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RDCS Fetal Echo study materials
RDCS Fetal Echo study resources

RDCS Fetal Echo practice questions

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Question 1Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

At a 20-week anatomy scan, the fetal heart lies in the left chest, the apex points leftward, and the cardiac axis measures about 45 degrees from the anterior midline. How should this be reported?

  1. Normal cardiac axis Correct answer.
  2. Mesocardia with a midline apex
  3. Levocardia with a rightward axis
  4. Dextrocardia with a rightward apex

Explanation

In normal situs solitus the fetal cardiac axis is approximately 45 degrees to the left of the anterior midline, with an accepted range of roughly 25 to 65 degrees. A leftward apex with an axis in this range is a normal finding and needs no further comment.

Question 2Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

On the standard four-chamber view, which cardiac chamber is seen immediately anterior to the descending aorta?

  1. Left ventricle
  2. Right ventricle
  3. Right atrium
  4. Left atrium Correct answer.

Explanation

The left atrium is the most posterior cardiac chamber and sits directly anterior to the descending aorta, which appears as a circular echolucent structure to the left of the spine. The right ventricle, by contrast, is the most anterior chamber.

Question 3Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which feature most reliably identifies the morphologic right ventricle in the fetal four-chamber view?

  1. A smooth, unribbed endocardial surface
  2. A moderator band near the apex Correct answer.
  3. Continuity with the pulmonary veins
  4. The most posterior position in the mediastinum

Explanation

The right ventricle contains the moderator band, a prominent trabeculation running from the septal to the parietal wall near the apex, and this is the classic marker of right ventricular identity. The left ventricle has a smoother endocardial surface and never receives the pulmonary veins into its cavity.

Question 4Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which structure forms the thin, mobile flap valve of the foramen ovale?

  1. Septum secundum
  2. Atrioventricular septum
  3. Septum primum Correct answer.
  4. Eustachian valve

Explanation

The septum primum is a thin membrane on the left atrial side of the fossa ovalis that is pushed into the left atrium by higher right atrial pressure, acting as the flap valve. The septum secundum is the thicker, rigid rim that forms the limbus of the fossa ovalis.

Question 5Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

The fetal stomach is identified in the left abdomen, the cardiac apex points to the left, and the aortic arch is left-sided. Which term best describes this arrangement?

  1. Situs inversus with dextrocardia
  2. Situs solitus with levocardia Correct answer.
  3. Situs solitus with dextrocardia
  4. Situs inversus with levocardia

Explanation

When the stomach and other abdominal viscera are on the left and the cardiac apex is also on the left, the arrangement is situs solitus with levocardia. Discordance between visceral and cardiac positions defines situs inversus or heterotaxy.

Question 6Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

In the normal four-chamber view, the fetal heart occupies approximately what fraction of the thoracic cross-sectional area?

  1. About one half
  2. About three quarters
  3. About one quarter
  4. About one third Correct answer.

Explanation

The normal fetal heart occupies roughly one third of the thoracic area in the four-chamber view, corresponding to a cardiothoracic area ratio of about 0.25 to 0.33. Values substantially above one third raise suspicion for cardiomegaly or a high-output state.

Question 7Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

As the great arteries leave the ventricular outflow tracts, the main pulmonary artery normally passes the ascending aorta in which way?

  1. Anterior to it, coursing leftward Correct answer.
  2. Parallel and to its right
  3. Directly anterior without crossing it
  4. Posterior to it, coursing rightward

Explanation

The right ventricular outflow tract and main pulmonary artery pass anterior to the ascending aorta as they course leftward, producing the normal crossing of the great arteries. Loss of this crossing is a hallmark of transposition and related conotruncal anomalies.

Question 8Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

What is the accepted normal fetal heart rate in the second trimester?

  1. 110 to 160 beats per minute Correct answer.
  2. 60 to 100 beats per minute
  3. 80 to 110 beats per minute
  4. 160 to 200 beats per minute

Explanation

The normal fetal heart rate in the second and third trimesters is approximately 110 to 160 beats per minute. Rates persistently below or above this range prompt evaluation for arrhythmia or fetal compromise.

