Adult Echocardiography Practice Exam

Which echocardiographic finding suggests constrictive pericarditis?

1. Thickened pericardium

2. Decreased left ventricular compliance

3. Increased left atrial size

4. Cardiac mass

The correct answer is: Thickened pericardium

The presence of a thickened pericardium is a hallmark echocardiographic finding suggesting constrictive pericarditis. In this condition, the pericardium, which is the fibrous sac surrounding the heart, becomes markedly thickened and fibrotic. This thickening restricts the heart's ability to expand properly during diastole, leading to impaired ventricular filling. Echocardiography can visualize this abnormality, and a thickened pericardial layer is often noted, typically measuring greater than 2-3 millimeters. While decreased left ventricular compliance and increased left atrial size can be associated with various forms of heart disease, they are not specific indicators of constrictive pericarditis. Decreased compliance reflects a reduced ability of the ventricle to stretch and fill, but this can occur in a variety of conditions beyond constrictive pericarditis, such as hypertensive heart disease or restrictive cardiomyopathy. Similarly, increased left atrial size can result from various cardiac issues, including atrial fibrillation or left ventricular diastolic dysfunction, and is not exclusive to constrictive pericarditis. The presence of a cardiac mass, which refers to an abnormal growth within the heart, is also