HF

Question 1

Class I recommendations for diagnosis of HF

Answer 1

BNP/NT-proBNP
12L ECG
Transthoracic echocardiography
Chest Xray
Tests for comorbids ( CBC, BUN Crea, electrolytes, thyroid, FBS, HbA1c, lipids, iron studies TSAT and ferritin)
CMR if poor echo window

Question 2

Class IA recommendation for ICD for patients who recovered from ventricular arrhythmia causing hemodynamic instability in the absence of _______ or unless ______.

Answer 2

In the absence of reversible causes
Unless ventricular arrhythmia occurred <48hr after MI

Question 3

Class IA recommendation for ICD with symptomatic HF (NYHA ______) of _______ etiology and LVEF _____ despite _________. (except MI in prior 40 days)

Answer 3

NYHA II-III
ischemic etiology
LVEF <=35% despite 3 mos OMT

Question 4

Class IA recommendation for CRT in symptomatic patients with HF in SR with QRS ______ and ______ with LVEF ______ despite _____.

Answer 4

QRS >=150ms and LBBB
LVEF <=35% despite OMT

Question 5

Class IA recommendation for ______ rather than _________ in HF regardless of NYHA or QRS if with indication for pacing is high degree AV block

Answer 5

CRT (biventricular pacing) rather than RV pacing

Question 6

CMR finding of subendocardial scarring points to what etiology of HF?

Answer 6

ischemic heart disease

Question 7

CMR finding of mid-wall scarring points to what etiology of HF?

Answer 7

dilated cardiomyopathy

Question 8

In acute heart failure, noninvasive positive pressure ventilation should be started at what RR and O2 sat?

Answer 8

RR>25 and O2 sat <90%

Question 9

4 Categories of Aortic Stenosis
(by mean gradient: ____, peak gradient: ___, valve area: ____, and stroke volume index: ____)

Answer 9

1. High gradient AS (>40mmHg, >4m/s, <1cm2, regardless of SVi)
2. Low gradient, low flow, low EF AS (<40mmHg, <1cm2, EF<50, SVi <35)
3. Low gradient, low flow, normal EF AS (<40mmHg, <1cm2, EF>50, SVi <35)
4. Low gradient, normal flow, normal EF (<40mmHg, <1cm2, EF>50, SVi >35)