Cardiovascular Medicine Flashcards
1
Q
What is indicated by a late-peaking systolic murmur, diminished S2, and delayed and diminished carotid upstroke?
A
Severe aortic stenosis
MKSAP 20
2
Q
What are the indications for repair in chronic severe primary mitral regurgitation?
A
Symptoms; asymptomatic and EF <60%, and/or LV end-systolic diameter >40 mm
MKSAP 20
3
Q
What is the new onset of LV dysfunction at the end of pregnancy or after delivery called?
A
Peripartum cardiomyopathy
MKSAP 20
4
Q
What is the treatment for acute type A aortic dissection?
A
Surgical repair
MKSAP 20
5
Q
What is the treatment of stable angina refractory to optimal medical therapy?
A
PCI or CABG
MKSAP 20
6
Q
What baseline ECG abnormalities warrant imaging along with stress testing?
A
ST segment depression, LVH, LBBB, digitalis effect, preexcitation, paced beats
MKSAP 20
7
Q
What is the treatment of atrial myxoma?
A
Surgical excision
MKSAP 20
8
Q
What is the treatment of end-stage HF in nontransplant candidates?
A
LVAD
MKSAP 20
9
Q
What are the symptoms of critical limb ischemia?
A
Leg pain at rest and skin ulceration
MKSAP 20
10
Q
What are the asymptomatic murmurs that require TTE evaluation?
A
Grade ≥3/6, late systolic or holosystolic, diastolic, or continuous
MKSAP 20
11
Q
Which P2Y12 inhibitor has dyspnea as a side effect?
A
Ticagrelor
MKSAP 20
12
Q
What is the BP target for the prevention of symptomatic HF?
A
<130/80 mm Hg
MKSAP 20
13
Q
What are the physical findings in chronic mitral regurgitation?
A
Blowing holosystolic murmur, systolic click, S3, lateral displacement of apical impulse
MKSAP 20
14
Q
What condition is indicated by bounding peripheral pulses and a diastolic decrescendo murmur along the sternal border?
A
Aortic regurgitation
MKSAP 20
15
Q
What is an alternative for aspirin-intolerant patients with CAD?
A
Clopidogrel
MKSAP 20
16
Q
What is the impact of obesity on BNP levels?
A
Lowers
MKSAP 20
17
Q
What are the primary symptoms of severe aortic stenosis?
A
Dyspnea, angina, syncope
MKSAP 20
18
Q
What are the risk factors for digoxin toxicity?
A
Impaired kidney function, older age, female sex
MKSAP 20
19
Q
What is the treatment of acute aortic regurgitation due to aortic dissection?
A
Emergent surgical repair
MKSAP 20
20
Q
What are the USPSTF criteria for starting statin therapy for primary prevention of ASCVD?
A
Adults aged 40 to 75 with ≥1 ASCVD risk factor and a 10-year ASCVD risk ≥10%
MKSAP 20
21
Q
What is the most common cause of tricuspid stenosis?
A
Rheumatic disease
MKSAP 20
22
Q
What is the indication for pacemaker implantation in atrial fibrillation?
A
Permanent atrial fibrillation with symptomatic bradycardia
MKSAP 20
23
Q
What causes acute severe mitral regurgitation after STEMI?
A
Papillary muscle rupture
MKSAP 20
24
Q
What is the leading cause of death in patients with TAA?
A
Ruptured aneurysm
MKSAP 20
25
What is indicated by a holosystolic murmur along the left sternal border that increases with inspiration?
Tricuspid regurgitation
| MKSAP 20
26
Initial nondrug therapy of acute SVT
Vagal maneuvers
| MKSAP 20
## Footnote
Vagal maneuvers can include techniques such as the Valsalva maneuver or carotid sinus massage to increase vagal tone and potentially terminate the SVT.
27
Effect of medical therapy for valvular heart disease on survival
None
| MKSAP 20
## Footnote
Medical therapy may help manage symptoms but does not improve survival rates in valvular heart disease.
28
Vascular complication of Marfan syndrome during pregnancy
Aortic dissection and rupture
| MKSAP 20
## Footnote
Pregnant individuals with Marfan syndrome are at increased risk for serious cardiovascular events, particularly involving the aorta.
29
Concentric ventricular wall thickness with low QRS voltage
Cardiac amyloidosis
| MKSAP 20
## Footnote
This condition often presents with structural heart changes and electrical abnormalities on ECG.
