Discuss ARDMS AE-Adult-Echocardiography Exam Topic 1 Question 9

Which flow component is indicated by the arrows on this image?

AVentricular reversal

BDiastolic flow reversal

CAtrial reversal

DSystolic forward flow

Suggested Answer: C

The Doppler waveform shows pulmonary vein flow with several components. The arrows point to small reversed flow spikes just after the atrial contraction wave, which corresponds to the atrial reversal (AR) flow component. Atrial reversal occurs as blood briefly flows backward into the pulmonary veins during atrial contraction.

Ventricular reversal is not typically seen in pulmonary veins. Diastolic flow reversal is abnormal and usually not part of normal pulmonary vein flow. Systolic forward flow is the major forward component during ventricular systole.

This interpretation is standard in ASE guidelines on diastolic function assessment and pulmonary vein Doppler evaluation12:ASE Diastolic Function Guidelinesp.85-9016:Textbook of Clinical Echocardiography, 6ep.130-135.

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26 comments · newest first

Francoise 1 month ago

I agree with Felice. B) makes sense based on the image.

Bette 1 month ago

I'm leaning towards D) Systolic forward flow. The direction seems forward to me.

Felice 2 months ago

I feel it's B) Diastolic flow reversal. The arrows suggest a reversal during diastole.

Eleni 2 months ago

I think it's A) Ventricular reversal. Looks like the flow is going back.

Alfred 2 months ago

D) Systolic forward flow could be it. The arrows might indicate normal flow direction.

Clement 2 months ago

C) Atrial reversal seems right. The image shows flow towards the atria.

Elmira 2 months ago

I'm leaning towards B) Diastolic flow reversal. The arrows suggest a reversal during diastole.

Merilyn 2 months ago

I think it's A) Ventricular reversal. Looks like the flow is going back.

Denny 3 months ago

D) Systolic forward flow could be it. The arrows might indicate normal flow direction.

Twana 3 months ago

C) Atrial reversal seems right. The image shows flow towards the atria.

Dorothy 3 months ago

I'm leaning towards B) Diastolic flow reversal. The arrows suggest a reversal during diastole.

Laura 3 months ago

I think it's A) Ventricular reversal. Looks like the flow is going back.

Timmy 3 months ago

The arrows definitely indicate ventricular reversal.

Reena 4 months ago

Wait, are we sure about that? Looks confusing.

Galen 5 months ago

No way, it's systolic forward flow for sure!

Stephen 5 months ago

I think it's actually atrial reversal.

Lamonica 5 months ago

Definitely looks like diastolic flow reversal.

Moira 6 months ago

Definitely not C) Atrial reversal, that's for sure!

Erick 6 months ago

Wait, is that really what it shows? I'm not convinced.

Cyndy 6 months ago

Looks like D) Systolic forward flow to me.

Sina 6 months ago

I disagree, I think it's A) Ventricular reversal.

Lashandra 6 months ago

I'm pretty sure it's B) Diastolic flow reversal.

Myra 6 months ago

I feel like the answer could be atrial reversal, but I need to double-check my notes on flow patterns.

Lenita 7 months ago

I remember something about ventricular reversal, but I can't recall if that's what this image shows.

Candida 7 months ago

This looks similar to a practice question we did on flow components, but I can't remember the exact details.

Barbra 7 months ago

I think the arrows might indicate diastolic flow reversal, but I'm not entirely sure.

ARDMS AE-Adult-Echocardiography Exam - Topic 1 Question 9 Discussion