Echocardiography Techniques II Exam 2 Practice

Aortic stenosis creates a pressure overload on the left ventricle, and the heart initially responds with concentric hypertrophy to generate higher systolic pressures needed to push blood through the narrowed valve. On 2D echocardiography this shows up as increased LV wall thickness (LV hypertrophy). Over time, the stiff, hypertrophied left ventricle raises filling pressures, leading to left atrial enlargement. The high-velocity jet through the stenotic valve also distorts flow in the aorta, producing post-stenotic dilation of the ascending aorta and characteristic contour changes such as systolic bowing of the aortic root and an oval-shaped orifice at the valve. Put together, LV hypertrophy, LA enlargement, post-stenotic aortic dilation, and the described aortic root/valve morphology form the pattern most consistent with aortic stenosis on 2D echo. The other patterns don’t fit because they either miss the LV hypertrophy and LA enlargement expected with chronic pressure overload, or they describe findings more aligned with other conditions (for example, normal heart size without LVH, or isolated posterior wall thickening, which isn’t the typical diffuse LVH seen with AS, and findings like pulmonary edema with a dilated right heart point to different pathophysiology).