30
Cardiac biomarker to distinguish restrictive cardiomyopathy (elevated) from constrictive pericarditis (normal)
BNP
| MKSAP 20
## Footnote
B-type natriuretic peptide (BNP) levels are typically elevated in restrictive cardiomyopathy but remain normal in constrictive pericarditis.
31
Treatment of symptomatic bradycardia without reversible cause
Permanent pacemaker
| MKSAP 20
## Footnote
A pacemaker is indicated to maintain adequate heart rate and prevent symptoms in patients with persistent bradycardia.
32
Medical therapy for chronic aortic regurgitation and hypertension
Dihydropyridine calcium channel blockers, ACE inhibitors, or ARBs
| MKSAP 20
## Footnote
These medications help manage blood pressure and reduce the volume overload on the heart.
33
Indications for sleep assessment in HF
NYHA functional class II-IV with excessive daytime sleepiness or suspected sleep-disordered breathing
| MKSAP 20
## Footnote
Heart failure patients may suffer from sleep apnea, which can worsen overall health.
34
Drug therapy for persistent PAD symptoms despite supervised exercise training, antiplatelet and statin therapy
Cilostazol
| MKSAP 20
## Footnote
Cilostazol is indicated for improving symptoms of intermittent claudication in peripheral artery disease.
35
Drug that lowers mortality and HF hospitalization 20% compared with enalapril in patients with symptomatic HFrEF
Valsartan-sacubitril
| MKSAP 20
## Footnote
This combination therapy is effective in managing heart failure with reduced ejection fraction.
36
Indications for intervention in aortic coarctation
Systolic pressure gradient ≥20 mm Hg, evidence of collateral flow, upper extremity hypertension
| MKSAP 20
## Footnote
These criteria help determine when surgical or catheter-based intervention is necessary.
37
ACC/AHA LDL cholesterol threshold for starting statin therapy for primary prevention regardless of other risk factors
≥190 mg/dL
| MKSAP 20
## Footnote
This threshold indicates a high level of LDL cholesterol that warrants treatment to reduce cardiovascular risk.
38
Drug infused during pharmacologic stress echocardiography
Dobutamine
| MKSAP 20
## Footnote
Dobutamine is often used to simulate exercise in patients unable to perform physical stress tests.
39
Wolff-Parkinson-White syndrome first-line treatment
Catheter ablation
| MKSAP 20
## Footnote
Catheter ablation is a definitive treatment for this condition, addressing the accessory pathway responsible for the arrhythmia.
40
Treatment of tachycardia-mediated cardiomyopathy
Heart rate control with drugs
| MKSAP 20
## Footnote
Managing the heart rate is crucial to prevent further deterioration of cardiac function.
41
Predisposition to constrictive pericarditis
Previous cardiac surgery, pericarditis, chest radiation
| MKSAP 20
## Footnote
These factors can lead to scarring and thickening of the pericardial layer, contributing to constrictive physiology.
42
Pulmonary stenosis, short stature, neck webbing, hypertelorism
Noonan syndrome
| MKSAP 20
## Footnote
Noonan syndrome is a genetic disorder that can present with various congenital anomalies, including cardiac defects.
43
Optimal pretest probability of CAD for stress testing
Intermediate (10%-90%)
| MKSAP 20
## Footnote
This range indicates a significant chance of coronary artery disease, warranting further evaluation.
44
Immediate diagnostic test for acute limb ischemia
Invasive angiography
| MKSAP 20
## Footnote
This test provides detailed images of blood vessels to identify occlusions or blockages.
45
Noncardiac causes of elevated BNP levels
CKD, older age, female sex, ARNI therapy
| MKSAP 20
## Footnote
These factors can cause elevated BNP levels that may not be related to heart failure.
46
Biatrial enlargement; diastolic dysfunction; normal LV size, thickness, function
Restrictive cardiomyopathy
| MKSAP 20
## Footnote
This condition is characterized by impaired filling of the heart due to rigid ventricular walls.
47
Drugs to inhibit SVT induction and block AV conduction
β-Blockers and nondihydropyridine calcium channel blockers
| MKSAP 20
## Footnote
These medications are effective in managing supraventricular tachycardias.
48
Indications for warfarin anticoagulation in moderate to severe mitral stenosis
Atrial fibrillation, left atrial thrombus, or systemic embolization
| MKSAP 20
## Footnote
Anticoagulation is crucial in these scenarios to prevent thromboembolic complications.
