Case Analysis & Practical Application Flashcards
7 cards from real CET practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Case Analysis & Practical Application flashcards as text
A 65-year-old patient with dyspnea shows a parasternal long-axis view with a dilated left ventricle, reduced wall motion, and an EF of 25%. The mitral valve appears to have incomplete leaflet coaptation. Which condition best explains these findings?
Answer: Functional mitral regurgitation due to dilated cardiomyopathy
Dilated cardiomyopathy causes annular dilation and papillary muscle displacement, leading to functional (secondary) mitral regurgitation with incomplete leaflet coaptation.
During a stress echo, a patient develops new regional wall motion abnormality in the mid-anterior and anteroseptal segments at peak stress that was absent at rest. Which coronary artery territory is most likely ischemic?
Answer: Left anterior descending artery
The mid-anterior and anteroseptal walls are supplied by the LAD; new WMA in these segments at stress indicates LAD territory ischemia.
A neonate presents with cyanosis. Echo shows a large VSD, an overriding aorta, right ventricular hypertrophy, and pulmonary stenosis. Which diagnosis does this constellation represent?
Answer: Tetralogy of Fallot
The four components described—VSD, overriding aorta, RVH, and pulmonary stenosis—are the classic tetrad of Tetralogy of Fallot.
A patient recovering from a large anterior MI is found to have a thin, akinetic apical segment that bulges outward during systole. Color Doppler shows slow swirling flow within this segment. What complication has developed?
Answer: True left ventricular aneurysm with thrombus risk
A dyskinetic, thin-walled apical segment post-MI represents a true LV aneurysm; slow swirling flow indicates stagnant blood with high thrombus risk.
On TEE, a patient with atrial fibrillation scheduled for cardioversion shows a spontaneous echo contrast ('smoke') in the left atrial appendage but no discrete thrombus. What is the most appropriate next step based on echocardiographic findings?
Answer: Defer cardioversion and extend anticoagulation, as smoke indicates stasis and elevated thrombus risk
Spontaneous echo contrast represents red cell aggregation due to stasis and is associated with thromboembolic risk, indicating the need for extended anticoagulation before cardioversion.
A patient presents with fever, bacteremia, and a new holosystolic murmur. TEE reveals an oscillating echodense mass attached to the atrial side of the posterior mitral leaflet. What is the most likely diagnosis?
Answer: Mitral valve endocarditis vegetation
An oscillating mass on the atrial side of the mitral leaflet in a febrile patient with bacteremia is classic for infective endocarditis vegetation.
A 72-year-old patient with exertional syncope has a peak instantaneous gradient of 72 mmHg across the aortic valve and an AVA of 0.7 cm² by continuity equation. The LVEF is 60%. How should these findings be classified?
Answer: Severe aortic stenosis
An AVA ≤0.8 cm² and mean gradient typically >40 mmHg (peak >64 mmHg) with preserved EF fulfill criteria for severe aortic stenosis.