Adult Echocardiography Practice Exam

A small fibroelastic protrusion on the aortic valve in older patients may represent which of the following?

1. Chiari's network

2. Osler nodes

3. Lambl's excrescence

4. Janeway lesions

The correct answer is: Lambl's excrescence

In older patients, a small fibroelastic protrusion on the aortic valve is most commonly identified as Lambl's excrescence. These are thin, fibrous filaments or projections that may appear on the edges of heart valves, particularly the aortic valve. Lambl's excrescences are often considered benign and are not associated with significant valve pathology or hemodynamic compromise. The presence of such protrusions can be an incidental finding on echocardiography and may sometimes be mistaken for more serious conditions, but they are generally recognized as a normal variant that can occur with aging. Their appearance is linked to the natural aging process of the heart valves, where degeneration can lead to the formation of these small outgrowths. The other options refer to distinct medical conditions. For instance, Chiari's network is a fibrous structure in the right atrium, often considered a variant of normal anatomy, but unrelated to valve structures. Osler nodes and Janeway lesions are associated with infective endocarditis and represent different manifestations of infection rather than benign findings on the aortic valve. Thus, Lambl's excrescence appropriately fits the description of a small fibroelastic protrusion found on the aortic valve in older adults.