49
Imaging to distinguish different subtypes of cardiac amyloid
99m-Technetium pyrophosphate scintigraphy
| MKSAP 20
## Footnote
This imaging modality helps identify the specific type of amyloidosis affecting the heart.
50
Imaging test for suspected arrhythmogenic RV cardiomyopathy/dysplasia
CMR imaging
| MKSAP 20
## Footnote
Cardiac magnetic resonance imaging provides detailed images of the right ventricle and can help diagnose this condition.
51
Recommended heart valve type for patients older than 65 years
Bioprosthesis
| MKSAP 20
## Footnote
Bioprosthetic valves are often preferred in older patients due to lower risk of thromboembolism.
52
Primary management of hypertriglyceridemia
Decreased caloric intake to achieve 5%-10% weight loss; reduced consumption of alcohol, sugar, and total fat
| MKSAP 20
## Footnote
Lifestyle modifications are crucial in managing hypertriglyceridemia.
53
Treatment of chronic pericardial constriction
Pericardiectomy
| MKSAP 20
## Footnote
This surgical procedure involves removing the pericardium to relieve constriction.
54
Primary diagnostic test for evaluation of HF
Echocardiography
| MKSAP 20
## Footnote
Echocardiography is essential for assessing heart function and structure in heart failure.
55
Most common tachycardia, typically related to physiologic demand
Sinus tachycardia
| MKSAP 20
## Footnote
Sinus tachycardia is a normal response to increased physiological demands.
56
Upper extremity hypertension, radial-femoral pulse delay, infraclavicular systolic murmur
Aortic coarctation
| MKSAP 20
## Footnote
These signs indicate a narrowing of the aorta, leading to differential blood pressures.
57
SVT with short PR interval and slurred QRS upstroke
Wolff-Parkinson-White syndrome
| MKSAP 20
## Footnote
This condition is characterized by an accessory pathway leading to pre-excitation of the ventricles.
58
Most effective drug therapy for hypertriglyceridemia
Fenofibrate
| MKSAP 20
## Footnote
Fenofibrate is particularly effective in lowering triglyceride levels.
59
Timing of ACE inhibitor initiation after STEMI
Within 24 hours
| MKSAP 20
## Footnote
Early initiation of ACE inhibitors can improve outcomes post-STEMI.
60
Treatment of transient constrictive pericarditis
NSAIDs plus colchicine
| MKSAP 20
## Footnote
This combination helps reduce inflammation and pain in constrictive pericarditis.
61
Condition characterized by ventricular interdependence
Constrictive pericarditis
| MKSAP 20
## Footnote
This condition leads to impaired filling of the ventricles due to a thickened pericardium.
62
Treatment of symptomatic chronic severe mitral regurgitation in nonsurgical candidates
Transcatheter mitral valve repair
| MKSAP 20
## Footnote
This minimally invasive procedure is an option for high-risk patients.
63
Imaging method of choice to diagnose TAA
CT angiography
| MKSAP 20
## Footnote
CT angiography provides detailed images of the aorta and is preferred for diagnosing thoracic aortic aneurysms.
64
HF indications for ICD placement
LVEF ≤35%, NYHA functional class II-III symptoms
| MKSAP 20
## Footnote
These criteria help identify patients at high risk for sudden cardiac death.
65
Drug therapy for inherited long QT syndrome
β-Blocker
| MKSAP 20
## Footnote
β-Blockers are used to reduce the risk of arrhythmias in patients with long QT syndrome.
66
Definitive treatment of atrial flutter
Catheter ablation
| MKSAP 20
## Footnote
Catheter ablation targets the areas of the heart responsible for abnormal electrical impulses.
67
Duration of DAPT after ACS
At least 12 months
| MKSAP 20
## Footnote
Dual antiplatelet therapy is critical for preventing further cardiovascular events after acute coronary syndrome.
68
Hypotension, back pain, and drop in hemoglobin level after femoral artery access for cardiac catheterization
Retroperitoneal hemorrhage
| MKSAP 20
## Footnote
This complication requires immediate evaluation and management.
69
Nonischemic cardiomyopathy ICD indications
LVEF ≤35% and NYHA functional class II-III symptoms
| MKSAP 20
## Footnote
Similar to ischemic cardiomyopathy, these criteria apply to nonischemic cases for ICD placement.
70
Contraindications to early β-blocker therapy after STEMI
Cardiogenic shock, hypotension, bradycardia, conduction disturbance
| MKSAP 20
## Footnote
These conditions may worsen with β-blocker use.
