Adult Echocardiography Practice Exam

In an echocardiogram, a prominent a-wave in the atrial pressure wave is typically seen in which condition?

1. A. aortic regurgitation

2. B. mitral stenosis

3. C. tricuspid regurgitation

4. D. pulmonary hypertension

The correct answer is: B. mitral stenosis

A prominent a-wave in the atrial pressure wave is particularly indicative of mitral stenosis. In this condition, the left atrium faces difficulties during diastole due to the narrowing of the mitral valve, leading to elevated pressure in the left atrium. As the atrium contracts to push blood into the ventricle, this contraction produces a pronounced a-wave due to the increased pressure gradient against the obstructed mitral valve. In healthy individuals, the a-wave is present but not overly accentuated. However, with mitral stenosis, the impaired blood flow through the valve results in the left atrium contracting with greater force to overcome the resistance, hence creating a more prominent a-wave. This prominent a-wave can be detected during echocardiographic examination, highlighting the pressure dynamics within the atrium and assisting in diagnosing mitral stenosis. The presence of this feature is one of the crucial echocardiographic criteria used to evaluate and confirm the diagnosis.