Question 9Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

In the normal fetal four-chamber view, the tricuspid valve annulus lies in what relation to the mitral valve annulus?

  1. Exactly at the same level
  2. More apical, toward the cardiac apex Correct answer.
  3. Variable, depending on cardiac cycle phase
  4. More basal, toward the atria

Explanation

The tricuspid annulus normally inserts slightly closer to the apex than the mitral annulus, creating the characteristic offset at the cardiac crux. Loss of this normal offset suggests an atrioventricular septal defect or Ebstein malformation.

Question 10Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which great-vessel arch produces the 'candy cane' appearance on a longitudinal fetal view?

  1. Inferior vena cava
  2. Ductal arch
  3. Aortic arch Correct answer.
  4. Ductus venosus

Explanation

The aortic arch gives off the brachiocephalic vessels before continuing into the descending aorta, producing the curved 'candy cane' profile. The ductal arch has no arch vessels and instead resembles a 'hockey stick'.

Question 11Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

In a normal three-vessel and trachea view, which of the three vessels is the largest?

  1. Aorta
  2. Superior vena cava
  3. Pulmonary artery Correct answer.
  4. Azygos vein

Explanation

The pulmonary artery and ductal arch are the largest of the three vessels and lie to the left of the aorta, while the superior vena cava is the smallest and lies on the right. Vessel caliber normally decreases from pulmonary artery to aorta to superior vena cava.

Question 12Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

How many pulmonary veins normally enter the left atrium?

  1. Six
  2. Two
  3. Four Correct answer.
  4. One

Explanation

Four pulmonary veins, two from each lung, normally drain into the left atrium. Demonstrating at least one pulmonary vein entering the left atrium helps exclude total anomalous pulmonary venous connection.

Question 13Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

At 24 weeks, the four-chamber view shows right and left ventricles of nearly equal size, with the right ventricle slightly larger and more heavily trabeculated. What is the appropriate interpretation?

  1. Normal fetal appearance Correct answer.
  2. Ebstein anomaly
  3. Right ventricular hypertrophy
  4. Hypoplastic left heart syndrome

Explanation

In the normal fetus the right ventricle is mildly dominant, being slightly larger and more trabeculated than the left, and this mild asymmetry is expected. Pathologic asymmetry is usually accompanied by other findings such as AV valve size discrepancy, chamber compression, or an abnormal cardiac axis.

Question 14Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which chamber normally forms the apex of the fetal heart?

  1. Right ventricle
  2. Right atrium
  3. Left ventricle Correct answer.
  4. Left atrium

Explanation

The left ventricle forms the true cardiac apex and reaches the most distal point of the heart in the normal fetus. The right ventricle is more anterior and does not normally extend to the apex.

Question 15Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

On a short-axis view at the level of the great vessels, which structure appears as a central circle surrounded by the right ventricular outflow tract?

  1. Superior vena cava
  2. A pulmonary vein
  3. Aorta Correct answer.
  4. Main pulmonary artery

Explanation

In the short-axis view the aorta is the central circular structure, with the right ventricular outflow tract and pulmonary artery wrapping around it anteriorly. This plane also displays the pulmonary artery bifurcation.

Question 16Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which cardiac chamber lies most anteriorly, directly behind the sternum, in the normal fetus?

  1. Left ventricle
  2. Right atrium
  3. Right ventricle Correct answer.
  4. Left atrium

Explanation

The right ventricle is the most anterior chamber and lies immediately behind the sternum and anterior chest wall. The left atrium is the most posterior chamber, sitting in front of the descending aorta.

Question 17Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

At the level of the fetal stomach, the inferior vena cava normally lies in what relation to the abdominal aorta?

  1. To the left and anterior
  2. Anterior and to the right Correct answer.
  3. Directly anterior
  4. Posterior and to the left

Explanation

In normal situs the inferior vena cava lies anterior and to the right of the abdominal aorta at the level of the stomach. Reversal of this relationship raises concern for situs inversus or heterotaxy.

