MKSAP I Flashcards
Pt presents with 3rd degree heart block within 1 year of cardiac transplantation. What are you concerned about and how do you diagnose it?
- acute rejection
- endomyocardial biopsy
When can you use Coronary CT angiography in chest pain?
- suspected NSTE-ACS with normal initial trop and inconclusive EKG findings (but if there is a high pretest probability of CAD, you should go straight to urgent angiography)
What is preferred- MV repair or MV replacement?
MV repair
Who should get MV repair?
- symptomatic pts with EF >30%
- asymp pts with EF 30-60% and/or LV end-systolic diameter > or equal to 40
- pts undergoing another cardiac surgical procedure
Also can be considered in aysmp pts with new a fib or pHTN (PASP >50mmHg)
Most common cardiovascular SFX of:
- bevacizumab
- cisplatin
- paclitaxel
- HTN
- VTE, SVT, MI, cardiomyopathy
- bradycardia, heart block (and with doxorubicin, can cause cardiomyopathy)
Ddx of upper extremity HTN, radial artery-to-femoral artery pulse delay, “figure 3 sign” and rib notching
Aortic coarctation
In a fib with stable CAD, what AC do you need?
Just oral AC (no antiplatelet indicated)
UNLESS ACS or revasc in past 12 months
How to differentiate between pseudostenosis and true aortic stenosis in low-flow, low-gradient stenosis where primary abnormality may be severe LV dyfunction with pseudostenosis or critical aortic stenosis?
Dobutamine echocardiography
Continuous murmur beneath left clavicle that envelops S2 but no other cardiovascular features
small patent ductus arteriosus
What is cardiac syndrome X?
Angina and stress testing abnormalities in the absences angiographically significant CAD (typical in women and w/o traditional risk factors for CAD)
How often do you monitor patients with severe MV regurg with preserved EF?
6-12 month with ECHO
What is the cornerstone of treatment with patients with HFpEF to maintain euvolemia?
Diuresis (lasix)
