Closure of which valve, in concert with the tricuspid valve, marks the beginning of systole and causes the first heart sound (S1)?StatPearls, Physiology, Cardiac Cycle, section "Mechanism"
During isovolumic relaxation, what is the state of the aortic and mitral valves?StatPearls, Physiology, Cardiac Cycle, section "Mechanism"
From which veins does the superior vena cava originate?StatPearls, Anatomy, Thorax, Heart Great Vessels, section "Structure and Function"
On pulsed wave Doppler of mitral inflow, what produces the A wave?StatPearls, Atrial Kick, section "Key Clinical Considerations"
What are the two papillary muscles of the left ventricle called?StatPearls, Anatomy, Thorax, Heart Papillary Muscles, section "Structure and Function"
What joins the papillary muscles to the leaflets of the mitral and tricuspid valves?StatPearls, Anatomy, Thorax, Heart Papillary Muscles, section "Introduction"
Which leaflets does the mitral valve have?StatPearls, Anatomy, Thorax, Mitral Valve, section "Structure and Function"
Which period of the cardiac cycle lies between closure of the mitral valve and opening of the aortic valve?StatPearls, Physiology, Cardiac Cycle, section "Mechanism"
Show all 55 questions (47 more)
Pathology 22
A large pericardial effusion can produce electrical alternans on the ECG. What motion of the heart does it result from?StatPearls, Cardiac Tamponade, section "Evaluation"
After patent foramen ovale, which type of atrial septal defect is the most frequent?StatPearls, Atrial Septal Defect, section "Continuing Education Activity"
How does secondary mitral regurgitation differ from primary mitral regurgitation?StatPearls, Mitral Regurgitation, section "Introduction"
How is dilated cardiomyopathy characterized?StatPearls, Dilated Cardiomyopathy, section "Continuing Education Activity"
How is pulsus paradoxus defined?StatPearls, Pulsus Paradoxus, section "Continuing Education Activity"
In cardiac tamponade, when does right ventricular collapse occur?StatPearls, Cardiac Tamponade, section "Evaluation"
In classical asymmetric left ventricular hypertrophy of hypertrophic cardiomyopathy, which region is most commonly affected?StatPearls, Hypertrophic Cardiomyopathy, section "Pathophysiology"
In constrictive pericarditis, what is "septal bounce"?StatPearls, Constrictive Pericarditis, section "Evaluation"
In patients with nonvalvular atrial fibrillation, what is the primary site of thrombus formation?StatPearls, Anatomy, Thorax, Heart Left Atrial Appendage, section "Clinical Significance"
In the staging table for mitral stenosis, which pair of findings marks severe stenosis?StatPearls, Mitral Stenosis, section "Evaluation"
On what does the Stanford system base its two types of aortic dissection?StatPearls, Aortic Dissection, section "Introduction"
What characterizes Ebstein anomaly?StatPearls, Ebstein Anomaly and Malformation, section "Continuing Education Activity"
What distinguishes restrictive cardiomyopathy?StatPearls, Restrictive Cardiomyopathy, section "Introduction"
What does chronic rheumatic heart disease do to the mitral valve to cause mitral stenosis?StatPearls, Mitral Stenosis, section "Introduction"
What is systolic anterior motion (SAM) of the mitral valve in hypertrophic cardiomyopathy?StatPearls, Hypertrophic Cardiomyopathy, section "Pathophysiology"
What is the most common primary cardiac tumor in adults, and where does it most often arise?StatPearls, Atrial Myxoma, section "Continuing Education Activity"
Where is the narrowing of coarctation of the aorta typically located?StatPearls, Coarctation of the Aorta, section "Introduction"
Which congenital valve forms are named among the etiologies of aortic stenosis?StatPearls, Aortic Stenosis, section "Continuing Education Activity"
Which finding in the inferior vena cava is highly sensitive for cardiac tamponade?StatPearls, Cardiac Tamponade, section "Evaluation"
Which inferior vena cava finding is listed among the echocardiographic signs that suggest pulmonary hypertension?StatPearls, Pulmonary Hypertension, section "Table 4: Echocardiographic Signs Suggestive of Pulmonary Hypertension"
Which set of findings characterizes tetralogy of Fallot?StatPearls, Tetralogy of Fallot, section "Continuing Education Activity"
Which type of ventricular septal defect is the most common?StatPearls, Ventricular Septal Defect, section "Pathophysiology"
Clinical care and safety 6
How long is a patient required to fast before a transesophageal echocardiogram?StatPearls, Echocardiography Imaging Techniques, section "Preparation"
In which position is the patient placed for the parasternal and apical views?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
Which of these is a relative, not an absolute, contraindication to transesophageal echocardiography?StatPearls, Echocardiography Imaging Techniques, section "Contraindications"
Which of these is an absolute contraindication to transesophageal echocardiography?StatPearls, Echocardiography Imaging Techniques, section "Contraindications"
Which statement about transthoracic echocardiography is correct?StatPearls, Echocardiography Imaging Techniques, section "Contraindications"
Why are ECG leads placed for an echocardiographic examination?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
Measurement techniques, maneuvers and views 13
At what ratio of pulmonary to systemic flow (Qp/Qs) is an atrial shunt called significant?StatPearls, Atrial Septal Defect, section "Pathophysiology"
From the parasternal long axis position, a tilt of the transducer brings the right ventricular inflow into view. What is this view good for?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