Question 18Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

The fetal cardiac axis is measured as the angle between the anterior midline and which structure?

  1. Aortic arch
  2. Atrial septum
  3. Descending aorta
  4. Interventricular septum Correct answer.

Explanation

The cardiac axis is the angle between the interventricular septum and the anterior midline, drawn from the spine to the sternum. It is a simple screen for cardiac malposition and some conotruncal anomalies.

Question 19Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Doppler interrogation of the normal fetal mitral inflow at 22 weeks shows which pattern?

  1. E wave taller than the A wave
  2. Equal E and A waves
  3. A wave taller than the E wave Correct answer.
  4. A single monophasic wave with no A wave

Explanation

In the fetus the A wave produced by atrial systole is normally taller than the early-diastolic E wave because ventricular compliance is low and atrial contraction contributes a larger share of filling. An E wave taller than the A wave, or loss of the A wave, is abnormal in fetal life.

Question 20Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

In the normal fetus, the ductus arteriosus arises from which structure?

  1. Main pulmonary artery Correct answer.
  2. Right ventricle directly
  3. Aortic arch after the left subclavian artery
  4. Ascending aorta just above the valve

Explanation

The ductus arteriosus arises from the distal main pulmonary artery near its bifurcation and joins the descending aorta. It is the continuation of the ductal arch and carries most of the right ventricular output in fetal life.

Question 21Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

At the level of the semilunar valves, the aortic valve normally lies in what relation to the pulmonary valve?

  1. Superior and to the left
  2. Posterior, inferior and to the right Correct answer.
  3. Directly anterior and to the left
  4. At the same level and directly to the right

Explanation

The aortic root lies posterior, inferior, and to the right of the pulmonary valve, which is why the great arteries cross rather than run parallel. Loss of this relationship is a clue to transposition or double-outlet right ventricle.

Question 22Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

At 22 weeks a small echo dropout is seen in the muscular ventricular septum on the four-chamber view when the apex points toward the transducer. What is the most likely explanation?

  1. Beam-septum alignment artifact Correct answer.
  2. A true muscular septal defect
  3. An unclosed foramen ovale
  4. An echogenic intracardiac focus

Explanation

When the ultrasound beam runs parallel to the ventricular septum, the thin muscular portion can appear falsely discontinuous, producing a drop-out artifact. Confirming the finding in a view where the beam is perpendicular to the septum, and with color Doppler, distinguishes artifact from a real defect.

Question 23Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which statement correctly describes the ductal arch in a normal fetus?

  1. It arises from the left ventricle
  2. It gives off no arch vessels Correct answer.
  3. It gives off the three head and neck vessels
  4. It connects the superior vena cava to the right atrium

Explanation

The ductal arch carries the main pulmonary artery into the descending aorta and gives off no branches, which produces its smooth 'hockey stick' contour. The aortic arch, by contrast, gives rise to the brachiocephalic vessels.

Question 24Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

On a short-axis view at the level of the atrioventricular valves, which valve has a 'fish-mouth' appearance?

  1. Aortic valve
  2. Pulmonary valve
  3. Mitral valve Correct answer.
  4. Tricuspid valve

Explanation

In short axis the mitral valve opens as two leaflets that separate like a fish mouth. The tricuspid valve shows three leaflets and does not produce this bifoliate appearance.

Question 25Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

In the normal four-chamber view, the descending aorta is seen in which position relative to the spine?

  1. Posterior, right of the spine
  2. Anterior, left of the spine Correct answer.
  3. Directly behind the spine
  4. Anterior, right of the spine

Explanation

The descending aorta normally lies anterior and to the left of the spine, appearing as a circular echolucent structure. A right-sided descending aorta suggests a right aortic arch or situs abnormality.

Question 26Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

In the normal fetal heart, the flap of the foramen ovale opens into which chamber?

  1. Left atrium Correct answer.
  2. Right ventricle
  3. Right atrium
  4. Left ventricle

Explanation

The foramen ovale is a right-to-left atrial shunt in fetal life. The septum primum flap is pushed into the left atrium because right atrial pressure exceeds left atrial pressure. After birth, left atrial pressure rises and the flap closes functionally.

