Cardiac catheterization Flashcards

1
Q

For assessing the cause of arterial desaturation, which of the following is not useful?

a. Double-sampling dye curves
b. Repeat determination of the saturation after administration of 100% O2
c. Pulmonary vein saturation
d. Single-sampling dye curve: RA to FA
e. Saline contrast injection under two-dimensional echocardiography

A

a. Double-sampling dye curves

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2
Q

In patients with known stable CAD, which of the following statements is not true?

a. Death and MI can be prevented by percutaneous revascularization
b. MI can be prevented and LV function preserved with CABG surgery
c. In nondiabetic patients, CABG surgery and percutaneous revascularization have similar rates of subsequent death, MI, and subsequent revascularization
d. Improved survival is observed after CABG (compared to medical therapy) for patients with three-vessel disease and either LV dysfunction or class III to IV symptoms

A

d. Improved survival is observed after CABG (compared to medical therapy) for patients with three-vessel disease and either LV dysfunction or class III to IV symptoms

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3
Q

A 58-year-old man presents with atypical chest pain. Coronary angiography reveals a 60% diameter stenosis in the mid-LAD coronary artery. Which of the following intracoronary US or Doppler measurements is the most sensitive for determining if this intermediate stenosis is hemodynamically significant?

a. Luminal area
b. Proximal-to-distal velocity ratio
c. Coronary flow reserve
d. Percent plaque area in the stenosis
e. Absolute coronary flow

A

c. Coronary flow reserve

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4
Q

A 58-year-old man with multiple CAD risk factors presents with a 1-year history of DOE and exertional chest pressure. He has had orthopnea and an episode of paroxysmal nocturnal dyspnea.

■ Laboratory findings: serum potassium 4.5; creatinine 3.2
■ ECG shows nonspecific ST abnormalities
■ Echocardiography shows a mildly dilated LV; EF 25% to 30%; global hypokinesis
■ Coronary angiography shows an 80% stenosis of proximal LAD, 85% proximal LFX, 90% mid-RCA; distal vessels are good caliber

The appropriate next step includes:

a. Surgical consultation for CABG
b. Rest thallium test with delayed imaging
c. Initiation of spironolactone therapy
d. All of the above

A

b. Rest thallium test with delayed imaging

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5
Q

Ventriculography:

a. Must be performed in the LAO view in addition to the RAO view to visual-ize the posterior portion of the LV
b. Can be used to quantify MR and AR
c. Is associated with a significantly higher risk of complications than coronary angiography
d. Permits the accurate and reproducible assessment of both MR and LV wall motion

A

a. Must be performed in the LAO view in addition to the RAO view to visual-ize the posterior portion of the LV

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6
Q

Abrupt closure following coronary angioplasty:

a. Is more common in men than women
b. Is reduced in high risk patients pretreated with abciximab (Reopro)
c. Occurs most frequently in LAD lesions
d. Occurs less frequently with directional atherectomy in comparison to balloon angioplasty

A

b. Is reduced in high risk patients pretreated with abciximab (Reopro)

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