Cardio

Question 1

What is the gold standard inx to diagnose and define the location of obstruction in superior vena cava syndrome?

Answer 1

Conventional catheter based central venography

Question 2

Treatment of acute papillary muscle rupture post MI causing acute mitral regurgitation?

Answer 2

Medical and surgical emergency

• IV nitroprusside to reduce after load (limited by systemic hypotension)
• if in cardiogenic shock: inotropes and pressors
• intra aortic balloon pump to reduce after load and increase forward flow in preparation for surgery

Urgent surgical consult for early MV repair

Question 3

Mitral regurgitation: mitral valve repair vs replacement

Answer 3

MV repair is typically preferred especially in pts with isolated disease affecting <1/2 of the posterior leaflet
- assoc with superior outcomes compared to MV replacement

MV replacement in those with extensive rheumatic MV disease for eg

Question 4

first line tx of symptomatic premature ventricular contractions?

Answer 4

BB or CCB
- BB preferred in patients with ventricular dysfunction