71
Contraindications for percutaneous balloon mitral commissurotomy to treat mitral stenosis
Left atrial thrombus, moderate mitral regurgitation, severely calcified valve
| MKSAP 20
## Footnote
These factors increase the risk of complications during the procedure.
72
Imaging test for endocarditis and suspicion of myocardial abscess
TEE
| MKSAP 20
## Footnote
Transesophageal echocardiography provides better visualization of cardiac structures in these cases.
73
Hypotension, pulsus paradoxus, electrical alternans
Cardiac tamponade
| MKSAP 20
## Footnote
These findings suggest fluid accumulation in the pericardial space affecting heart function.
74
Aortic atheroma treatment
Antiplatelet agent and statin
| MKSAP 20
## Footnote
These medications help manage atherosclerosis and reduce cardiovascular risk.
75
Indications for CRT
EF ≤35% and NYHA functional class >II, LBBB, or QRS complex >150 ms
| MKSAP 20
## Footnote
Cardiac resynchronization therapy is indicated for selected heart failure patients.
76
Preferred hypertension drugs for pregnant patients
Labetalol and methyldopa
| MKSAP 20
## Footnote
These medications are considered safe for managing hypertension during pregnancy.
77
First-line drugs for symptomatic HCM
Nonvasodilating β-blockers (not carvedilol, labetalol)
| MKSAP 20
## Footnote
These drugs help manage symptoms in patients with hypertrophic cardiomyopathy.
78
Treatment of recurrent or chronic pericarditis or pericarditis associated with other autoimmune disease
Glucocorticoids
| MKSAP 20
## Footnote
Glucocorticoids are effective anti-inflammatory agents used in these conditions.
79
Diagnostic testing option for infrequent symptomatic palpitations or syncope
Event recorder
| MKSAP 20
## Footnote
This device records heart activity over an extended period to capture infrequent events.
80
Target INR for mechanical mitral prosthetic valve
3.0 (range, 2.5-3.5)
| MKSAP 20
## Footnote
This INR target helps prevent thromboembolic events in patients with mechanical valves.
81
Large groin hematoma or new bruit after femoral artery access for cardiac catheterization
Pseudoaneurysm
| MKSAP 20
## Footnote
This complication can occur due to incomplete hemostasis after catheterization.
82
Coronary plaque rupture, platelet adhesion, aggregation, acute thrombosis
STEMI
| MKSAP 20
## Footnote
ST-Elevation Myocardial Infarction is a serious condition that requires immediate medical attention.
83
Fever, myalgia, and respiratory symptoms followed by HF
Viral myocarditis
| MKSAP 20
## Footnote
This condition involves inflammation of the heart muscle often triggered by viral infections.
84
Cardiac toxicity of trastuzumab
Reversible LV dysfunction
| MKSAP 20
## Footnote
Monitoring is essential for patients receiving trastuzumab due to potential heart damage.
85
ABI value diagnostic of PAD
≤0.90
| MKSAP 20
## Footnote
An Ankle-Brachial Index (ABI) of 0.90 or less indicates peripheral artery disease.
86
ST-segment coving in leads V1-V3, VF, cardiac arrest
Brugada syndrome
| MKSAP 20
## Footnote
This genetic condition can lead to sudden cardiac events and requires careful monitoring.
87
Diastolic opening snap and diastolic murmur at cardiac apex
Mitral stenosis
| MKSAP 20
## Footnote
These auscultatory findings are characteristic of narrowing of the mitral valve.
88
First nonstatin added to maximal statin therapy for secondary ASCVD prevention in patients not considered at very high risk
Ezetimibe
| MKSAP 20
## Footnote
Ezetimibe is used to further lower cholesterol levels in high-risk patients.
89
Treatment of recurrent symptomatic AF
Catheter ablation with pulmonary vein isolation
| MKSAP 20
## Footnote
This procedure aims to restore normal heart rhythm in atrial fibrillation patients.
90
Treatment of cardiac tamponade
Pericardiocentesis or surgical drainage
| MKSAP 20
## Footnote
These procedures relieve pressure on the heart caused by fluid accumulation.
91
Drug classes commonly associated with QT prolongation
Macrolides, fluoroquinolones, antipsychotics, antidepressants
| MKSAP 20
## Footnote
These medications can increase the risk of life-threatening arrhythmias.
