolic dysfunction (Correct answer)
- Normal diastolic function
- Grade I diastolic dysfunction
- Hyperdynamic LV function
Correct answer: Grade III or IV diastolic dysfunction
A restrictive filling pattern (high E, low A, short deceleration time) corresponds to Grade III or IV (irreversible) diastolic dysfunction.
Question 3: Using the continuity equation, if LVOT diameter is 2 cm, LVOT VTI is 20 cm, and aortic VTI is 80 cm, what is the aortic valve area?
- 0.785 cm² (Correct answer)
- 1.57 cm²
- 3.14 cm²
- 0.39 cm²
Correct answer: 0.785 cm²
AVA = (π × r² × LVOT VTI) / Aortic VTI = (3.14 × 1² × 20) / 80 ≈ 0.785 cm².
Question 4: What does the pressure half-time method estimate in echocardiography?
- Mitral valve area (Correct answer)
- Pulmonary artery pressure
- Cardiac output
- Left atrial pressure
Correct answer: Mitral valve area
Pressure half-time (PHT = 220/MVA) estimates mitral valve area based on how quickly the diastolic pressure gradient equalizes.
Question 5: Which formula estimates right atrial pressure to calculate pulmonary artery systolic pressure from TR jet velocity?
- PASP = 4V² + RAP (Correct answer)
- PASP = 4V² − RAP
- PASP = 2V² + RAP
- PASP = V² + RAP
Correct answer: PASP = 4V² + RAP
PASP is estimated by adding right atrial pressure to the pressure gradient across the tricuspid valve using the simplified Bernoulli equation (4V²).
Question 6: Which parameter best reflects LV filling pressures when the mitral E/e' ratio exceeds 14?
- Elevated LV end-diastolic pressure (Correct answer)
- Normal LV filling pressure
- Reduced preload
- Hyperdynamic systolic function
Correct answer: Elevated LV end-diastolic pressure
An E/e' ratio >14 (averaged medial and lateral) correlates with elevated LV filling pressures and diastolic dysfunction.
ARDMS Echo Cardiac Hemodynamics 1
Which Doppler measurement is used to calculate cardiac output in echocardiography?