Cardiology Flashcards
What is the best initial stress test for a patient who can exercise and has normal baseline EKG
exercise EKG
high value care
Should patients on HD be on statins?
no
high value care
What intervention can reduce early readmission for heart failure
follow up within 1 week of discharge
high value care
Do you need treatment or follow up for an asymptomatic PFO
no
high value care
How should you manage uncomplicated VSD?
periodic clinical follow up and imaging
high value care
What is the primary treatment for patients with PAD who are asymptomatic
risk factor modification
high value care
In a patient with an ABI greater than 1.4 how do you evaluate for PAD?
toe- brachial index (see cards q #24)
high value care
when should you replace a bicuspid aortic valve?
iso clinically significant regurgitation:
- symptomatic HF
- asymptomatic LVEF <50%
when should you replace a valve in acute AR?
immediately!
when should you replace valve in chronic AR?
if the patient is sypmtomatic regardless of LV systolic function
LVEF < 50%
when should you replace the mitral valve in mitral stenosis?
percutaneous balloon mitral commissurotomy for symptomatic patients and asymptomatic if valve area < 1.0
surgical repair if balloon valvotomy is not possible
when should you replace the mitral valve in mitral regurgitation?
- acute MR
- chronic MR if symptomatic
- asymptomatic MR with LVEF <60% or LV end systolic diameter <40
- PH 2/2 MR
- new onset AF
- chronic MR iso another planned cardiac surgery
best diagnostic test to evaluate a suspected prosthetic heart valve dysfunction?
TEE
what is the goal INR for a prosthetic aortic valve?
2.5
what is the goal INR for a prosthetic aortic valve with thromboembolism risk factors
3.0
What is the treatment for Prinzmetals’
long acting nitrate, CCB
What is the treatment for Takutsubo’s
ACEi, BB
who needs spironolactone or eplerenone s/p MI
EF <40%, clinical HF or diabetes
What is the most predictive EKG finding of RV infarct
ST segment elevation on R sided EKG lead V4R
tx: IVF
who needs an ICD post-MI
> 40 days since MI
LVEF <35% and NYHA class II or II or LVEF <30% and NYHA class I
> 3 months since PCI or CABG
