ARDMS RDCS AE-Adult-Echocardiography New Questions

The M-mode image shows characteristic diastolic doming or “hockey stick” appearance of the anterior mitral leaflet with restricted leaflet motion. This is a classic sign of mitral stenosis, where leaflet thickening and fusion cause limited opening during diastole.

Dilated cardiomyopathy shows increased chamber sizes and decreased systolic function but not mitral leaflet doming. Hypertrophic cardiomyopathy is characterized by septal thickening and SAM of the mitral valve. Mitral valve prolapse shows leaflet billowing into the left atrium during systole.

This pattern is well described in ASE valvular heart disease guidelines and echocardiography texts【12:ASE Valve Imaging Guidelines†p.180-185】【16:Textbook of Clinical Echocardiography, 6e†p.200-205】.

Comprehensive and Detailed Explanation From Exact Extract:

Atrioventricular canal defect (AV canal defect) is a congenital cardiac malformation characterized by defects in the atrial and ventricular septa, along with abnormalities of the atrioventricular valves including cleft mitral valve. These features collectively cause shunting and valve regurgitation.

Ebstein anomaly primarily involves the tricuspid valve and right atrium, Marfan syndrome is a connective tissue disorder with different manifestations, and Shone syndrome involves left-sided obstructive lesions.

This is clearly outlined in the "Textbook of Clinical Echocardiography, 6e", Chapter on Congenital Heart Defects - Atrioventricular Septal Defects【20:120-125†Textbook of Clinical Echocardiography】.

Decreasing the color scale (velocity range) improves the sensitivity of color Doppler for detecting low-velocity flow, such as shunting across the interatrial septum (e.g., patent foramen ovale). A lower scale allows subtle flow jets to be visualized.

Decreasing color gain would reduce sensitivity, increasing color sector size can degrade frame rate and resolution, and increasing the wall filter may remove low-velocity signals.

This optimization is discussed in the "Textbook of Clinical Echocardiography, 6e", Chapter on Color Doppler Imaging Techniques【20:100-105†Textbook of Clinical Echocardiography】.

Comprehensive and Detailed Explanation From Exact Extract:

The parasternal short axis view at the level of the aortic valve is optimal for evaluating valve morphology, including detection of bicuspid aortic valve (BAV). This view clearly visualizes the valve leaflets en face during systole.

Right sternal border and apical views provide hemodynamic information but are less optimal for detailed valve anatomy. Apical long axis is better for left ventricular and outflow tract evaluation but limited for valve leaflet number.

This is described in the "Textbook of Clinical Echocardiography, 6e", Chapter on Aortic Valve Morphology and Congenital Anomalies【20:350-355†Textbook of Clinical Echocardiography】.