Echocardiography Board Review🫀👩🏻‍⚕

Echocardiography Board Review🫀👩🏻‍⚕

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Updated: May 19, 2026 at 1:57 PM

Echocardiography Board Review🫀👩🏻‍⚕

Channel to post articles, questions and insights relating to Echocardiography, Cardiology and Cardiac Imaging

@echocardiographyboardreview offers specialized information about cardiology and channel for subscribers interested in Blogging

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 29, 2026, 03:14 PM

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 29, 2026, 03:14 PM

Week 2 – "Right Heart Matters"

This week, we will cover the right heart in detail. Stay tuned!🫀

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 29, 2026, 03:14 PM

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 29, 2026, 03:14 PM

🩺 Echo Insight: Propagation Velocity (Vp)

What is it?
Measured using Color M-mode, Vp reflects LV relaxation.

Normal:
👉 Vp ≥50 cm/s

Interpretation:
• Low Vp (<50 cm/s) → Impaired relaxation

Bonus:
👉 E/Vp ratio helps estimate filling pressures
• E/Vp >2.5 → Elevated LV filling pressure

💡 Take-home:
Vp is useful when E/A is misleading (especially pseudonormal cases).

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 29, 2026, 03:14 PM

⚠️Echo Pitfall: Pseudonormal Pattern

The trap:
E/A appears normal (1–1.5) → mistaken as normal filling

But actually:
• e′ is reduced
• LA is enlarged
• Filling pressures are elevated

👉 This is Grade II diastolic dysfunction

How to unmask it:
• Use TDI (e′)
• Check E/e′
• Look at LA volume
• Perform Valsalva maneuver (E/A may reverse)

💡 Take-home:
Not everything that looks normal is normal — diastology is a pattern, not a number.

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 29, 2026, 03:14 PM

🩺 Echo Insight: E/A Ratio

What is it?
The E/A ratio is derived from mitral inflow Doppler:
• E wave = early diastolic filling
• A wave = atrial contraction

Normal:
👉 E/A ≈ 1–1.5

Interpretation:
• E/A <1 → Impaired relaxation (Grade I)
• E/A 1–2 → Can be normal or pseudonormal
• E/A >2 → Restrictive filling (Grade III)

💡 Take-home:
E/A alone is not enough — always combine with TDI and LA size.

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 29, 2026, 03:14 PM

🩺 Echo Insight: E/e′ Ratio

What is it?
Ratio of mitral E velocity to mitral annular e′ (TDI).

Why it matters:
👉 Estimates LV filling pressures

Cut-offs:
• E/e′ <8 → Normal filling pressures
• E/e′ >14 → Elevated filling pressures
• 8–14 → Indeterminate (needs more parameters)

💡 Take-home:
E/e′ is one of the most practical bedside tools for diastolic assessment

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 29, 2026, 03:14 PM

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 29, 2026, 03:14 PM

Last month we covered major Echocardiography signs 🫀. This month, we're launching a learning series on various topics! 📚 Watch out for insights, pitfalls, and quizzes 🧩.

This week, we begin with "Diastology demystified" 🔍.

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 29, 2026, 03:14 PM

🩺 Echo Sign of the Day – Right Ventricular Diastolic Collapse

*What it looks like:
The right ventricular free wall collapses inward during early diastole, instead of maintaining its normal contour.

*Where to see it:
• Best seen in subcostal and parasternal long-axis (PLAX) views and M-Mode
• Pay close attention to timing — occurs in early diastole

*What it indicates:
• A key echocardiographic sign of cardiac tamponade

*Why it happens:
In cardiac tamponade, rising pericardial pressure exceeds RV diastolic pressure, causing the thin-walled right ventricle to collapse during filling.

💡 Clinical Pearl:
RV diastolic collapse is more specific for tamponade, while right atrial collapse is more sensitive. Always interpret along with IVC plethora and clinical findings.

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 16, 2026, 01:29 PM

🩺 Echo Sign of the Day – Swinging Heart Sign

*What it looks like:
The heart appears to swing freely within the pericardial sac, moving back and forth with each cardiac cycle.

