MOCK Seminar 3

What are we looking at here?

• Aortic valve zoom from apical window, aortic regurgitation
• Mitral valve zoom from apical window, normal colour
• Aortic valve zoon from parasternal window, normal colour flow
• Pulmonic valve zoom from parasternal window, normal colour flow

What view is this? Is the colour flow doppler set appropriately?

• Apical 4 chamber, appropriate colour flow Doppler settings on tricuspid valve
• Subcoastal 4 chamber view, inappropriate colour flow Doppler settings on mitral valve
• Apical 4 chamber, appropriate colour flow Doppler settings on mitral valve
• Apical 4 chamber, inappropriate colour flow Doppler settings on mitral valve

What view is this and what is the arrow pointing at?

• Parasternal LV short axis, basal inferior segment
• Subcostal LV short axis, basal inferior segment
• Parasternal LV short axis, basal anterior segment
• Subcostal LV short axis, mid inferolateral segment
• Parasternal LV short axis, mid anterior segment

What view is this and what structure is shown by the arrow?

• Apical 4 chamber, left atrium
• Parasternal RV outflow, main PA
• Parasternal RV inflow, right atrium
• Apical 2 chamber, left atrium

What view is this and what is shown by the arrow?

• Apical RV inflow/outflow, right cusp of pulmonic valve
• Apical RV inflow/outflow, right coronary cusp of aortic valve
• Parasternal RV inflow/outflow, noncoronary cusp of aortic valve
• Apical RV inflow/outflow, left coronary cusp of aortic valve
• Parasternal RV inflow/outflow, right coronary cusp of aortic valve

What view is this and what structure is shown by the arrow?

• Parasternal 2 chamber, apical inferolateral segment
• Apical 2 chamber, apical inferior segment
• Apical 2 chamber, apical anterior segment
• Parasternal 2 chamber, basal anteroseptal segment

Where is the arrow pointing?

• Left cusp of pulmonic valve
• Left coronary cusp of AV
• Non coronary cusp of AV
• Right coronary cusp of AV

What view is this (careful) and what structure is shown with the arrow?

• Parasternal LV short axis, mid anteroseptal segment
• Parasternal LV short axis, mid inferoseptal segment
• Subcostal LV short axis, mid inferoseptal segment
• Transgastric LV short axis, apical septal segment
• Subcostal LV short axis, mid anteroseptal segment

What are we looking at here?

• Subcostal long axis, aortic valve
• Parasternal long axis, mid anteroseptal segment
• Parasternal long axis, mid inferolateral segment
• Apical long axis, basal anteroseptal segment
• Apical long axis, basal inferoseptal segment

What view is this and what is the arrow pointing at?

• Transgastric LV short axis, posteromedial papillary muscle
• Parasternal LV short axis, posteromedial papillary muscle
• Parasternal LV short axis, anterolateral papillary muscle
• Transgastric LV short axis, anterolateral papillary muscle

What view is this and what structure is shown by the arrow?

• Parasternal LV short axis, midpapillary level, mid anteroseptal segment
• Subcostal LV short axis, midpapillary level, midinferoseptal segment
• Parasternal LV short axis, apical level, apical septal segment
• Subcostal LV short axis, apical level, apical septal segment

What view is this and what is seen?

• Parasternal long axis, color flow across the aortic valve concerning for stenosis
• Apical long axis, color flow across the aortic valve concerning for dynamic outflow obstruction
• Parasternal long axis, normal color flow across the aortic valve
• Parasternal long axis, color flow across the aortic valve concerning for insufficiency

What view is this? Describe the global right ventricular systolic function.

• Parasternal 4 chamber, reduced RV function
• Apical 4 chamber, reduced RV function
• Apical 4 chamber, normal RV function
• Subcostal 4 chamber, normal RV function
• Subcostal 4 chamber, reduced RV function

What view is this and what structure is shown by the arrow?

• Apical 4 chamber, left lower pulmonary vein
• Apical 2 chamber, left atrial appendage
• Apical 2 chamber, coronary sinus
• Apical long axis, thoracic aorta
• Apical long axis, aortic valve

What view is this and what is shown by the arrow?

• Suprasternal aortic arch long axis, innominate artery
• Parasternal aortic long axis, right common carotid artery
• Suprasternal aortic arch long axis, left subclavian artery
• Parasternal aortic long axis, right subclavian artery

What view is this and what do we see?

