Cardiology Flashcards
for patients with low risk, stable chest pain without known CAD, what two options are reaonable to proceed with for further evaluation?
CAC or exercise stress testing
t/f USPSTF found that the harms of screening low risk patients who are asymptomatic with exercise stress testing outweigh benefits
true
what calculator should be used to determine need for further testing in a patient with stable chest discomfort with known triggers?
CAD consortium 2 calculator
what is the standard criterion for the diagnosis of exercise induced ischemia on stress EKG?
horizontal or downsloping ST segments
t/f studies show an inverse relationship between METs achieved on exercise stress testing and mortality
true
what are the two chemical forms of stress test?
dobutamine and Lexiscan
what two modalities can be used to conduct myocardial perfusion scan?
CT or PET
perfusion defects seen on myocardial perfusion imaging that are present with stress but not at rest indicate what?
ischemia
on myocardial perfusion imaging, perfusion deficits that present with both rest and stress indicate what?
prior infarction
what pathway can be used to risk stratify patients with acute chest pain?
HEART score
in a patient with acute chest pain with high risk for ACS, what is generally the next step?
invasive coronary angiography
patients with acute chest pain and intermediate risk of ACS without known history of CAD should undergo what?
further evaluation with GXT, MPI or CMR imaging
in a patient with stable chest pain at intermediate or high risk without known CAD, in addition to stress echo, MPI, CMR, stress EKG, what other modality for testing may be appropriate?
CTCA
a patient without known CAD but with HTN and HLD and 3 months of chest pain has a low CAD consortium 2 risk. what are the two next potential options for evaluation of possible CAD?
CAC score or GXT
what is the cutoff for METs needed during stress testing to qualify for exercise stress testing?
at least 5 METS
t/f conditions such as COPD, chronic renal insufficiency and inflammatory conditions cause increase in troponin levels
true
what is thhe recommended test for evaluation in an intermediate risk patient with stable chest pain?
CTCA
in the case of afib, what intervention is more effective for acute rhythm control than medications?
electrical cardioversion
in up to what percentage of patients does afib recur after catheter ablation?
40%
in the case of newly diagnosed afib, what adjunct cardiac study should be done?
echo
t/f caffeine abstinence helps reduce the risk of afib
false
what is the most important risk factor for afib?
HTN
in what two cardiac settings would warfarin be preferred for anticoagulation in afib?
mechanical heart valve or severe mitral stenosis
what is the threshold CHADSVASC score for anticoagulation in men and women?
men: 2 or greater
women: 3 or greater
for how long is anticoagulation indicated after acute synchronized cardioversion for the treatment of acute rhythm control in afib?
4 weeks
what are the only two safe medication options for rhythm control in afib in a patient with reduced ejection fraction?
dofetilide and amiodarone
for how long after ablation should anticoagulation be continued in the treatment of afib?
3 months
t/f surgical exclusion / occlusion of the left atrial appendage have decreased CV, stroke, and all cause mortality
true
t/f exercise based cardiac rehab reduces the risk of short term all cause mortality in patients with HF with or without reduced EF
false
