Photos

Question 1

Mitral Valve Assessment 1

Answer 1

Question 2

Mitral Valve Assessment 2

Answer 2

Question 3

Mitral Valve Stenosis Scoring System

Answer 3

Question 4

Normal Hepatic Vein Flow

Answer 4

Question 5

Answer 5

Tetrology of Fallot

Question 6

Answer 6

Doubly-committed subarterial VSD

Question 7

ASDs

Answer 7

Question 8

VSDs

Answer 8

Question 9

Glenn and Fontan Procedure

Answer 9

Question 10

Norwood Procedure

Answer 10

Question 11

Hypoplastic Left Heart

Answer 11

Question 12

Tricuspid Atresia

Answer 12

Question 13

Double Inlet LV

Answer 13

Question 14

Stages of Diastolic Dysfunction

Answer 14

Question 15

Answer 15

Lipoma

• Second most common in adult (10%)
• Usually ventricle origin, occasional atrial
• Sessile, increased echogenicity, smooth
• Slow growing, large
• Distinguish from lipomatous hypertrophy

Question 16

Answer 16

Lipomatous Hypertrophy

• Common in older women
• Spares the fossa ovalis

Question 17

Answer 17

Papillary Fibroelastoma

• Small, pedunculated, mobile, echogenic
• Originate at valve leaflets, occasionally
  endocardium (AV, then MV)
• High risk of embolism
• Mistaken for vegetations
  * Fibroelastoma grow on aortic side of AV,
  vs. ventricular side as vegetations

Question 18

Answer 18

Lambl Excrescences

Question 19

Answer 19

Fibroma

(2nd most common in kids) (Rhabdomyoma #1)

• Originate in ventricles or AV groove
• Large single mass with central calcification

Question 20

Answer 20

Sarcoma

• Malignant cardiac tumors
• Originate from ventricular myocardium
• Large and invade surrounding tissue
• **Enhance with ultrasound contrast due to
  vascularity**

Question 21

Answer 21

Left Atrial Appendage Thrombus

Question 22

Answer 22

Migrating Thrombus across PFO

Question 23

Answer 23

Myxoma

(30% primary cardiac tumors - Most common adult)

• Left atrium (occasionally RA or ventricles)
• Attaches to fossa ovalis from left atrial side
• Obstructs mitral valve flow
• Slow growing, pedunculated, large, smooth
• Friable and embolize

Question 24

Answer 24

Rhabdomyoma

Most common in kids

• Strong associated with tuberous sclerosis
• Arise from ventricles (often multiple)
• Large, cause obstruction
• May spontaneously resolve

Question 25

Answer 25

Christa Terminalis - originates at the junction of the SVC and Right atrium - separates trabeculated appendage of atrium from smooth tubular portion Eustachian Valve/Chiari Network - reminent of embryologic right venous valve (directs IVC blood across the fossa ovalis) - originates at junction of IVC and right atrium

Question 26

Answer 26

Pericardial Fat

Question 27

Answer 27

Mirroring - Result of quadrature phase demodulation, which allows the echo to separate out the Doppler shifted signals from the complex returning signal

Question 28

Answer 28

Range Ambiguity of Pulsed Wave Doppler - Strong reflected signals originating from blood flow at two to three times the depth of the pulsed wave sample arrive at the transducer the same time as the target, and are super imposed - Best example, LVOT and AV velocities superimposed on pulse wave mitral flow

Question 29

Answer 29

Moderator Band

Question 30

Answer 30

1 = SVC 2 = Right Upper Pulm Vein 3 = Right Lower Pulm Vein