Adult Echocardiography Practice Exam

Which cusp is affected by aortic calcification as shown in the parasternal long axis image?

1. Right coronary cusp

2. Posterior coronary cusp

3. Non-coronary cusp

4. Left coronary cusp

The correct answer is: Non-coronary cusp

The non-coronary cusp is commonly affected by aortic calcification, particularly in cases of age-related degenerative changes or chronic aortic stenosis. In a parasternal long-axis echocardiographic image, calcification in this area can lead to a decrease in the cusp's mobility, contributing to valvular stenosis and potential regurgitation. This cusp is situated between the right and left coronary cusps and is not directly associated with the coronary arteries, which may influence the patterns observed in calcified valves. Aortic calcification often presents in a symmetrical pattern on echocardiographic imaging, but it frequently targets the non-coronary cusp, making it the most likely candidate for identifiable lesion in this context. Understanding this relationship is crucial for evaluating aortic valve function and diagnosing related heart conditions. The other cusps may also have calcifications, but the non-coronary cusp has a well-documented tendency to be affected in many patients who have aortic disease, particularly in the elderly population.