Adult Echocardiography Practice Exam

Acute aortic insufficiency may be associated with all of the following EXCEPT:

1. pulmonary vein systolic flow reversal

2. decreased deceleration time of mitral valve inflow

3. pulmonary edema

4. sinus tachycardia

The correct answer is: pulmonary vein systolic flow reversal

Acute aortic insufficiency leads to a rapid volume overload of the left ventricle due to the backflow of blood from the aorta during diastole. This condition can manifest in various clinical and echocardiographic findings. The phenomenon of pulmonary vein systolic flow reversal is typically associated with severe pulmonary hypertension or elevated left atrial pressures, which can occur in conditions like mitral stenosis or other forms of left heart failure but is not a direct consequence of acute aortic insufficiency. In acute aortic insufficiency, the left ventricle may not yet cause significant upstream effects on pulmonary circulation, especially not to the extent that would reverse pulmonary vein flow. On the other hand, decreased deceleration time of mitral valve inflow in acute aortic insufficiency is related to the increased stroke volume that reaches the left atrium and subsequently impacts the mitral inflow pattern. This can arise because the left ventricle struggles to accommodate the large volume returning to it. Pulmonary edema is a possibility because the acute volume overload can lead to increased pressures in the left atrium and subsequently in the pulmonary circulation, resulting in pulmonary congestion. Sinus tachycardia can occur as a compensatory response to the reduced effective circulating