Heart Failure
EF at which ICD placement is indicated if patient is on GDMT and has NYHA Class II or III symptoms
<35%
Target INR for mechanical mitral prosthetic valve
3.0 (2.5 to 3.5)
Paroxysmal AF stops spontaneously within this time frame
7 days
Most common cause of cardiogenic shock
MI
The USPSTF recommends for AAA in men with a smoking history and in this age range.
65-75
In the RALES trial this medicine showed a significant reduction in the primary outcome of all-cause mortality in patients with CHF NYHA III-IV and EF<35%
Spironolactone
Life-prolonging therapy for severe aortic stenosis
Aortic valve replacement
Duration of anticoagulation required following cardioversion (at least this amount of time)
At least 4 weeks
Traditional treatment for cardiogenic shock has been reperfusion to increase oxygen supply to hear muscle. Newer treatment paradigms focus on this goal.
Unloading or decreasing oxygen demand
Initial diagnostic test for syncope when arrythmia is suspected
Resting ECG
This landmark trial established the superiority of sacubitril/valsartan over enalapril, showing a 20% RRR and 4.7% ARR in CV mortality and hospitalization due to heart failure
PARADIGM-HF
Valve abnormality associated with aortic coarctation
Bicuspid aortic valve
These 2 conditions receive 2 points when calculating CHA2DS2VASc. All other conditions receive 1 point.
Prior stroke or TIA and age >75
Cardiogenic shock is a primary cardiac disorder showing signs of tissue hypoperfusion and SBP below this level for this amount of time.
SBP >90 for 30 minutes (will accept 1 of 2)
Baseline EKG changes that warrant the inclusion of imaging (MPS) during a stress test (provide 2)
ST depression, LVH, LBBB, digitalis effect, preexcitation, paced beats
The three beta-blockers showing mortality benefit in HFrEF
Bisoprolol, carvedilol, and metoprolol succinate
Treatment for symptomatic chronic severe mitral regurgitation in nonsurgical candidates
Transcatheter mitral valve
A vitamin K antagonist is used in lieu of a DOAC in these two conditions
Mechanical valve and mod to severe mitral stenosis
Criteria for stage E cardiogenic shock includes elevated lactate, need for pressors, CPR, or this lab value (hint - comes from ABG)
pH <7.2
Features of hypertrophic cardiomyopathy murmur (describe murmur and functional testing)
Systolic murmur that increases with Valsalva and standing
In patients with chronic symptomatic HF and EF<35% who are in sinus rhythm taking maximally tolerated doses of a beta blocker, this sinoatrial node stimulator (drug) reduces heart failure-associated hospitalizations and the combined endpoint of mortality and heart failure hospitalization
Ivabradine
Echo follow-up interval following placement of valve bio prothesis
TTE at 5 years, then annually starting at 10 s/p valve replacement
This landmark trial showed improved outcomes (CV death, stroke, hospitalization) with early rhythm control (drugs or ablation) compared to usual care in high risk patients
EAST-AFNET 4 trial
Two first line inotropes for cardiogenic shock
Dobutamine and Milrinone
Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022;145(18):e895–1032
Concentric ventricular wall thickness, low QRS voltage, peripheral neuropathy
Cardiac amyloidosis