From the parasternal long axis position, how is the parasternal short axis view obtained?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
From which window are the inferior vena cava and the hepatic veins brought into view for right-sided hemodynamic assessment?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
How is an M-mode image displayed?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
In hypertrophic cardiomyopathy, what does the Valsalva maneuver do to the systolic ejection murmur of outflow obstruction?StatPearls, Hypertrophic Cardiomyopathy, section "History and Physical"
In quantifying mitral regurgitation, what is the vena contracta?StatPearls, Mitral Regurgitation, section "Evaluation"
In the parasternal long axis view, which structure is at the top of the image?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
What does the apical five-chamber view add to the apical four-chamber view?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
What is the suprasternal view used to assess?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
Which equation lets Doppler velocities be used to detect pressure gradients?StatPearls, Echocardiography Imaging Techniques, section "Introduction"
Which left ventricular walls are assessed in the apical four-chamber view?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
Which view is traditionally the first view of a standard transthoracic examination?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
Instrumentation, optimization and contrast 6
How should the Doppler beam be aligned with the jet of blood flow?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
In a "bubble study", agitated saline is injected and bubbles are watched for passage between the atria. What is the study looking for?StatPearls, Echocardiography Imaging Techniques, section "Clinical Significance"
On pulsed wave Doppler, a velocity above the Nyquist limit wraps around the baseline. What is this called?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
What does time gain compensation (TGC) do?StatPearls, Echocardiography Imaging Techniques, section "Equipment"
What is the trade-off of a higher-frequency probe?StatPearls, Echocardiography Imaging Techniques, section "Equipment"
Why is continuous wave Doppler used for high velocities such as the jet of aortic stenosis?StatPearls, Echocardiography Imaging Techniques, section "Technique or Treatment"
How this list was compiled: Our own questions, written to the five domains of the Adult Echocardiography Examination Content Outline, version 24.2, that ARDMS publishes through Inteleos (https://www.inteleos.org/wp-content/uploads/2026/05/AE-Content-Outline_v24.2.1.pdf, linked from https://www.inteleos.org/exam/adult-echocardiography/, read 2026-10-12): anatomy and physiology 15%, pathology 40%, clinical care and safety 11%, measurement techniques, maneuvers and sonographic views 25%, instrumentation, optimization and contrast 9%. The bank holds 8, 22, 6, 13 and 6 questions. Every fact was read on 2026-10-12 in the StatPearls chapter the question names (StatPearls Publishing, on the NCBI Bookshelf, https://www.ncbi.nlm.nih.gov/books/NBK430685/), read through Europe PMC's copy of the book: Echocardiography Imaging Techniques; Ultrasound Adult Echocardiography Assessment, Protocols, and Interpretation; Physiology, Cardiac Cycle; Atrial Kick; four anatomy chapters; and the chapters on mitral stenosis, aortic stenosis, mitral regurgitation, hypertrophic, dilated and restrictive cardiomyopathy, cardiac tamponade, pulsus paradoxus, constrictive pericarditis, atrial and ventricular septal defect, tetralogy of Fallot, Ebstein anomaly, coarctation of the aorta, aortic dissection, atrial myxoma and pulmonary hypertension. Licence: Questions, choices and explanations are original work of this site.
How it works
This free ARDMS echocardiography practice test has 55 questions of our own in the five domains of the Adult Echocardiography (AE) exam. Unofficial: not affiliated with or endorsed by the American Registry for Diagnostic Medical Sonography (ARDMS) or Inteleos.
Read the full guide
What the exam covers
The ARDMS Adult Echocardiography content outline, version 24.2, read October 12, 2026, has five domains. Pathology is the largest: valve disease, cardiomyopathies, pericardial disease, masses, septal defects and other congenital heart disease.
Where the answers come from
Each answer names a StatPearls chapter on the NCBI Bookshelf and its section, such as Echocardiography Imaging Techniques or Mitral Stenosis. No registry review book or question bank was used.
Text only, and timing
The real exam shows images and clips and asks hotspot questions. This bank is text only. Exam mode asks 50 questions in 60 minutes, the pace of the real exam.
Practice the views on a scanner or with an atlas as well. A text question cannot train you to read an image.
Questions and answers
Are there more ARDMS adult echo free practice tests here?
No. This page holds the one, free with no sign-up. Its 55 questions come in a new order each time.
How many questions are on the ARDMS adult echo exam?
About 150 multiple-choice questions over three hours, by the ARDMS exam page. Some are hotspot questions, answered by marking directly on an image.
What is the passing score for the ARDMS echo exam?
555 on a scale from 300 to 700, by the ARDMS exam page. It is not a percentage and is not curve-based, so a number right here cannot be converted to it.
Do I need the SPI exam as well as the AE exam?
Yes, for the RDCS credential. ARDMS requires both the AE specialty exam and the SPI exam, passed within five years of each other, in any order.