cardio 11

Question 1

First-degree AV block management?

Answer 1

Observatory

Question 2

When we need a further evaluation?

Answer 2

When symptomatic(24 hour ECG monitoring)

Question 3

Why?

Answer 3

since highly associated with HF and AFib

Question 4

When will be patient with a previous diagnosis of MI will have a high risk of SCD?

Answer 4

When a patient has systolic cardiac dysfunction which not respond to medication.

Question 5

What will be the MCC of SCD in these patients?

Answer 5

Ventricular tachycardia

Question 6

How we manage?

Answer 6

Intracardiac defibrilator.

Question 7

WPWS pathophysiology?

Answer 7

abnormal electrical conduction from atria to ventricle that bypass AV node called bendele of kent.

Question 8

ECG future?

Answer 8

Short PR interval < 120(ventricular preexitation)
Delta waves(Ventricular preexitation)
QRS widening(VP)
ST and T wave abnormality(Change in 2ndary depolarization)
This ECG future may not visible when patient have in episode of RSVT as complication.

Question 9

Complication?

Answer 9

Supraventricular re-enteratnt tachycardia

SCD

Question 10

Management?

Answer 10

If the patient has AFib or Aflu with rapid ventricular response give amiodarone/Procainamide and avoid drug slow AV nodal activity.
cardioversion in hemodynamically unstable patient
do risk stratification

Question 11

Risk stratification Importance?

Answer 11

High-risk patient (When have the accessory way have lower repolarization time done with cardiac stimulation in cardiac electrophysiology testing)–They need catheter ablation of a bundle of kent.
If have high repolarization time and reappearance of delta wave during stimulation—low risk–observe

Question 12

Definition of QT prolongation?

Answer 12

> 450 in males

>470 in females

Question 13

When we do pharmacologic stress test?

Answer 13

For  diagnosis of stable angina when patient not able to do ECG exercise stress test like patient with
lower extremity and joint problems
LBB
Pacemaker
Patient unable to get target HR

Question 14

What pharmacologic agent used for stress tests?

Answer 14

Adenosin(analog:regadenoson and regadenoson)

Dipyiridamol(PDE inhibitor)

Question 15

Mechanism?

Answer 15

No effect in HR/BP unlike EST
Coronary artery vasodilation-Increase B/F to non obstructed area several-fold to that of the ischemic area(detected by radioisotope)–induce ischemia

Question 16

Contraindication to PST?

Answer 16

Reactive airway disease

Patient taking dipyridamole or methylxanthines

Question 17

Exercise ST mechanism?

Answer 17

Increase HR

Increase B/P

Question 18

EST best for

Answer 18

Patient able to reach target HR(Which is 85%, of (220 -age patient))

Question 19

Dobutamine-induced echocardiography used for?

Answer 19

Patient with reactive airway disease and

Patient unable to reach the target HR

Question 20

Goal?

Answer 20

Increase HR/BP

Question 21

Not Used?

Answer 21

Patient with tachyarrhythmia

Question 22

What do we see?

Answer 22

wall motion abnormality in echo after dopamine administration

Question 23

MCC of AR in a developed nation?

Answer 23

BAV(Sporadic or Autosomal dominant)

Question 24

Clinical menifestation?

Answer 24

If cause valvular AR(Murmur in LSB)
If vause aortic root (murmur in R@ICS)
Age presentation(30-40), lower than when it causes AS

Question 25

Pulses paradoxus definition?

Answer 25

Drop-in systolic B/P more than 10 during inspiration.

Question 26

Role of tectenium injected(photoemission) CT scan?

Answer 26

Use for diagnosing Ischemic heart disease

It is passively defused to perfused myocardium

Question 27

Interpretation?

Answer 27

same both at rest and exercise test–normal
decrease only in exercise stress–Stable A
decrease both at rest and exercise–scaring with IHD and CAD

Question 28

Management of stable angina?

Answer 28

Lifestile modification
beta-blocker
Asprine