ARDMS AE-Adult-Echocardiography Exam - Topic 1 Question 3 Discussion

Actual exam question for ARDMS's AE-Adult-Echocardiography exam

Question #: 3
Topic #: 1

[All AE-Adult-Echocardiography Questions]

Which technique best determines a trileaflet aortic valve from a bicuspid aortic valve?

AVisualize all three leaflets simultaneously during systole

BVisualize all three leaflets simultaneously during diastole

CUse pulsed wave Doppler to demonstrate normal flow velocity

DUse continuous wave Doppler to demonstrate normal flow velocity

Show Suggested Answer

Suggested Answer: B

The most reliable technique to distinguish a trileaflet aortic valve from a bicuspid valve is to visualize all three leaflets simultaneously during diastole when the valve is closed. During diastole, the aortic valve leaflets coapt, and the three cusps form a characteristic ''Y-shaped'' or ''Mercedes-Benz'' sign on short-axis echocardiographic views, clearly demonstrating the number of leaflets.

Visualization during systole is less reliable because the valve is open, and the leaflets are moving rapidly. Doppler techniques (pulsed or continuous wave) assess flow velocities but do not definitively determine leaflet number, only stenosis severity.

This approach is well documented in adult echocardiography textbooks and ASE valvular imaging guidelines, which emphasize the diastolic short-axis view for valve morphology assessment16:Textbook of Clinical Echocardiography, 6ep.190-19512:ASE Valve Imaging Guidelinesp.180-185.

by Lucia at Nov 25, 2025, 01:59 PM

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Jose

9 hours ago

B) seems like it could work too, but I’m not convinced.

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Cruz

6 days ago

I think C) could also be useful, but not as definitive.

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Leota

11 days ago

Option B for sure. Diastole is the money shot for seeing those leaflets in all their glory.

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India

16 days ago

Haha, I'm just going to guess and hope for the best. These valve questions always trip me up!

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Carmela

21 days ago

C and D are both good options too. Doppler can help differentiate the flow patterns between the two valve types.

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Sean

26 days ago

I recall that continuous wave Doppler is used for measuring high velocities, but I’m not confident it would help in identifying the valve type.

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Pedro

1 month ago

I practiced a similar question where Doppler techniques were involved. I feel like C and D are more about flow rather than directly visualizing the leaflets.

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Noel

1 month ago

I'm not entirely sure, but I remember something about diastole being important for valve assessment. Maybe option B is worth considering?

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Nettie

1 month ago

I think option A might be the right choice since visualizing all three leaflets during systole could help differentiate between the two types of valves.

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Justine

2 months ago

Hmm, I'm leaning towards option A. Visualizing the leaflets during systole seems like it would give the most definitive answer on whether it's a trileaflet or bicuspid valve.

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Janessa

2 months ago

For this type of question, I'd focus on directly visualizing the valve leaflets. Seeing all three leaflets clearly during systole seems like the most reliable way to identify a trileaflet valve.

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Francoise

2 months ago

Using Doppler to check the flow velocity could also be helpful, but I'm not sure if pulsed wave or continuous wave would be the better technique here.

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