Cardiology

Question 1

Possible ECG finding for 52 / M , smoker, hypertensive, diabetic, (+) severe , crushing chest pains, cold sweats, shortness of breath 1hr duration?

Answer 1

I. 3-4mm ST elevation in V1-V6
II. 3-4mm ST depression in V1-V6
III. Diffusely low QRS voltages with pathologic Q waves
IV. T wave inversion in V1-V5, I, II, III, AVF , AVL

Question 2

52/M , smoker , hypertensive, diabetic , severe ceushing chest pains , cold sweats, shortness of breath 1 hr duration.
Trop I= 0.40 ng/ml
BP: 80/60
HR: 120 bpm
Most appropriate intervention?

Answer 2

Percutaneous coronary intervention

Question 3

Symptoms of myocardial ischemia other than angina are called ? Examples?

Answer 3

Anginal equivalents
( Dyspnea, Nausea, Fatigue, Faintness)

Question 4

Atypical presentation of myocardial ischemia is more common in what population? (3)

Answer 4

1. Elderly
2. Women
3. Diabetic

Question 5

Clenched fist over the chest to indicate squeezing substernal discomfort in patients with myocardial ischemia?

Answer 5

Levine’s sign

Question 6

1st heart sound is heard during?

Answer 6

Isovolumic Contraction

Question 7

2nd heart sound is heard during?

Answer 7

Isovolumic relaxation

Question 8

3rd heart sound is heard during?

Answer 8

Rapid Inflow

Question 9

4th heart sound is heard during?

Answer 9

Atrial Systole

Question 10

Most widely used test for the diagnosis of ischemic heart disease?

Answer 10

12- Lead ECG before, during and after exercise (stress test).

Question 11

Positive ECG stress test finding for ischemic heart disease?

Answer 11

Flat or down sloping depression of ST segment.

( T wave abnormalities and conduction disturbances are noted but are not diagnostic)

Question 12

Commonly used anti-anginal drugs for the treatment of angina pectoris?

Answer 12

Beta blockers
CCB
Nitrates

Question 13

Pivotal diagnostic and triage tool that decides direction of management in patients presenting with acute coronary syndrome?

Answer 13

12- lead ECG