92
Management of constrictive pericarditis
Surgical pericardiectomy
| MKSAP 20
## Footnote
This surgery removes the thickened pericardium that restricts heart function.
93
Classic radiographic findings of aortic coarctation
Rib notching and the “figure 3” sign (dilatation of aorta above and below area of coarctation)
| MKSAP 20
## Footnote
These findings are indicative of aortic narrowing, often diagnosed via imaging.
94
Treatment for AF with rapid heart rate and hemodynamic instability
Cardioversion
| MKSAP 20
## Footnote
This procedure restores normal rhythm and stabilizes the patient's hemodynamics.
95
Test to differentiate obstructive from nonobstructive HCM
Doppler echocardiography
| MKSAP 20
## Footnote
This imaging technique evaluates blood flow and helps diagnose hypertrophic cardiomyopathy.
96
Chest pain and pulseless electrical activity 3 days after STEMI
Ventricular free wall rupture
| MKSAP 20
## Footnote
This is a life-threatening complication following a myocardial infarction.
97
Elevated resting heart rate, exaggerated increase with activity
Inappropriate sinus tachycardia
| MKSAP 20
## Footnote
This condition is characterized by an abnormal increase in heart rate without physiological cause.
98
Most common structural disorder following TOF repair
Pulmonary regurgitation
| MKSAP 20
## Footnote
This condition often occurs after surgical correction of Tetralogy of Fallot.
99
Syndrome of angina and normal coronary arteries
Cardiac syndrome X (microvascular angina)
| MKSAP 20
## Footnote
Patients experience angina-like symptoms despite having normal coronary arteries.
100
Target systolic BP for acute aortic dissection
≤120 mm Hg within 1 hour
| MKSAP 20
## Footnote
This target helps reduce stress on the aorta and prevent further complications.
101
Criteria for adding to maximal statin therapy in secondary ASCVD prevention in patients at very high risk
LDL cholesterol level ≥55 mg/dL or <50% reduction in LDL
| MKSAP 20
102
Monitoring for amiodarone toxicity
Thyroid and liver chemistry tests every 6 months; PFTs and ophthalmologic exam yearly
| MKSAP 20
103
Diagnostic criteria for acute pericarditis
Two of the following: chest pain, pericardial rub, typical ECG changes, effusion
| MKSAP 20
104
Strategy to avoid nitrate tolerance
12-Hour nitrate-free interval
| MKSAP 20
105
Characteristic features of Eisenmenger PDA
Clubbing, oxygen desaturation affecting the feet but not the hands
| MKSAP 20
106
Drug treatment for tricuspid regurgitation with right HF
Loop diuretics and aldosterone antagonists
| MKSAP 20
107
Sawtooth pattern seen in leads II, III, and aVF on ECG
Atrial flutter
| MKSAP 20
108
Common secondary causes of LDL cholesterol elevation
Hypothyroidism, DM, nephrotic syndrome, glucocorticoid use
| MKSAP 20
109
Treatment of life-limiting claudication unresponsive to medical therapy
Endovascular (preferred) or surgical revascularization
| MKSAP 20
110
Indications for emergent surgery in acute aortic dissection
Shock, type A aortic dissection, type A intramural hematoma
| MKSAP 20
111
TTE surveillance frequency in asymptomatic HCM
Every 1-2 years
| MKSAP 20
112
Improves survival in multivessel CAD and LV dysfunction
CABG
| MKSAP 20
113
Echocardiographic follow-up interval in stable patients after bioprosthetic valve replacement
TTE at 5 years, then annually starting at 10 years after valve replacement
| MKSAP 20
114
Class of calcium channel blockers to avoid in HF
Nondihydropyridine
| MKSAP 20
115
Alternative treatment for patients with HFrEF intolerant of ACE inhibitors or ARBs
Isosorbide dinitrate-hydralazine
| MKSAP 20
116
Typical murmur of HCM
Systolic murmur that increases with Valsalva and standing
| MKSAP 20
117
Procedure to detect asymptomatic cardiac transplant rejection
Endomyocardial biopsy
| MKSAP 20
118
Most common ECG findings in HCM
Increased QRS voltage, left atrial enlargement, LV conduction abnormalities, pathologic Q waves, repolarization abnormalities
| MKSAP 20
119
First nonstatin options added to maximal statin therapy for secondary ASCVD prevention in patients at very high risk
Ezetimibe and/or PCSK9 monoclonal antibodies
| MKSAP 20
120
Duration of DAPT following CABG for stable CAD
12 months
| MKSAP 20
121
Criteria for assessing aminotransferase levels and muscle enzymes in asymptomatic patients taking statins
None
| MKSAP 20
122
Test for low-flow, low-gradient aortic stenosis
Dobutamine echocardiography
| MKSAP 20
123
Initial diagnostic test for syncope when arrhythmia is suspected
Resting ECG
| MKSAP 20
124
Management of TAA with diameter <5.0 cm
β-Blockers with target BP <130/80 mm Hg
| MKSAP 20
125
ECG findings of acute pericarditis
Multiple-lead ST-segment elevation and PR-segment depression in lead II
| MKSAP 20
126
RV failure, normal BNP, pericardial thickening
Constrictive pericarditis
| MKSAP 20
## Footnote
Constrictive pericarditis is characterized by the thickening of the pericardium leading to restricted diastolic filling of the heart.
