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Cardiology > ACCSAP Pearls > Flashcards

ACCSAP Pearls Flashcards

1
Q

Risk factors for patient-prosthesis mismatch (PPM)

A

small valve, large BSA, female, low LVEF, young age, Afib, severe MR or TR

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2
Q

What vessel causes high lateral MI

A

OM

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3
Q

At what timepoints should asymptomatic patients with bpMVR get TTEs?

A

5yrs post-op, 10yrs, then annually

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4
Q

Quantitative TTE findings in severe MR

A

EROA >/= 0.4 cm^2
RF >/= 50%
RVol >/= 60 mL
VCV >/= 0.7 cm

(Every Fat Vegan Cooks: E-F-V-C, 4-5-6-7)

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5
Q

Echo criteria for bpAV patient-prosthesis mismatch

A
  1. DVI 0.25-0.29
  2. AT <100ms
  3. Normal valve
  4. EOA index <0.65
  5. LV stroke volume normal
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6
Q

What is Galectin-3?

A

Mediator of cardiac fibrosis. Class IIb for HF risk stratification, associated with increased HF readmission, arrhythmias, and mortality.

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7
Q

Agaston score cutoff (by sex) for severe AS in suspected LFLG AS

A

Women: >1300
Men: >2000

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8
Q

Hibernating myocardium is defined as:

A

Bimodal response for a hypokinetic area on dobutamine stress echo.
Low dose –> improves (contractile reserve)
Peak stress –> akinetic (ischemic response)

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9
Q

Post-MI 1* prevention ICD indication

A

LVEF <30% while receiving GDMT (regardless of NYHA functional class) >40 days post-MI

MADIT-II (NEJM, 2002)

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10
Q

Cilostazol mechanism

A

PDE3 inhibitor –> systemic vasodilation

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11
Q

Valvular criterion in revised Ghent nosology for Marfans

A

mitral valve prolapse

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12
Q

How often should aortic root be imaged in Marfan

A

At time of diagnosis then 6mo later to ensure stability
Then Annually (more frequent if >4.5cm)

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13
Q

Where are Lambl’s excrescences seen?

A

Ventricular surface of AV

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14
Q

How is cancer therapy-related cardiac dysfunction (CRTCD) defined?

A

Drop in LVEF >/=10% in asx patients or >/=5% in sx patients

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15
Q

Surgical bpAVR or bpMVR antithrombotic regimen

A

Initial 3-6mo: warfarin (INR goal 2.5)
Lifelong: Aspirin 81mg daily

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16
Q

Provoking factors for Brugada

A

Flecainide, procainamide (Class I AADs–use to challenge type 2+3)
Cocaine
Fever
Anesthesia (propofol, lidocaine)
TCAs
RV ischemia/PE

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17
Q

What does PCSK9 stand for

A

proprotein convertase subtilisin/kexin type 9

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18
Q

Agents used to test for vasospastic angina during LHC

A

methylergonovine
acetylcholine

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19
Q

STEMI criteria

A

> /=2mm STE (1.5 in women) V2-3 or 1mm in any 2 other contiguous leads
/=0.5mm isolate STD in V1-3

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20
Q

PCI door to balloon time goal

A

90 minutes if PCI-capable hospital
120 minutes if transfer

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21
Q

What is Fabry disease?

A

X-linked alpha-galactosidase deficiency –> sphingolipid myocardial deposition –> biV thickening (with increased QRS voltage)

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22
Q

How does amiodarone increase digoxin levels?