Question 27Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which normal structure is characteristic of the morphologic right ventricle on fetal echocardiography?

  1. Moderator band Correct answer.
  2. Fish-mouth mitral valve
  3. Smooth apical wall
  4. Two papillary muscles

Explanation

The morphologic right ventricle has coarse trabeculations and a moderator band, also called the septomarginal trabecula, extending from the septum to the anterior papillary muscle. The left ventricle has a smoother apical wall and two papillary muscles. These features help assign ventricular morphology when orientation is uncertain.

Question 28Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

The normal fetal aortic arch gives rise to how many major branches?

  1. Three major branches Correct answer.
  2. Two major branches
  3. Four separate major branches
  4. One major branch

Explanation

The normal aortic arch gives rise to the brachiocephalic (innominate) artery, the left common carotid artery, and the left subclavian artery. The ductus arteriosus is not a branch of the arch; it connects the pulmonary artery to the descending aorta.

Question 29Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which valve separates the right atrium from the right ventricle in the normal fetal heart?

  1. Tricuspid valve Correct answer.
  2. Aortic semilunar valve
  3. Pulmonary semilunar valve
  4. Mitral (bicuspid) valve

Explanation

The tricuspid valve guards the right atrioventricular junction between the right atrium and right ventricle. The mitral valve guards the left atrioventricular junction, and the semilunar valves separate ventricles from great arteries.

Question 30Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

In the normal three-vessel view, what is the left-to-right order of the three vessels?

  1. Pulmonary artery, superior vena cava, aorta
  2. Superior vena cava, aorta, main pulmonary artery
  3. Aorta, main pulmonary artery, superior vena cava
  4. Pulmonary artery, aorta, superior vena cava Correct answer.

Explanation

In the normal three-vessel view, the main pulmonary artery lies farthest left, the aorta is central, and the superior vena cava lies farthest right. The superior vena cava is normally the smallest of the three vessels.

Question 31Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which structure directs oxygenated blood from the inferior vena cava toward the foramen ovale in the normal fetus?

  1. Coronary sinus ostium
  2. Chiari network remnant
  3. Eustachian valve Correct answer.
  4. Septum secundum ridge

Explanation

The Eustachian valve, or valve of the inferior vena cava, helps stream inferior vena caval blood toward the foramen ovale. The Chiari network is a mobile right atrial remnant and does not normally direct flow in this way.

Question 32Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

The main pulmonary artery normally divides into which branches?

  1. Aortic arch and ductus arteriosus
  2. Right and left coronary arteries
  3. Right and left pulmonary arteries Correct answer.
  4. Superior and inferior vena cavae

Explanation

The main pulmonary artery bifurcates into the right and left pulmonary arteries. The ductus arteriosus arises from the main pulmonary artery or proximal left pulmonary artery and connects to the descending aorta.

Question 33Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

An echogenic intracardiac focus in an otherwise normal fetal heart is most commonly located in which chamber?

  1. Right atrium
  2. Left atrium
  3. Right ventricle
  4. Left ventricle Correct answer.

Explanation

An echogenic intracardiac focus is a small bright focus, usually a microcalcification within a papillary muscle. It is most often seen in the left ventricle and is commonly a normal variant.

Question 34Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

The aortic isthmus is the segment of the aorta between which two structures?

  1. Aortic valve and brachiocephalic artery
  2. Ductus arteriosus and descending aorta
  3. Left subclavian artery and ductus arteriosus Correct answer.
  4. Left common carotid and left subclavian arteries

Explanation

The aortic isthmus is the short segment between the origin of the left subclavian artery and the insertion of the ductus arteriosus. It is a site of normal fetal narrowing.

Question 35Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

The membranous portion of the fetal ventricular septum is located in which region?

  1. Between the two atria
  2. Within the right ventricular outflow tract
  3. Near the apex, between trabeculations
  4. Immediately adjacent to the aortic valve Correct answer.