127
Treatment of PVC-induced cardiomyopathy
Catheter ablation
| MKSAP 20
## Footnote
Catheter ablation can help eliminate the source of premature ventricular contractions (PVCs) and improve cardiac function.
128
Diagnostic test for CAD when LBBB is present
Vasodilator stress myocardial perfusion imaging
| MKSAP 20
## Footnote
This test helps assess coronary artery disease (CAD) in patients with left bundle branch block (LBBB) when traditional stress tests are inconclusive.
129
Baseline nonlipid laboratory testing
ALT level measurement
| MKSAP 20
## Footnote
Measuring ALT (alanine aminotransferase) is important for assessing liver function, especially when starting statin therapy.
130
Treatment of chronic severe mitral regurgitation with LV dysfunction or dilation
Mitral valve repair
| MKSAP 20
## Footnote
Mitral valve repair is preferred over replacement in many cases, as it preserves the patient's own valve structure.
131
Continuous murmur heard beneath left clavicle
PDA
| MKSAP 20
## Footnote
A patent ductus arteriosus (PDA) can create a continuous murmur due to the abnormal blood flow between the aorta and pulmonary artery.
132
Causes of coronary vasospasm
Spontaneous; drugs such as methamphetamine, cocaine, 5-FU, bromocriptine
| MKSAP 20
## Footnote
Coronary vasospasm can result from various triggers, including certain medications and illicit drugs.
133
Long-term anticoagulant for valvular AF
Warfarin
| MKSAP 20
## Footnote
Warfarin is commonly used for anticoagulation in patients with atrial fibrillation (AF) associated with valvular heart disease.
134
Primary CV side effect of bevacizumab
Hypertension
| MKSAP 20
## Footnote
Bevacizumab, an anti-VEGF therapy, can lead to increased blood pressure as a significant cardiovascular side effect.
135
Criteria for adding to maximal statin therapy in secondary ASCVD prevention in patients not considered at very high risk
LDL cholesterol level ≥70 mg/dL or <50% reduction in LDL
| MKSAP 20
## Footnote
These criteria help determine if additional therapy is needed to further reduce cardiovascular risk.
136
Drug class to avoid during nitrate therapy
Phosphodiesterase-5 inhibitors
| MKSAP 20
## Footnote
Combining nitrates with phosphodiesterase-5 inhibitors can lead to severe hypotension.
137
Indications for aldosterone antagonist after STEMI
LVEF ≤40% and either HF symptoms or diabetes
| MKSAP 20
## Footnote
Aldosterone antagonists are beneficial in reducing mortality post-STEMI in this high-risk group.
138
Treatment to prevent SCD in high-risk patients with HCM
ICD
| MKSAP 20
## Footnote
An implantable cardioverter-defibrillator (ICD) is indicated for patients with hypertrophic cardiomyopathy (HCM) at high risk for sudden cardiac death.
139
Bridging therapy for hemodynamic instability in cardiac tamponade
Normal saline infusion
| MKSAP 20
## Footnote
Fluid resuscitation with normal saline can temporarily stabilize hemodynamics until definitive treatment is performed.
140
Common CVD after coarctation repair
Hypertension
| MKSAP 20
## Footnote
Patients often develop hypertension post-repair due to changes in aortic arch blood flow dynamics.
141
Two most common genetic conditions that require screening for aortic disease
Marfan and Ehlers-Danlos syndromes
| MKSAP 20
## Footnote
Both conditions are associated with connective tissue abnormalities that increase the risk of aortic dissection and aneurysm.
