Cardiology - random topics

Question 1

indications for permanent pacemaker placement

Answer 1

symptomatic bradycardia (without reversible cause)
complete heart block
Mobitz type II second degree heart block
Alternating bundle branch block

Question 2

type of SVT that can be reversed with vagal maneuvers

Answer 2

AVNRT

Question 3

type of SVT that cannot be reversed with vagal maneuvers

Answer 3

atrial tachycardia

Question 4

What should be ordered/done if there are discrepancies between aortic stenosis clinical and echocardiographic findings in symptomatic patients?

Answer 4

cardiac catheterization

Question 5

What test should be done for asymptomatic patients with aortic stenosis to prove that they are indeed asymptomatic?

Answer 5

Stress test

Question 6

Parameters for severe aortic stenosis

Answer 6

Aortic valve area <1.0 cm2
Aortic valve peak velocity >4 m/s
Aortic valve mean gradient >40 mmHg

Question 7

What should be ordered/done when there are discrepancies on echo findings and symptoms of mitral regurgitation?

Answer 7

Cardiac MRI or TEE

Question 8

What should be ordered/done for patients with rheumatic mitral stenosis who have discrepancies between echo findings and symptoms?

Answer 8

Exercise echo or exercise testing during cardiac catheterization

Question 9

2 aortic stenosis exceptions (that do not follow parameters for severe AS)

Answer 9

Low flow low gradient AS w/ severe LV dysfunction
Paradoxical low flow low gradient AS w/ preserved LV function

Question 10

Testing to determine if low flow low gradient AS is true AS or pseudo-AS?

Answer 10

Dobutamine echo or dobutamine cardiac cath
(dobutamine will cause increase in valve area above 1 cm in pseudostenosis)

Question 11

Who needs to be screened for AAA with abdominal duplex?

Answer 11

All Men aged 65-75 yo who have ever smoked

Question 12

Who requires perioperative warfarin bridging?

Answer 12

patients ag high risk for cardiovascular or embolic event off anticoagulation
Patients who had embolic stroke within past 3 months
Patients with CHADSVASC score >7

Question 13

High risk features of pericarditis

Answer 13

fever
Leukocytosis
Acute trauma
Abnormal cardiac biomarkers
Large pericardial effusion
Oral anticoagulant use
Immunocompromise
Evidence of cardiac tamponade

Question 14

Management of peripheral artery disease

Answer 14

exercise program
Statin
Antiplatelet monotherapy
Cilostazol (vasodilator)
Revascularization

Question 15

Diastolic rumble

Answer 15

severe mitral regurgitation

Question 16

Patient with angina who cannot undergo exercise ECG stress testing that are high risk for ischemic disease

Answer 16

cardiac catheterization

Question 17

Patient with angina who cannot undergo exercise ECG stress testing that are intermediate risk for ischemic disease and are age >65 and more obstructive disease expected

Answer 17

dobutamine stress testing
vasodilator nuclear medicine stress testing

Question 18

avoid vasodilator cardiac stress imaging in these patients

Answer 18

patients with COPD (as it can cause bronchospasm)

Question 19

Patient with angina who cannot undergo exercise ECG stress testing that are intermediate risk for ischemic disease and are age <65 and less obstructive disease expected

Answer 19

coronary CTA