Explanation

The membranous ventricular septum is a small, thin region immediately beneath the aortic valve, continuous with the atrioventricular septum. It is best appreciated in the four-chamber and outflow views.

Question 36Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which cardiac chamber lies most posteriorly in the normal fetal four-chamber view, immediately anterior to the descending aorta?

  1. Right atrium
  2. Right ventricle
  3. Left ventricle
  4. Left atrium Correct answer.

Explanation

In the normal four-chamber view, the left atrium is the most posterior chamber and lies directly anterior to the descending aorta and spine. The right ventricle is the most anterior chamber, behind the sternum.

Question 37Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

In the normal fetus, the cardiac apex points to the left side of the chest. This normal position is termed:

  1. Levocardia Correct answer.
  2. Mesocardia
  3. Dextrocardia
  4. Situs inversus

Explanation

Levocardia describes the normal position in which the cardiac apex points to the left. Dextrocardia points right, mesocardia is midline, and situs inversus is a mirror-image arrangement.

Question 38Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

The coronary sinus in the normal fetal heart lies in which location and drains into which chamber?

  1. Left atrioventricular groove; right atrium Correct answer.
  2. Anterior interventricular groove; right ventricle
  3. Posterior interventricular groove; left ventricle
  4. Right atrioventricular groove; left atrium

Explanation

The coronary sinus runs in the left atrioventricular groove and drains into the right atrium near the inferior vena cava. It collects most coronary venous blood.

Question 39Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which segment of the normal right ventricle is smooth-walled and forms the outflow tract?

  1. Infundibulum Correct answer.
  2. Septomarginal trabecula
  3. Trabecular apex
  4. Inlet component

Explanation

The right ventricle has three components: inlet, trabecular apex, and smooth outlet, also called the infundibulum or conus arteriosus. The infundibulum is a muscular, smooth-walled outflow tract supporting the pulmonary valve.

Question 40Fetal Cardiac Anatomy and Normal Echocardiographic Appearance

Which feature helps identify the morphologic tricuspid valve rather than the mitral valve in the normal fetal heart?

  1. Its septal chordae insert on the ventricular septum Correct answer.
  2. Both leaflets are thin and equally translucent
  3. It is located posterior and superior to the mitral valve
  4. It possesses only two valve leaflets in total

Explanation

The septal leaflet of the tricuspid valve has chordal attachments to the ventricular septum, whereas the mitral valve normally has no septal chordal attachments. This feature, along with the more apical tricuspid annulus, helps identify valve morphology.

Question 41Congenital Heart Disease and Fetal Cardiac Pathology

In hypoplastic left heart syndrome, which cardiac chamber is most characteristically small or absent on the four-chamber view?

  1. Right atrium
  2. Left atrium
  3. Right ventricle
  4. Left ventricle Correct answer.

Explanation

Hypoplastic left heart syndrome involves underdevelopment of the left ventricle together with the mitral valve, aortic valve, and ascending aorta, while the right ventricle is enlarged and supplies the systemic circulation through the ductus arteriosus. The four-chamber view therefore shows a small, slit-like LV alongside a dominant right ventricle.

Question 42Congenital Heart Disease and Fetal Cardiac Pathology

Apical displacement of the septal leaflet of the tricuspid valve is the defining feature of which anomaly?

  1. Ebstein anomaly Correct answer.
  2. Tricuspid atresia
  3. Tricuspid valve dysplasia
  4. Pulmonary atresia with intact ventricular septum

Explanation

In Ebstein anomaly the septal and often posterior tricuspid leaflets insert toward the apex, atrializing part of the right ventricle and causing severe tricuspid regurgitation with massive right atrial enlargement. The result may be hydrops and pulmonary hypoplasia.

Question 43Congenital Heart Disease and Fetal Cardiac Pathology

Which congenital heart defect is most strongly associated with trisomy 21?

