Chest and cardiac imaging: dobutamine stress echocardiography: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Chest and cardiac imaging: dobutamine stress echocardiography

Sample item

A patient with a recent anterior infarct and a hypokinetic septum has a dobutamine stress echocardiogram. At low dose the segment improves, and at peak dose it worsens. What does this biphasic response indicate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Viable myocardium supplied by a critically stenosed artery

Improvement at low dose shows contractile reserve in viable myocardium, and deterioration at high dose shows that the supplying vessel cannot meet demand. This biphasic response is the best predictor of recovery after revascularisation. Scar shows no response and normal myocardium improves throughout.

Option by option

  • A. Transmural scar

    Transmural scar has no contractile reserve and does not improve at low dose.

  • B. Normal myocardium

    Normal myocardium becomes hyperdynamic with increasing dose.

  • C. Viable myocardium supplied by a critically stenosed artery (correct)

    Correct. Biphasic response means viable but ischaemic myocardium.

  • D. Constrictive pericarditis

    Constriction is a pericardial disease and does not give a segmental response.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Viable myocardium supplied by a critically stenosed artery. Improvement at low dose shows contractile reserve in viable myocardium, and deterioration at high dose shows that the supplying vessel cannot meet demand.

Why is "Transmural scar" not the answer?

Transmural scar has no contractile reserve and does not improve at low dose.

Why is "Normal myocardium" not the answer?

Normal myocardium becomes hyperdynamic with increasing dose.

Why is "Constrictive pericarditis" not the answer?

Constriction is a pericardial disease and does not give a segmental response.

What concept does this question test?

It tests Chest and cardiac imaging: dobutamine stress echocardiography in Radiology. This biphasic response is the best predictor of recovery after revascularisation. Scar shows no response and normal myocardium improves throughout.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Chest and cardiac imaging: dobutamine stress echocardiography?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.