142
Cardiac toxicity of anthracyclines
Irreversible dilated cardiomyopathy
| MKSAP 20
## Footnote
Anthracyclines can cause dose-dependent cardiotoxicity, leading to heart failure.
143
Life-prolonging therapy for severe aortic stenosis
Aortic valve replacement
| MKSAP 20
## Footnote
Surgical intervention is essential for symptomatic patients with severe aortic stenosis.
144
Most common cause of HFpEF
Hypertension
| MKSAP 20
## Footnote
Hypertension is the leading risk factor for heart failure with preserved ejection fraction (HFpEF).
145
Diagnostic test for PAD if ABI >1.4
Toe-brachial index
| MKSAP 20
## Footnote
The toe-brachial index is useful for diagnosing peripheral artery disease (PAD) when ankle-brachial index (ABI) results are inconclusive.
146
Surgical indications for chronic aortic regurgitation
Symptoms, LVEF <55%, LV dilatation
| MKSAP 20
## Footnote
Surgery is indicated when patients exhibit symptoms or significant left ventricular changes.
147
Drugs indicated for all NYHA functional classes of HFrEF
β-Blockers, specifically bisoprolol, carvedilol, or metoprolol succinate, and ACE inhibitors
| MKSAP 20
## Footnote
These medications are foundational for managing heart failure with reduced ejection fraction (HFrEF).
148
Recommended aortic valve type for patients younger than 50 years
Mechanical
| MKSAP 20
## Footnote
Mechanical valves are preferred in younger patients due to their durability compared to bioprosthetic valves.
149
Fixed split S2, right axis deviation, incomplete RBBB
Ostium secundum ASD
| MKSAP 20
## Footnote
These findings on an EKG suggest the presence of an atrial septal defect (ASD).
150
The “6 P's” of acute limb ischemia
Paresthesia, pain, pallor, pulselessness, poikilothermia (coolness), paralysis
| MKSAP 20
## Footnote
These clinical signs help in the rapid assessment of acute limb ischemia.
151
Indications for ABI measurement
Exertional leg symptoms, nonhealing leg ulcers, atypical leg symptoms
| MKSAP 20
## Footnote
ABI measurement is utilized to assess peripheral arterial disease.
152
First-line treatment of acute aortic dissection without shock
IV β-blocker
| MKSAP 20
## Footnote
Initiating β-blockade helps control blood pressure and reduce stress on the aortic wall.
153
Treatment of cardiac device infection
Extraction, pocket debridement, antibiotics
| MKSAP 20
## Footnote
Management often requires surgical intervention and systemic antibiotics.
154
Complication if ACE inhibitor is discontinued <36 hours before valsartan-sacubitril is started
Angioedema
| MKSAP 20
## Footnote
This risk underscores the need for careful transition between these medications.
155
Primary imaging modality to evaluate aortic stenosis
TTE
| MKSAP 20
## Footnote
Transthoracic echocardiography is the first-line imaging technique for assessing aortic stenosis.
156
TEE criteria for severe aortic stenosis
Valve area ≤1.0 cm2, peak velocity >4 m/s, mean gradient >40 mm Hg
| MKSAP 20
## Footnote
These criteria help in the diagnosis and management of severe aortic stenosis.
157
Wide-complex tachycardia in patients with structural heart disease
Ventricular tachycardia
| MKSAP 20
## Footnote
This arrhythmia is a common complication in patients with underlying heart disease.
158
Treatment of acute pericarditis
NSAIDs plus colchicine
| MKSAP 20
## Footnote
This combination is effective in reducing inflammation and preventing recurrences.
159
AHA/ACC guideline treatment for cholesterol for secondary prevention of ASCVD in patients aged ≤75 years
High-intensity statin therapy
| MKSAP 20
## Footnote
Statins are critical for reducing cardiovascular events in high-risk individuals.
160
Role of thrombolytic therapy in non–ST-elevation ACS
None
| MKSAP 20
## Footnote
Thrombolytics are not indicated for non-ST elevation acute coronary syndromes.
161
Valve abnormality associated with aortic coarctation
Bicuspid aortic valve
| MKSAP 20
## Footnote
This congenital defect is frequently seen in patients with coarctation of the aorta.
162
Minimum duration of DAPT after bare metal stent placement for stable CAD
1 month
| MKSAP 20
## Footnote
Dual antiplatelet therapy is crucial to prevent stent thrombosis.