  1. Transposition of the great arteries
  2. Atrioventricular septal defect Correct answer.
  3. Coarctation of the aorta
  4. Tetralogy of Fallot

Explanation

Failure of the endocardial cushions to fuse produces a common atrioventricular junction with a primum atrial septal defect and an inlet ventricular septal defect, and this lesion is the cardiac defect most strongly linked to trisomy 21. The four-chamber view shows loss of the normal crux.

Question 44Congenital Heart Disease and Fetal Cardiac Pathology

What is the most common primary cardiac tumor in the fetus?

  1. Hemangioma
  2. Rhabdomyoma Correct answer.
  3. Teratoma
  4. Fibroma

Explanation

Rhabdomyoma is the most frequently encountered fetal cardiac tumor; it is often multiple and ventricular, strongly associated with tuberous sclerosis, and frequently regresses spontaneously after birth. Large lesions may obstruct inflow or outflow or provoke arrhythmia.

Question 45Congenital Heart Disease and Fetal Cardiac Pathology

The normal fetal cardiac axis measured in the four-chamber view is approximately:

  1. 45 degrees Correct answer.
  2. 75 degrees
  3. 135 degrees
  4. 15 degrees

Explanation

The normal axis is roughly 45 degrees from the anteroposterior midline, with an accepted range of about 25 to 65 degrees, measured at end-diastole. Values outside this range warrant detailed assessment for conotruncal anomalies, Ebstein anomaly, or extracardiac causes.

Question 46Congenital Heart Disease and Fetal Cardiac Pathology

The most characteristic fetal cardiac finding in an infant of a diabetic mother is:

  1. Ventricular septal defect
  2. Pericardial effusion
  3. Dilated cardiomyopathy
  4. Septal hypertrophy Correct answer.

Explanation

Maternal hyperglycemia drives fetal hyperinsulinemia, which produces myocardial and particularly septal hypertrophy; the hypertrophy is often asymmetric and may cause dynamic outflow obstruction. It usually regresses over the first months of life.

Question 47Congenital Heart Disease and Fetal Cardiac Pathology

Which view is used to identify the crux of the heart and both atrioventricular valves?

  1. Short-axis view
  2. Four-chamber view Correct answer.
  3. Three-vessel trachea view
  4. Aortic arch view

Explanation

The four-chamber view displays both atria, both ventricles, the interventricular and interatrial septa, the foramen ovale flap, and the crux with both atrioventricular valves. This is why it forms the cornerstone of fetal cardiac screening.

Question 48Congenital Heart Disease and Fetal Cardiac Pathology

Complete heart block in a fetus with a structurally normal heart is most strongly associated with which maternal finding?

  1. Anti-Ro/SSA antibodies Correct answer.
  2. Maternal hyperthyroidism
  3. Maternal diabetes
  4. Maternal rubella infection

Explanation

Maternal anti-Ro/SSA and anti-La antibodies cross the placenta and can injure the fetal atrioventricular node, producing first- to third-degree block in a heart that is otherwise structurally normal. Exposed pregnancies are monitored with serial echocardiography.

Question 49Congenital Heart Disease and Fetal Cardiac Pathology

In d-transposition of the great arteries, the two great arteries are best described as:

  1. Parallel and non-crossing Correct answer.
  2. Joined by a single truncal valve
  3. Both arising from the right ventricle
  4. Crossing at the outlet septum

Explanation

In d-transposition the aorta arises anteriorly from the right ventricle and the pulmonary artery posteriorly from the left ventricle, so the vessels run parallel rather than crossing. This appears as loss of the normal crossover in the outflow-tract views.

Question 50Congenital Heart Disease and Fetal Cardiac Pathology

Which additional finding is expected in tetralogy of Fallot?

  1. A common atrioventricular valve
  2. Pulmonary stenosis Correct answer.
  3. Aortic atresia
  4. Parallel great arteries

Explanation

Tetralogy of Fallot comprises a ventricular septal defect, an overriding aorta, pulmonary outflow tract obstruction, and secondary right ventricular hypertrophy. The severity of the pulmonary stenosis determines whether the pulmonary circulation is ductal dependent.