Adult Echocardiography Practice Exam

If the inferior vena cava, superior vena cava, and hepatic veins demonstrate systolic flow reversal, what type of valvular abnormality is likely present?

1. Severe mitral regurgitation

2. Severe tricuspid regurgitation

3. Mild mitral regurgitation

4. Mild tricuspid regurgitation

The correct answer is: Severe tricuspid regurgitation

Systolic flow reversal in the inferior vena cava, superior vena cava, and hepatic veins is indicative of increased right atrial pressure and significant backflow issues, particularly associated with conditions affecting the right side of the heart. In the context of valvular abnormalities, severe tricuspid regurgitation results in significant retrograde flow in the venous return pathways during systole, as the elevated pressures in the right atrium push blood back through the tricuspid valve into the systemic venous circulation. In severe tricuspid regurgitation, the ability of the valve to close effectively during systole is compromised, leading to a situation where blood does not adequately move forward into the right ventricle but instead regurgitates back into the venous system. This creates abnormal blood flow patterns observable on echocardiography, including reversed flow in the IVC, SVC, and hepatic veins. In contrast, conditions such as severe mitral regurgitation primarily affect the left side of the heart and typically do not cause the same retrograde flow in the inferior and superior vena cava. Mild forms of mitral or tricuspid regurgitation would not generate sufficient pressure gradients to produce the notable flow reversal seen with severe cases. Thus