Exam Content Outline

The American Registry of Diagnostic Medical Sonographers publishes its exam outlines and other important information on its website (www.ARDMS.org). Visit the site for complete information about applying for and taking the registry examinations. The outline for each exam indicates the approximate percentage of the exam that a particular topic represents. This information is important because it indicates the relative importance of each topic and allows you to study more effectively. For example, the topic of structural heart anomalies represent 35%–55% of the Fetal Echo exam, whereas normal fetal heart physiology represents 4%–8%.

The complete outline for the Fetal Echocardiography specialty examination appears below.

I. Embryology (1%–5%)
A. Timing of heart formation    B. Teratogenic insults    C. Atrial septal components    D. Endocardial cushion    E. d- and l-looping
II. Indications (1%–5%)
A. Maternal    B. Fetal    C. Environmental
III. Incidence of congenital heart disease (5–10%)
A. General population    B. Heredity    C. Chromosomal    D. Syndromes    E. Extracardiac anomalies
IV. Timing of the fetal echocardiographic exam (1%–5%)
A. American Institute of Ultrasound in Medicine Standards
V. Standard sonographic views (10%–20%)
A. Position/Situs         1. Cardiac Axis         2. Cardiac Position    B. Two-dimensional heart views         1. Four-chamber              a. Apical              b. Subcostal         2. Long axis of the aorta (Left ventricular outflow tract)         3. Long axis of the pulmonary artery (Right ventricular outflow tract)         4. Short axis of the ventricles         5. Short axis of the great arteries         6. Aortic arch         7. Ductal arch         8. Five-chamber view         9. Three-vessel view         10. Inferior vena cava/Superior vena cava    C. Doppler Hemodynamics (Pulsed / Color)         1. Regurgitation         2. Stenosis         3. Intracardiac shunts         4. Dysrhythmias    D. M-mode         1. Dysrhythmias         2. Ventricular function         3. Color
VI. Normal fetal heart anatomy (8%–12%)
A. Size    B. Venous connections         1. Superior vena cava         2. Inferior vena cava         3. Pulmonary veins    C. Atria and septum    D. Atrioventricular valves    E. Ventricles and septum    F. Outflow tracts    G. Semilunar valves    H. Great arteries    1. Pulmonary artery    2. Aorta    3. Ductal arch    I. Pericardium    J. Other
VII. Normal fetal heart physiology (4%–8%)
A. Heart rate    B. Blood flow and cardiac output    C. In-utero shunts         1. Ductus venosus         2. Foramen ovale         3. Ductus arteriosus    D. Series circulation
VIII. Structural heart anomalies (35%–55%)
A. Cardiac malposition         1. Levocardia         2. Dextrocardia         3. Mesocardia         4. Levoposition         5. Dextroposition    B. Enlarged heart         1. Dilated cardiomyopathy         2. Hypertrophic cardiomyopathy              a. Type I diabetes mellitus              b. Syndromes    C. Venous abnormalities         1. Bilateral superior vena cava         2. Interrupted inferior vena cava with azygous continuation         3. Pulmonary venous abnormalities              a. Total anomalous pulmonary venous connection              b. Partial anomalous pulmonary venous connection              c. Pulmonary vein stenosis    D. Atria and septum         1. Atrial septal defect              a. Primum              b. Secundum              c. Sinus venosus              d. Unrooted coronary sinus         2. Dilated coronary sinus              a. Left superior vena cava to coronary sinus              b. Anomalous veins to coronary sinus              c. Right atrial obstruction         3. Cor triatriatum         4. Eustachian valve         5. Restrictive foramen ovale    E. Atrioventricular valves         1. Tricuspid valve              a. Atresia              b. Stenosis              c. Regurgitation                   (1) Ebstein anomaly              d. Dysplasia         2. Mitral valve              a. Atresia              b. Stenosis                   (1) Parachute                   (2) Supravalvular mitral ring              c. Regurgitation                   (1) Cleft    F. Ventricles and septum         1. Ventricular septal defect              a. Membranous              b. Muscular              c. Inlet              d. Outlet              e. Atrioventricular septal defect         2. Endocardial fibroelastosis         3. Tumors              a. Rhabdomyoma              b. Other    G. Semilunar valves         1. Pulmonary valve              a. Atresia              b. Stenosis              c. Insufficiency              d. Absence         2. Aortic valve              a. Atresia              b. Stenosis              c. Regurgitation              d. Absence    H. Great arteries         1. Transposition of the great arteries              a. d-Transposition of the great arteries              b. l-Transposition of the great arteries         2. Truncus arteriosus         3. Coarctation of the aorta         4. Interrupted aortic arch         5. Ductal constriction              a. Premature              b. Pharmacologic              c. Tetralogy of Fallot              d. Subaortic stenosis              e. Double outlet right ventricle    I. Pericardium         1. Pericardial effusion         2. Pericardial tumor    J. Complex cardiac anomalies         1. Single ventricle         2. Hypoplastic left heart syndrome         3. Hypoplasia of the right ventricle         4. Double inlet left ventricle         5. Heterotaxy    K. Miscellaneous         1. Echogenic intracardiac focus
IX. Dysrhythmias (5%–10%)
A. Bradyarrhythmias         1. Congenital heart block         2. Blocked ectopic beats    B. Tachyarrhythmias         1. Supraventricular tachycardia         2. Atrial flutter         3. Ventricular tachycardia    C. Ectopy         1. Premature atrial contractions         2. Premature ventricular contractions
X. Acquired pathology (1%–5%)
A. Metabolic/Endocrine         1. Type I diabetes mellitus         2. Phenylketonuria         3. Collagen vascular disease         4. Hyperthyroidism    B. Infection         1. TORCH         2. Parvovirus    C. Twin-to-twin transfusion    D. Intrauterine growth restriction    E. Drugs
XI. Miscellaneous (1%–5%)
A. Hydrops fetalis    B. Extracardiac anomalies    C. Syndromes

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