Discuss ARDMS AE-Adult-Echocardiography Exam Topic 5 Question 6

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

ACardiac tamponade

BConstrictive pericarditis

CPulmonary embolism

DPulmonary hypertension

Suggested Answer: B

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 disease guidelines16:Textbook of Clinical Echocardiography, 6ep.280-28512:ASE Pericardial Disease Guidelinesp.300-305.

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30 comments · newest first

Laquanda 6 months ago

I’m not sure, but C) Pulmonary embolism seems less likely here.

Kate 6 months ago

I lean towards D) Pulmonary hypertension. The right heart looks stressed.

Emmanuel 6 months ago

Definitely B) Constrictive pericarditis. The image shows restricted filling.

Alica 6 months ago

I feel like A) Cardiac tamponade could fit too. The fluid buildup is a concern.

Cheryl 7 months ago

I agree, the findings really point to cardiac tamponade.

Loreta 7 months ago

Wait, are we sure about that? This image is kinda vague.

Novella 7 months ago

Definitely leaning towards pulmonary hypertension here.

Shonda 8 months ago

Looks like classic signs of cardiac tamponade.

Elise 8 months ago

I'm going with B, constrictive pericarditis, that's the most plausible based on the image.

Lashawnda 8 months ago

Haha, I bet the answer is D - pulmonary hypertension, just to mess with us.

Casey 8 months ago

Nah, gotta be pulmonary embolism, that's one massive clot in the pulmonary artery.

Luis 8 months ago

Hmm, I'm not so sure, could be constrictive pericarditis with that thickened pericardium.

Krystina 8 months ago

Looks like cardiac tamponade to me, that arrow is pointing right at the pericardial effusion.

Chantay 9 months ago

I'm leaning towards pulmonary hypertension, but I remember it can be tricky to differentiate from other conditions. I hope the image gives a clear clue!

Mignon 9 months ago

This question feels familiar; I think we had a practice question about pulmonary embolism that looked similar, but I can't recall the specifics.

Sylvie 9 months ago

I think constrictive pericarditis could also fit, especially if there's evidence of diastolic dysfunction. I need to double-check the image details.

Doretha 9 months ago

I remember studying cardiac tamponade and how it can show up on echocardiograms, but I'm not entirely sure if that's the right answer here.

Kristel 9 months ago

The key here is to carefully consider the specific finding indicated by the arrow and how it relates to the potential diagnoses. I think I can rule out pulmonary embolism, and then it's a matter of weighing the evidence for cardiac tamponade versus constrictive pericarditis.

Lawrence 9 months ago

I'm a bit confused by this question. The image doesn't seem to clearly point to any of the listed conditions. I'll have to make an educated guess, but I'm not sure which one is the most plausible.

Nichelle 10 months ago

I feel pretty confident about this one. Based on the image, the finding seems most consistent with pulmonary hypertension. The dilation of the right ventricle is a classic sign.

Paola 10 months ago

I think it's B) Constrictive pericarditis. Looks like thickened pericardium.

Glory 10 months ago

I agree with Emmanuel. B) makes the most sense based on the findings.

Cecil 10 months ago

I think it's more likely constrictive pericarditis.

Aleisha 11 months ago

Okay, the arrow is pointing to something that looks like it could be related to the pericardium. I'm leaning towards either cardiac tamponade or constrictive pericarditis as the most plausible options.

Delfina 11 months ago

Hmm, the image shows some kind of abnormality, but I'm not sure exactly what it is. I'll need to carefully review the options and think through the possible conditions.

Theresia 5 months ago

↳ replying to Delfina

I need to look at the image again to decide.

Asuncion 5 months ago

↳ replying to Delfina

What about pulmonary hypertension? Could be a possibility.

Ciara 6 months ago

↳ replying to Delfina

Pulmonary embolism seems less likely to me.

Jeannetta 6 months ago

↳ replying to Delfina

I’m leaning towards constrictive pericarditis.

Lizbeth 10 months ago

↳ replying to Delfina

I think it looks like cardiac tamponade.

ARDMS AE-Adult-Echocardiography Exam - Topic 5 Question 6 Discussion