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ARDMS AE-Adult-Echocardiography Exam
AE Adult Echocardiographyination (Page 5 )

Updated On: 9-Feb-2026
Page 5 of 29
PDF with 139 Questions

Which vessel is indicated by the arrow on this video?

  1. Right upper pulmonary vein
  2. Left upper pulmonary vein
  3. Right pulmonary artery
  4. Left pulmonary artery

Answer(s): A

Explanation:

The video shows a transthoracic echocardiographic apical four-chamber or modified view focusing on the left atrium and adjacent structures. The arrow points to a vessel entering the left atrium from the right side of the image, which corresponds anatomically to the right upper pulmonary vein. The right upper pulmonary vein returns oxygenated blood from the right lung to the left atrium and is visualized in echocardiography as entering the superior-lateral aspect of the left atrium.

The left upper pulmonary vein enters the left atrium on the opposite side. The right and left pulmonary arteries are located anteriorly and superiorly in the mediastinum and are visualized mainly in the parasternal or suprasternal views, not the apical four-chamber.

This identification aligns with standard adult echocardiography anatomy as described in the
12:ASE
"Textbook of Clinical Echocardiography" and ASE guidelines on pulmonary vein imaging

16:Textbook of Clinical Echocardiography,
Pulmonary Vein Imaging Guidelinesp.110-115.
6ep.120-125



Which artery is identified by the arrow on this image?

  1. Left common carotid
  2. Brachiocephalic
  3. Left subclavian
  4. Right common carotid

Answer(s): B

Explanation:

The image is a suprasternal or high parasternal echocardiographic view of the aortic arch and its branches. The arrow points to the first large branch arising from the aortic arch, which is the brachiocephalic artery (also called the innominate artery). This vessel courses superiorly and bifurcates into the right common carotid and right subclavian arteries.

The left common carotid artery is the second branch from the arch, the left subclavian artery is the third branch, and the right common carotid is a branch of the brachiocephalic artery, not directly off the arch.

This anatomic arrangement and its echocardiographic depiction are well documented in adult
12:ASE Vascular Imaging echocardiography references and vascular ultrasound guidelines

16:Textbook of Clinical Echocardiography, 6ep.400-405.
Guidelinesp.270-275



Which condition is most plausible based on the finding indicated by the arrow on this image?

  1. Cardiac tamponade
  2. Constrictive pericarditis
  3. Pulmonary embolism
  4. Pulmonary hypertension

Answer(s): B

Explanation:

The image is a parasternal long axis M-mode echocardiographic tracing demonstrating the interventricular septum and posterior left ventricular wall. The arrow points to the septal "bounce" or "shudder," which is an abnormal early diastolic septal motion.

This septal bounce is a classic echocardiographic finding in constrictive pericarditis, caused by rapid early diastolic filling with abrupt cessation due to pericardial constraint, resulting in paradoxical septal motion.

Cardiac tamponade usually shows pericardial effusion with chamber collapse but not septal bounce. Pulmonary embolism and pulmonary hypertension have different echocardiographic signs such as right ventricular dilatation and pressure overload but no septal bounce.

These features are well described in the "Textbook of Clinical Echocardiography" and ASE pericardial
16:Textbook of Clinical Echocardiography, 6ep.280-28512:ASE Pericardial disease guidelines

.
Disease Guidelinesp.300-305



Which valvular pathology is illustrated in this left heart pressure tracing?

  1. Mitral stenosis
  2. Aortic stenosis
  3. Mitral regurgitation
  4. Aortic regurgitation

Answer(s): A

Explanation:

Comprehensive and Detailed Explanation From Exact Extract:

The pressure tracing shows left atrial (LA), left ventricular (LV), and aortic (AO) pressures over time. The key feature is the large pressure gradient between the LA and LV during diastole (arrow pointing at early diastolic phase), where the LA pressure is elevated and there is a delayed, gradual rise in LV pressure during diastolic filling. This finding is typical of mitral stenosis, where obstruction at the mitral valve causes increased LA pressure and a pressure gradient between LA and LV during diastole.

In aortic stenosis, the pressure gradient is primarily between LV and AO during systole. Mitral regurgitation shows elevated LA pressure but not a diastolic gradient. Aortic regurgitation shows elevated LV diastolic pressure with aortic diastolic pressure falling.

These characteristic hemodynamic patterns are described in clinical cardiology and echocardiography literature and hemodynamic references such as the "Textbook of Clinical Echocardiography" and
16:Textbook of Clinical Echocardiography, 6ep.360-
cardiac catheterization textbooks

12:Hemodynamic Textsp.50-60.



An intravenous drug user presents with a fever of unknown origin, flu-like symptoms, dyspnea, and chest pain.
Which ultrasound finding is mostly likely associated with this presentation?

  1. Aortic dissection
  2. Hypertrophic cardiomyopathy
  3. Mitral valve prolapse
  4. Endocarditis

Answer(s): D

Explanation:

Intravenous drug use is a major risk factor for infective endocarditis, particularly involving the tricuspid valve and sometimes left-sided valves. Symptoms like fever, flu-like illness, dyspnea, and chest pain suggest possible septic emboli or valve destruction.

Echocardiographic findings associated with endocarditis include mobile echogenic masses attached to valve leaflets (vegetations), valve thickening, or destruction. These findings are diagnostic and guide treatment.

Aortic dissection, hypertrophic cardiomyopathy, and mitral valve prolapse can present with different clinical features and echocardiographic findings not consistent with infectious vegetations.

These clinical and echocardiographic correlations are detailed in the ASE guidelines on infective
16:Textbook of Clinical endocarditis and the "Textbook of Clinical Echocardiography"

12:ASE Infective Endocarditis Guidelinesp.380-390.
Echocardiography, 6ep.470-475






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