163
Indication for aldosterone antagonist for HFrEF
NYHA functional class II-IV HFrEF or after acute MI
| MKSAP 20
## Footnote
Aldosterone antagonists improve outcomes in heart failure with reduced ejection fraction.
164
Peripartum ACS
Spontaneous coronary artery dissection
| MKSAP 20
## Footnote
This condition can occur during pregnancy or shortly after delivery.
165
Intravenous vasoactive drug treatment of HF-related cardiogenic shock
Dobutamine or milrinone
| MKSAP 20
## Footnote
These agents help improve cardiac output in patients with cardiogenic shock.
166
Underlying risk factor predisposing to multifocal atrial tachycardia
Severe pulmonary disease
| MKSAP 20
## Footnote
Conditions like COPD can trigger this arrhythmia.
167
Treatment of asymptomatic PFO
No treatment required
| MKSAP 20
## Footnote
Asymptomatic patent foramen ovale typically does not necessitate intervention.
168
Severe pulmonary hypertension with cardiac shunt reversal (right-to-left shunting)
Eisenmenger syndrome
| MKSAP 20
## Footnote
This condition results from long-standing pulmonary hypertension leading to shunt reversal.
169
Drugs requiring ranolazine dosage reduction with concurrent administration
Verapamil, diltiazem
| MKSAP 20
## Footnote
These medications can increase ranolazine levels, necessitating dosage adjustments.
170
Management of type B aortic dissection
IV β-blocker
| MKSAP 20
## Footnote
Controlling blood pressure is essential in type B dissection management.
171
Specific β-blockers associated with reduced mortality in patients with HFrEF
Bisoprolol, metoprolol succinate, carvedilol
| MKSAP 20
## Footnote
These agents are shown to improve survival in heart failure patients.
172
Loop diuretic with increased bioavailability and longer half-life
Torsemide or bumetanide
| MKSAP 20
## Footnote
These diuretics are preferred in certain clinical scenarios for better fluid management.
173
Novel protein stabilizer therapy for patients with transthyretin amyloid cardiac amyloidosis
Tafamidis
| MKSAP 20
## Footnote
Tafamidis is approved for treating this specific type of amyloidosis.
174
Calcium channel blockers contraindicated in patients with HFrEF
Nondihydropyridine Ca++ channel blockers, such as verapamil and diltiazem
| MKSAP 20
## Footnote
These agents can exacerbate heart failure symptoms.
175
Indications for TAA repair
Symptoms, size ≥5.5 cm, expansion >0.5 cm/year
| MKSAP 20
## Footnote
Surgical intervention is indicated based on these criteria to prevent complications.
176
Drug therapy for all patients with PAD
Antiplatelets and statins
| MKSAP 20
## Footnote
PAD stands for Peripheral Artery Disease, which affects blood flow to the limbs.
177
Indications for ACE inhibitor therapy in stable angina
CKD, diabetes, previous MI, or LVEF ≤40%
| MKSAP 20
## Footnote
CKD stands for Chronic Kidney Disease; MI stands for Myocardial Infarction; LVEF stands for Left Ventricular Ejection Fraction.
178
Indications for immediate invasive treatment in non–ST-elevation ACS
Hemodynamic instability, refractory chest pain, HF, arrhythmias
| MKSAP 20
## Footnote
ACS stands for Acute Coronary Syndrome; HF stands for Heart Failure.
179
INR goal for mechanical aortic valve and no additional risk factors
2.5
| MKSAP 20
## Footnote
INR stands for International Normalized Ratio, which is used to monitor anticoagulation therapy.
180
Drug options available for high-intensity statin
Atorvastatin, 40-80 mg/d; rosuvastatin, 20-40 mg/d
| MKSAP 20
## Footnote
Statins are medications used to lower cholesterol levels.
181
Cardiomyopathy associated with apical dyskinesis or ballooning
Takotsubo (stress) cardiomyopathy
| MKSAP 20
## Footnote
Takotsubo cardiomyopathy is often triggered by emotional or physical stress.
182
Orthostatic intolerance and excessive tachycardia, worse with standing
Postural orthostatic tachycardia syndrome
| MKSAP 20
## Footnote
This syndrome is characterized by an abnormal increase in heart rate upon standing.
183
Lab test to distinguish cardiac from pulmonary causes of dyspnea
BNP or NT-proBNP
| MKSAP 20
## Footnote
BNP stands for B-type Natriuretic Peptide; NT-proBNP is its inactive form.
