Adult Echocardiography Practice Exam

An increase in EPSS on m-mode is indicative of what condition?

1. A. aortic regurgitation

2. B. systolic anterior motion of the anterior mitral valve leaflet

3. C. mitral regurgitation

4. D. aortic stenosis

The correct answer is: A. aortic regurgitation

An increase in the E-point septal separation (EPSS) measured on M-mode echocardiography is primarily indicative of impaired left ventricular systolic function. This is because EPSS measures the distance between the E-point of the mitral valve and the interventricular septum during early diastole, which reflects how well the heart is pumping blood. In the context of this question, an increase in EPSS is typically associated with conditions that lead to reduced left ventricular contraction ability, such as aortic regurgitation. In aortic regurgitation, the left ventricle can be volume-overloaded over time, leading to dilation and reduced contractility. This would cause the EPSS to increase, indicating that the mitral leaflets are not approaching the septum as closely during early diastole due to decreased forward flow from poor systolic function of the left ventricle. In contrast, other conditions such as systolic anterior motion of the anterior mitral valve leaflet or early mitral regurgitation may have different echocardiographic signs or would not specifically lead to an increase in EPSS. Aortic stenosis can also affect left ventricular function, but the EPSS is more closely tied to volume overload and resultant dilation