• Parasternal long axis, normal mitral valve color flow
• Parasternal RV inflow, normal tricuspid valve color flow
• Parasternal long axis, mitral valve color flow with significant regurgitation
• Parasternal RV inflow, significant tricuspid regurgitation

What view is this and what are we seeing?

• Apical long axis, normal colour flow
• Apical long axis, significant mitral regurgitation
• Parasternal long axis, significant aortic insufficiency
• Parasternal long axis, normal colour flow

What view is this?

• Parasternal RV outflow
• Parasternal RV inflow
• Apical long axis
• Subcostal 4 chamber
• Transgastric RV inflow-outflow

What view is this? Where are all the Zs?

• Apical LV short axis, basal inferoseptal and basal anterior segments
• Subcostal LV short axis, apical inferior and apical anterior segments
• Parasternal LV short axis, basal inferoseptal and basal anterolateral segments
• Parasternal LV short axis, mid inferoseptal and mid anterolateral segments

What view is this and what structure is shown by the arrow?

• Apical 4 chamber, right atrium
• Parasternal long axis, aorta
• Apical long axis, right atrium
• Apical 2 chamber, left atrial appendage
• Apical 2 chamber, coronary sinus

What view is this and what structure is indicated?

• Apical long axis, anterior mitral leaflet
• Apical 4 chamber, septal leaflet of tricuspid valve
• Apical long axis, aortic valve
• Apical 4 chamber, posterior mitral leaflet
• Apical 4 chamber, anterior mitral leaflet

What view is this?

• Parasternal long axis, normal mitral colour flow
• Subcostal 4 chamber, normal MV colour flow
• Parasternal RV inflow, normal tricuspid colour flow
• Apical 4 chamber, normal MV colour flow
• Apical 4 chamber, normal TV colour flow

What view is this and what is the arrow indicating?

• Parasternal long axis, right coronary cusp of the aortic valve
• Midesophageal long axis, left coronary cusp of the aortic valve
• Apical long axis, left coronary cusp of the aortic valve
• Midesophageal long axis, non-coronary cusp of the aortic valve
• Apical long axis, non-coronary cusp of the aortic valve
• Parasternal long axis, left coronary cusp of the aortic valve

What view is this? What does this tell us about the patient’s hemodynamic state?

• Subcostal IVC long axis, low-normal right atrial pressure
• Subcostal IVC long axis, elevated right atrial pressure
• Subcostal aortic long axis, severe aortic insufficiency
• Subcostal aortic long axis, cardiac tamponade

What view is this? Is the RV function normal, and how large is the effusion?

• Subcostal 4 chamber, normal RV function, no effusion seen
• Parasternal long axis, reduced RV function, small pericardial effusion
• Apical 4 chamber, reduced RV function, moderate pericardial effusion
• Apical 4 chamber, normal RV function, no pericardial effusion
• Subcostal 4 chamber, reduced RV function, small pericardial effusion

What view is this and what structure is indicated by the arrow?

• Subcostal 4 chamber, posterior mitral leaflet
• Subcostal 4 chamber, anterior mitral leaflet
• Apical 4 chamber, anterior mitral leaflet
• Apical 3 chamber, aortic valve
• Apical 4 chamber, posterior mitral leaflet

What view is this and what structure is shown by the arrow?

• Apical LV short axis, RV free wall
• Subcostal 4 chamber, RV free wall
• Subcostal 4 chamber, pericardial effusion
• Parasternal LV short axis, pulmonary embolus
• Parasternal LV short axis, moderator band

What view is this? Describe the colour flow Doppler findings.

• Apical 4 chamber, severe TR
• Subcostal 4 chamber, moderate TR
• Apical 4 chamber, mild TR
• Subcostal 4 chamber, mild TR

This patient is likely to have?

• Severe aortic stenosis (AS)
• Severe mitral regurgitation (MR)
• Severe pulmonary hypertension
• Mild AS

Risk of aortic dissection is increased in the following conditions except:

• Marfan’s syndrome
• Bicuspid aortic valve
• Pregnancy
• Mitral stenosis

This is an end systolic frame in a patient with shortness of breath. What is the most likely diagnosis?

• Ebstein’s anomaly
• Hypertrophic cardiomyopathy
• Atrial septal defect
• Dilated cardiomyopathy