A

Amio inhibits p-glycoprotein

23
Q

EOA index indicating severe mitral PPM

A

</=0.9 cm^2/m^2

24
Q

Doppler parameters of prosthetic MV function suggesting significant stenosis

A

pV >/= 2.5m/s
MG > 10mmHg
VTIprmv/VTIlvot > 2.5
EOA < 1cm^2
PHT >200ms

25
Q

Treatment for C. albicans endocarditis

A

Surgical removal of valve (class I indication)

26
Q

Fabry disease MRI LGE pattern

A

basal-inferolateral mid-wall

27
Q

ICD indications in HCM

A
  1. Prior SCD or sustained VT (class I)
  2. SCD in first degree relative (IIa)
  3. wall thickness >30mm (IIa)
  4. Unexplained recent syncope (IIa)
  5. LVEF <50% or apical aneurysm (IIa)
  6. NSVT on holter or LGE >15% burden on MRI (IIb)
28
Q

Fabry manifestations

A

angiokeratomas
acroparesthesias (severe episodes of distal limb pain)
anhidrosis

29
Q

MVA equation and cutoff for severe

A

MVA=220/PHT
Severe <1.5

30
Q

CMR finding in hereditary hemochromatosis

A

T2* relaxation time <20ms
(<10ms = more severe disease)

31
Q

Diagnostic rest/exercise PCWP for HFpEF diagnosis

A

> 15 mmHg at rest or >25 mmHg with exercise

32
Q

Most common pathogens for myocarditis

A

Classically: enteroviruses such as coxsackievirus
More recently: parvovirus B19 and human herpesvirus 6

33
Q

neprilyisin action

A

breaks down BNP, allowing for its continued effects on LV remodeling/RAAS system

(sac/val –> higher BNP, lower NT-proBNP

34
Q

HTN definition for 24h mean, daytime mean, and nighttime mean

A

24h: >130/80
Day: >135/85
Night: >120/70

35
Q

Class IV AADs & mechanism

A

CCBs
Prolongs phase 2

36
Q

Five steroid-sparing agents for 2nd/3rd line sarcoid tx

A

mycophenolate
methotrexate
infliximab
adalimumab
azathioprine

37
Q

Cardioprotective agent against anthracycline-induced cardiotoxicity and cumulative doxorubicin dose to qualify for it

A

Dexrazoxane
>300 mg/m^2 doxorubicin

38
Q

When does anthracycline cardiotoxicity present and what cumulative dose of doxorubicin significantly increases risk for toxicity?

A

within 12 months

39
Q

In a normal pregnancy, when is the greatest reduction in BP seen?

A

18 weeks gestation
(progesterone -> drop SVR)

40
Q

Indications for aortic surgery in bicuspid aortopathy

A

Class 1: Root >5.5cm (regardless of need for AVR)
Class 2a: Root >5cm plus additional risk factor (fam hx dissection, growth >0.5cm in one year, coarctation)
Class 2a: Root >4.5cm if performing AVR anyways

41
Q

Early afterdepolarizations are a type of triggered activity that lead to…

A

TdP or PMVY

42
Q

Delayed afterdepolarizations are a type of triggered activity that occur in…

A

Acute MI
Digoxin toxicity (bidirectional VT)
CPVT

43
Q

Most common cause of flail MV leaflet

A

Myxomatous MV disease

44
Q

LMCA IVUS MLA for revasc benefit

A

<6 mm^2
(LITRO study)

45
Q

Loeys-Dietz manifestations

A

TAA, bifid uvula, easy brusing

46
Q

Hakki equation

A

AVA = CO / sqrt(peak-peak gradient)

47
Q

Ezetimibe MOA

A

Inhibit Niemann-Pick C1-Like 1 protein –> inhibit intestinal cholesterol absorption

48
Q

Which class III AAD increases the defibrillation threshold

A

Amiodarone

49
Q

Mean 24h BP to diagnose HTN

A

125/75

50
Q

QP/QS formula

A

QP/QS = Ao-MV / PV-PA

51
Q

What flower is atropine from

A

Bella Donna

52
Q

What flower is dig from

A

Foxglove

53
Q

Collectively, the imaging criteria used to diagnose ICI myocarditis are known as…

A

2018 Lake Louise Criteria

Cardiology (9 decks)

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