*Where to see it:
• Best seen in subcostal and apical views
• Occurs in the presence of a large pericardial effusion

*What it indicates:
• Suggestive of a massive pericardial effusion
• May be associated with cardiac tamponade

*Why it happens:
A large volume of pericardial fluid allows the heart to become relatively mobile within the pericardial cavity, leading to this characteristic pendular motion.

💡 Clinical Pearl:
The swinging motion can cause electrical alternans on ECG—a key clue in large pericardial effusions. Always assess for tamponade signs such as chamber collapse and IVC plethora.

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 16, 2026, 01:29 PM

🎥 Video

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 16, 2026, 01:29 PM

🩺 Echo Sign of the Day – Spade-Shaped Left Ventricle

*What it looks like:
The left ventricular cavity appears narrow at the base and widened at the apex, resembling a “spade” shape (like a playing card symbol).

*Where to see it:
• Best seen in the apical 4-chamber view
• Most evident during end-diastole

*What it indicates:
• Classic finding in apical hypertrophic cardiomyopathy (Apical HCM)

*Why it happens:
Marked hypertrophy of the apical myocardium reduces the apical cavity size and alters LV geometry, creating the characteristic spade-like configuration.

💡 Clinical Pearl:
If you suspect apical HCM, consider contrast echocardiography or cardiac MRI to better delineate the apex—this variant can be easily missed on routine echo.

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 16, 2026, 01:29 PM

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 16, 2026, 01:29 PM

🩺 Echo Sign of the Day – Septal Bounce

*What it looks like:
A characteristic abrupt, early diastolic motion of the interventricular septum, appearing as a “bounce” or shudder toward the left ventricle.

*Where to see it:
• Parasternal long-axis (PLAX) or short-axis (PSAX) views
• Also well seen on M-mode

*What it indicates:
• Classic sign of constrictive pericarditis

*Why it happens:
In constrictive pericarditis, the non-compliant pericardium limits ventricular expansion, leading to exaggerated ventricular interdependence.
During inspiration, increased RV filling shifts the septum toward the LV, producing the characteristic bounce.

💡 Clinical Pearl:
Combine septal bounce with findings like annulus reversus and respiratory variation in mitral inflow to confidently diagnose constrictive physiology.

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 16, 2026, 01:29 PM

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 16, 2026, 01:29 PM

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 12, 2026, 10:53 PM

🩺 Echo Sign of the Day – McConnell Sign

*What it looks like:
A distinctive pattern where the right ventricular (RV) mid-free wall is akinetic, while the RV apex shows preserved or hyperdynamic contraction.

*Where to see it:
• Best seen in the apical 4-chamber view
• Focus on RV wall motion

*What it indicates:
• Classically associated with acute pulmonary embolism (PE)

*Why it happens:
Acute increase in RV afterload leads to regional dysfunction of the mid-free wall, while the apex is relatively spared—possibly due to shared myocardial fibers with the left ventricle.

💡 Clinical Pearl:
McConnell sign is suggestive but not specific for PE—it can also be seen in RV infarction. Always correlate with clinical findings and additional imaging.

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 12, 2026, 10:53 PM

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 12, 2026, 10:53 PM

🩺 Echo Sign of the Day – Apical Sparing Pattern/Cherry on top appearance 🍒

*What it looks like:
On longitudinal strain (bull’s-eye plot), the apical segments are relatively preserved (red) while the basal and mid segments show reduced strain (blue)— creating a characteristic “cherry-on-top” appearance.

*Where to see it:
• Speckle-tracking echocardiography (GLS strain imaging)
• Displayed on the polar (bull’s-eye) map

*What it indicates:
• Highly suggestive of cardiac amyloidosis

*Why it happens:
Amyloid deposition predominantly affects the basal and mid myocardial segments, while the apex remains relatively spared, leading to this distinct strain pattern.

💡 Clinical Pearl:
Apical sparing helps differentiate cardiac amyloidosis from other causes of LV hypertrophy (like hypertensive heart disease or HCM), where this pattern is typically absent.

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Echocardiography Board Review🫀👩🏻‍⚕

Apr 12, 2026, 10:53 PM

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